Biopsy waits too long in Saskatchewan: provincial auditor

Waits for biopsy results in Saskatchewan are taking too long according to the provincial auditor who said delays in diagnosis can impact a person’s chance of survival.

In her latest report, Judy Ferguson states that patients in Saskatoon wait an average of 12.1 days for results, in Regina, it increases to 18.7 days.

According to best practices in healthcare, the wait for those results should only be five business days and more complex cases should be six to nine days.

The two labs analyze about 45,000 cases a year. A surgical biopsy removes tissue for analysis to help healthcare providers diagnose health problems that patients face including whether a patient has cancer.

As of September 2018, the Regina and Saskatoon labs had a backlog of about 1,300 biopsies awaiting analysis.

All 150,000 specimens tested per year are tracked on paper and neither lab thoroughly tracked specimens during the analysis process to determine where the delays were.

“That’s a lot of paper. To do the analysis by paper, it’s time intensive,” said Ferguson.

Neither lab tracked biopsy specimens through the entire analysis process. The Saskatoon lab planned to do so through a new lab tracking IT system; it hoped to have this system in place by December 2018. The Regina lab did not have similar plans.

“A formal assessment of the surgical biopsy process and IT tracking system could help the Saskatchewan Health Authority to identify factors affecting delays in patient diagnosis,” Ferguson noted.

Furthermore, each lab had varying processes and practices resulting in different processing times.

“As a patient, I should have the same expectations if my biopsy goes to Regina versus Saskatoon. I shouldn’t have a difference,” Ferguson said.

The auditor explained when patients have to wait longer than needed for a diagnosis, it can cause additional stress and may result in reduced quality of life and/or chance of survival.

The health authority also did not have a written agreement with the Office of the Chief Coroner to set out the support each lab provides for forensic autopsies. Labs prioritize processing biopsies for forensic autopsies over surgical biopsies.

The auditor found not having clearly assigned responsibilities for forensic autopsies can create confusion for lab staff when prioritizing specimens, and managing workloads.

Saskatchewan Health Authority already working on backlog

“This is something we’re already working on,” Vice President of Provincial Programs Corey Miller said of the backlogs.

During a conference call Tuesday afternoon Miller said the backlog was identified last May at a Saskatchewan Medical Association meeting.

“We still have room for improvement and some of that is having vacancies that we’re recruiting into in pathology,” Miller said.

Some other improvements include the creation and standardization of provincial departments.

That includes creating a more visual system so pathologists can see how many samples are coming in on a given day.

An electronic tracking system for biopsy samples is also in the works in Saskatoon, thanks to funding from a partner foundation.

According to Miller, it will act as a test run before considering expanding electronic tracking to Regina.

-with files from 980 CJME’s Andrew Shepherd and 650 CKOM’s Erin McNutt