Joyce Shayer
​Joyce Shayer in a lab in Lake of the Woods District Hospital in Kenora, Ont. uses Televu Smart Glasses to collaborate seamlessly with a pathology assistant at Toronto General Hospital, enhancing specimen grossing with hands-free technology. (Photo: Lake of the Woods District Hospital)

​Pathologists play a central role in diagnostics and patient treatment. What happens if a hospital doesn't have a pathologist?

In the summer of 2022, the Kenora Rainy River Regional Laboratory Program (KRRRLP) faced that problem as their only pathologist was set to retire at the end of year.

They knew that having a significant gap in their ability to provide essential pathology services for 5,000 to 7,000 surgical cases annually was not an option.

That's when the lab manager at Lake of the Woods District Hospital in Kenora, Ont. connected with Christine Bruce, Senior Director, Laboratory Medicine Program (LMP), UHN. The manager had heard that LMP supported Thunder Bay Regional Health Sciences Centre when it was facing a similar situation with retiring pathologists.

Karen Parker, an experienced medical laboratory technologist who is Program Director and Quality Coordinator with the KRRRLP, navigated the challenges of needing pathology and regional lab oversight services by forging a partnership with LMP.

Operating across six remote northwestern Ontario hospitals, the KRRRLP conducts routine laboratory testing and monitoring. The landscape of medical oversight is rapidly changing, and recruitment is tough as the health human resources (HHR) crisis touches every laboratory profession, including pathologists and medical/scientific directors.

"There's a shortage of graduates, and fewer are specializing in general pathology," says Karen. "It's also a big undertaking for a new graduate to work in a remote region."

For Karen, UHN emerged as a beacon of hope amid an uncertain situation.

“Christine has such a 'can-do' attitude," Karen says. "I haven't heard a 'no' yet, and just the culture and the attitude at UHN has been amazing."

Christine says “when the call to action came, I didn't hesitate for a moment.

"The UHN mission is 'A Healthier World,' and we need to start in our own backyard!" she says. "I knew I could go to the LMP team and share that there was an issue in our system that only we could solve, and they wouldn't hesitate to innovate a path forward.

"We could also do this with confidence because we've had a successful collaboration with a cluster of 11 hospitals in the Timmins region for well over a decade that has improved patient outcomes."

In Vermillion Bay, Ont., on their way to a site visit in Red Lake, (L to R), Karen Parker, Program Director & Quality Coordinator, Kenora Rainy River Regional Lab Program (KRRRLP); Dr. Martha Lyon, Regional Lab Director and clinical biochemist, KRRRLP; Mary Fountas, Manager Quality and Safety, UHN Laboratory Medicine Program (LMP); Christine Bruce, Senior Director, LMP. (Photo: Courtesy Christine Bruce)

Staff from LMP and KRRRLP worked closely to implement strategies that would ensure continued service despite ongoing resourcing challenges.

LMP staff journeyed north to train medical laboratory technologists in handling cases of increasing complexity, enhancing their skills in grossing and exposure to intricate scenarios.

Over time, the goal is to handle cases locally and use digital solutions for interpretation. This strategy removes logistical and weather-related challenges in the region.

LMP's crucial support and standardization initiatives were especially evident in transfusion medicine, a department known for its high-risk nature.

"We're talking about blood products going into a patient," says Karen. "There are so many factors that can cause bad situations; we really have to be careful.

"Even though we're behind-the-scenes, we're invested in helping save lives."

Early collaborative initiatives between LMP's transfusion medicine team and local staff aimed to align policies, reduce risks, and ensure consistent best practices.

The KRRRLP has also joined LMP's Digital Pathology implementation, following suit with Timmins and District Hospital.

"Right now, slides are transported across Ontario by courier," says Karen. "So, there's a huge risk if they go missing or are delayed.

"With digital scanning, that whole issue of transportation will be eliminated – which will have a big impact for our region and our patients."

UHN's LMP now supports 25 hospitals in northern Ontario

The installation of KRRRLP's digital scanner is scheduled for late this winter, with the anticipated go-live date set for April 2024. Digital scanning will streamline processes, provide advanced image analysis, accurate diagnoses and personalized treatment plans, elevating the quality of patient care and driving cutting-edge research at UHN and its northern partners.

"It's so meaningful to provide this type of access to LMP services and its extremely talented team," says Christine. "Sending remote patient cases to UHN pathologists digitally could cut a week off turnaround times.

"I love that my team can make that a reality for this new partner community."

The partnership brought about a transformative shift in the region's health care landscape. Despite ongoing challenges, teaming up with LMP has brought hope for better health care access in remote areas.

"The relationship we've developed has provided a lot of stability and it's nice to have a longer-term plan," says Karen. "My hope is that it will continue."

The success story of KRRRLP's integration into UHN's broader strategy highlights the strength of collaboration, innovation and a shared commitment to serving communities with excellence, regardless of geographical constraints.

LMP now supports 25 hospitals in northern Ontario.

"We continue to seek ways to support our northern partners, be it through quality systems, digital pathology, AI integration, point-of-care solutions, expanded testing menus, decompressing HHR challenges or addressing unique health needs in indigenous communities," says Christine.

"Patients in Ontario should be receiving the same level of care no matter where they live – LMP can bring UHN to you."

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