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Diagnostic testing

Alberta to assess quality of DI and pathology services

CALGARY – Alberta Health Minister Fred Horne (pictured) has called for a province-wide review of diagnostic imaging and pathology test procedures after errors were discovered in three different cities in less than two months.

In November, a review of pathology tests was launched at Rockyview General Hospital after concerns were raised about the laboratory’s staining equipment.

In early December, officials disclosed that more than 1,700 diagnoses made by an Edmonton pathologist at the Royal Alexandra Hospital between July and September had to be re-tested after the pathologist allegedly misread samples taken from dozens of cancer patients.

And most recently, interpretation errors discovered in diagnostic imaging tests in early December prompted health officials Thursday to call for a review of 34 patient cases at Drumheller Hospital.

In response, the Alberta government has ordered a thorough examination of medical quality assurance processes related to diagnostic imaging and pathology testing.

“This examination is a proactive measure that will provide me and all Albertans with the necessary assurance that the system-wide checks and balances are in place and operating as they should be,” Health Minister Horne told reporters during a news conference.

“Once you have that, you are in a position to say you have a system that truly supports the prevention of errors such as these in the future.”

The province-wide probe came the same day as the third review in Drumheller was announced.

In that most recent case, the review was triggered by a patient’s complaint about a single X-ray exam. That led to a more thorough review of the radiologist’s work, in which possible errors in 34 exam interpretations were found involving CT scans. The government has been contacting the patients and their primary care doctors.

At this time, it’s not known how many of the 34 patients will require change in their treatment as the cases are currently being reviewed in detail with the patients’ physicians and independent radiologists.

The results of that review prompted the call for an expanded review to encompass 1,300 CT scans conducted at the hospital over the last six months, said Dr. Chris Eagle, Alberta Health Services president and CEO.

The review of the 1,300 cases – which includes everything from scans for knee pain to headaches – will likely take several weeks, Dr. Eagle said.

The radiologist who read the scans in Drumheller, who has been described as “experienced” and had worked at the hospital for “a substantial period of time,” is currently out of country but will not be practising with Alberta Health Services or privately when he returns. He has been asked to take a leave of absence as the review is being conducted.

Horne has asked Alberta Health and Wellness, Alberta Health Services, the College of Physicians and Surgeons of Alberta, and the Health Quality Council of Alberta to work collaboratively and recommend a plan of action for the quality assurance review.

In Alberta, about 10 per cent of pathology specimens are re-read by a second pathologist, but there are no set policies for diagnostic imaging reviews or quality checks. Recommendations might include random checks and re-reading of exams.

“This is not about blaming the people that deliver the care,” said Horne. “This is about answering some very fundamental questions about checks and balances in our health-care system. It has to do with the organization of the health-care system as opposed to the specific delivery of care that we experience each day.”

Posted January 12, 2012