When it comes to trouble with veins and arteries, Newfoundland and Labrador has distinguished itself.
Twelve per cent of our adult population has ‘peripheral vascular/arterial disease’ known as PAD – diseases of the blood vessels outside heart and brain. 40-60 per cent of people with PAD have evidence of cardiovascular or cerebrovascular disease.
In other words – candidates for heart attack, stroke, blood clots or aneurysms.
And the worrisome statistics don’t stop there.
- We have the highest incidence and prevalence of cardio-vascular disease in Canada;
- We have the highest death rate for cardio-vascular disease in Canada;
- We have the highest incidence of hypertension in Canada; and
- We have the highest rate of obesity.
Fortunately, when it comes to the diagnosis, treatment or prevention of diseased veins and arteries, the vascular lab at Eastern Health has also distinguished itself.
The lab is part of Eastern Health’s Vascular Surgery Service, and has just received accreditation in vascular testing from the Intersocietal Accreditation Commission (IAC). The IAC is the accrediting body for North America and widely respected within the medical community. The accreditation process subjected Eastern Health’s vascular lab to a thorough review of its operational and technical components by a panel of experts.
In its Accreditation letter, IAC stated that,
“IAC accreditation is a ‘seal of approval’ that patients can rely on as an indication that the facility has been carefully critiqued on all aspects of its operations considered relevant by medical experts in the field of vascular testing.”
The IAC only grants accreditation to facilities that are found to be providing quality patient care, in compliance with national standards, through a comprehensive application process, including detailed case study review.
“There’s no doubt that our vascular lab is equal, if not superior to, any other vascular service in the country,” says Ron Corcoran, the lab’s divisional manager.
“Our equipment is state of the art, our staff is highly trained and we are well positioned as the provincial referral centre to provide high quality care to the people of Newfoundland and Labrador.”
This IAC accreditation is not new to the vascular lab, located at St. Clare’s Mercy Hospital in St. John’s.
It is actually the sixth successful accreditation since 1998. The first accreditation preceded the formation of Eastern Health, when the lab was located at the Grace Hospital, part of the former Health Care Corporation.
Sixteen years ago, it was the first vascular lab in Atlantic Canada to be given the designation ‘Accredited’ – a significant distinction at the time.
It was largely due to the efforts of Dr. Kevin Melvin, a vascular surgeon who pushed for new equipment to test for diseased veins and arteries – and also for certification of both the technologists and the surgeons in the vascular health service.
That certification is known as RVT which stands for ‘Registered Vascular Technologists’ – and it was a significant step forward.
“That first Accreditation was an historic moment in the development of vascular testing and surgery here in the province,” says Dr. Melvin. “Prior to that, vascular surgery was combined with general surgery, but special certification of our surgeons and technologists allowed us to qualify for accreditation.
“This, in turn, led to a more specialized service, a higher profile of vascular disease – and ultimately, improved care for our patients.”
An average of 3,500 people with vascular disease are referred to the lab at St. Clare’s every year for a myriad of tests, including ultrasounds, CT Scans, TFAs (dye tests for legs), cardiovascular disease (CVD) risk assessments, blood tests and physical examinations.
Those with advanced disease are assessed for surgery – while those whose risk is not as high, receive education in nutrition and wound care intervention, along with prescriptions for exercise and preventive medications.
“Our primary goal is prevention,” says Dr. Melvin. “Our improved testing over the past couple of decades has reduced the need for ‘invasive’ surgery and dye tests to determine the extent of disease. More of our focus has shifted to risk reduction with education – and with increased access to specialized vascular care.”
And to make sure more Newfoundlanders and Labradorians have access to that specialized care – the Division of Vascular Surgery has taken their ‘show on the road’ – literally!
Since 2011, a team from the vascular lab has conducted dozens of mobile clinics around the island – from Conne River to St. Anthony – from Burin to Clarenville to Gander – to see patients who would otherwise have to make the trip to St. John’s to be assessed by certified specialists.
A nurse practitioner, a vascular technologist, a vascular surgeon and often a pharmacist will pack up their equipment and head out to see patients who’ve been referred to the mobile clinic by their local family physicians.
“We follow these patients closely,” says Cynthia Kettle, a nurse practitioner who’s been with the mobile clinics since the beginning. “We not only test and assess them on the spot – we help to arrange surgery if necessary – or offer counseling on how to manage their conditions. We also follow up with them once we return to St. John’s.
“There’s a lot of comfort in quality care that is not only consistent and reliable – but which we bring to them – instead of the other way around.”
Dr. Melvin agrees. He emphasizes that the clinics were set up solely to address a need made clear by statistics and distance.
“We have a huge geography in this province, which poses a major problem when it comes to access to specialized care,” he adds. We need to detect vascular disease earlier and these travelling clinics allow us to do that, because too often people don’t come to us until it’s too late.
“Reaching out to communities in this way allows men and women to take their health care into their own hands and partner with us to help ensure better outcomes. Saving lives and limbs – that’s what this is all about.” ■