‘Jam packed’ western Newfoundland waiting rooms not a good alternative to appointment-based clinics: immunocompromised patient

CORNER BROOK, N.L. — As COVID-19 began to invade this province, health authorities implemented measures to help reduce the spread of the virus.

For Western Health, that included moving to an appointment-based system for bloodwork and x-ray services.

On March 21, the health authority switched back to a walk-in service at some of its sites — a change not everyone is happy with.

John Butler has been undergoing medical treatment for kidney disease for the past two years, which requires monthly bloodwork.

When the appointment system first came in, the Pasadena resident thought it was a great idea.

“I said that’s one thing I hope comes out of COVID, is this stays,” he told SaltWire Network.

It only took one phone call and Butler was able to make three or four appointments in a row.

“And then I’d just walk on in and get them done.”

Reverting to pre-COVID procedure

Butler was due for an appointment March 21 at the Deer Lake Clinic, one of four Western Health locations that have returned to walk-in service for both blood and x-rays, except for those that previously required an appointment. The other sites are the Western Memorial Health Clinic in Corner Brook, Sir Thomas Roddick Hospital in Stephenville and the Dr. Charles L. LeGrow Health Centre in Port aux Basques.

Butler knew that all previously-booked appointments were cancelled with the return to walk-in. So, he called the clinic to see if it was busy and was told it was.

He then decided to try Corner Brook and found the clinic waiting room full.

“The place is blocked. Standing room only. People lined up against the wall,” he said.

“When I walked in and saw that, a health-care facility jam-packed, I said to myself, ‘No way.’”

Butler, who is immunocompromised, turned around and left with the thought that he’d try again another day in hopes it might be less busy.

“For a health-care facility, it’s just silly.”

“When I walked in and saw that, a health-care facility jam-packed, I said to myself, ‘No way.’”
— John Butler

He said the change was too quick and doesn’t understand why appointments are still required at motor registration when they aren’t in health care.

Butler is right that appointments can still be booked at motor registration, but Digital Government and Service NL told the SaltWire Network that they are no longer required.

“While appointments are still recommended, walk-in service is available at any of our locations,” said a spokesperson for the department.

Bulter was so disappointed with what he saw at the blood collection clinic that he shared his experience by responding to Western Health’s post about the changes on Twitter and since has spoken to many others who agree the appointment system was good.

He was so disappointed with what he saw that he shared his experience by responding to Western Health’s post about the changes on Twitter and since has spoken to many others who agree the appointment system was good.

“They should be able to do something,” said Butler.

Why the switch?

Jeanette Grabka, Western Health’s regional director of laboratory services, said not everybody liked the appointment-based system and not everybody likes the walk-in system.

“So, ideally, in order to meet everybody’s needs, some sort of mixed model that can offer both would be ideal. And that is what we would like to see.”

She said the appointment system was implemented in the spring of 2020 in response to the requirements to manage patient arrivals in facility waiting rooms with physical and social distancing.

“At that time, the concept of physical distancing was new to everybody,” Grabka said, noting that masking wasn’t a requirement at that time.

In order to implement booked appointments, Western Health established a call centre with four additional clerical positions to manage the bookings for the sites in Corner Brook, Deer Lake, Stephenville and Port aux Basques.

“And we did it for those sites because there’s a really high demand for those sites and we needed some means of meeting the high demand for services at those sites.”

Existing staff were able to book appointments for blood collection and medical imaging services at the Bonne Bay Health Centre in Norris Point, the Rufus Guinchard Health Centre in Port Saunders and the Calder Health Centre in Burgeo. Those sites are still operating with booked appointments.

Grabka said Western Health did look at other options before transitioning to full walk-in service at the four larger sites and is exploring electronic options to support self-booking of appointments, something that is being looked at on a provincial level.

“I would want to be able to provide a service that meets everybody’s needs as quickly as we could; however, electronic solutions are not quick to implement anyway,” she said.

“… in order to meet everybody’s needs, some sort of mixed model that can offer both would be ideal.”
— Jeanette Grabka

March 23 marked the third day of the return to walk-ins and Grabka said the health authority anticipated high volumes in the beginning.

She said Western Health will be monitoring the situation and will make changes if it sees any way that things can be done differently. She also encourages people to check back, as there will be days when it is slower.

“Every day since Monday, it has been less and less,” she adds.

She also noted that even pre-pandemic, anyone who showed up to the waiting room had to take a number and wait to be registered. But at the point of registration, individuals identified as being immunocompromised — for example, transplant and chemotherapy patients — are not asked to go back and sit in the waiting room.

“They go straight in to get their bloodwork done.”

As for the large number of people in the waiting room, Grabka said they are no longer asking people to social distance.

People are still being asked to clean their hands and wear a medical mask when in any facility. Medical masks are available at the sites for anyone who doesn’t have one.