The Division of Anatomical Pathology provides core diagnostic services to the Darlinghurst campus and various other clinics in metropolitan Sydney and regional NSW. The department’s expertise in in-situ molecular diagnosis is being complemented by the creation of a molecular tumour biology unit: a molecular pathologist has been appointed and assays are currently being validated. It is the department’s aim to offer comprehensive biomarker analysis in a variety of solid tumours, as well as haematological malignancies. The Division of Chemical Pathology has continued to develop an automation project aimed at returning results to doctors in the shortest possible time. There are clear benefits to acute care areas such as the Emergency Department and the Intensive Care Unit to be able to have results as soon as possible for urgent clinical decision making. Also within the general wards, the return of results within the same doctor’s shift in which the test was requested improves interpretation of the results. During the year the division also introduced a new high-sensitivity troponin assay for assessment of cardiac damage. This test can identify considerably smaller amounts of heart muscle damage than previous tests, allowing the more reliable exclusion of heart damage. As this was also moved to the automated system, the testing process was accompanied by an average reduction of the time to result for the Emergency Department of about 10 to 15 minutes, allowing earlier response to the testing. The division was again active in research and presentations in the field of chemical pathology. The Division of Clinical Pharmacology and Toxicology is the NSW state reference laboratory and is an Australian leader in the therapeutic drug monitoring of anti-HIV medicines and antifungal drugs as well as immunosuppressant medicines used in transplantation. The Division of Haematology Laboratories provides a comprehensive service which includes blood transfusion, coagulation and general haematology diagnostics. The Haemostasis Laboratory, in conjunction with the Blood, Stem Cells and Cancer Research Program and St Vincent’s Centre for Applied Medical Research, was successful in gaining funding and equipment to work on a
project assessing the clinical response to anti-platelet therapy in patients undergoing percutaneous coronary intervention, to see if it can help predict which patients are more likely to experience ongoing ischaemic events. In addition, it is planned that response to anti-platelet agents will also be assessed in patients undergoing cardiac surgery in an attempt to identify those who may be at a greater risk of surgical bleeding. The Haemostasis Laboratory has also collaborated with external investigators to study the effects of detergent sclerosants on the coagulation system, and is currently working with researchers at Royal North Shore Hospital in a multi centre study looking at improving testing for heparininduced thrombocytopenia. Some of this work has resulted in publications with further publications planned. The Contract Pathology Unit operates a specialist clinical trial business, which has been in operation since 1995, during which time it has established an international reputation for the provision of quality, central-laboratory services, locally and internationally. The Division of Immunopathology Laboratories provides diagnostic laboratory and contract services that span an extensive range of immunochemistry, autoimmune serology, and flow cytometry. The introduction of the FACS Canto II eight-colour flow cytometer has helped facilitate the diagnosis and monitoring of cancers and HIV. The Division of Microbiology provides a high quality comprehensive clinical microbiology diagnostic laboratory service to the Darlinghurst campus and to general practitioners in Sydney, Narrabri and Moree. A new diagnostic PCR test for respiratory viruses has significantly improved the detection rate of viruses in patients with respiratory illnesses, which has important therapeutic implications. An improved algorithm for diagnosis of Clostridium difficile infections is under development. With increasing numbers of multi-antibiotic resistant organisms being seen in the hospital, a review of the antibiotic stewardship program is taking place. A number of research projects continue, including prevalence of candida infections in the Intensive Care Unit at St Vincent’s Hospital and Malaysia, therapeutic drug monitoring
of antifungal drugs and parasitology research, including further work on Dientamoeba fragilis, which has led to the publication of a significant number of papers. SydPath follows all relevant principles of the International Conference on Harmonisation on Good Clinical Practice (GCP), Organisation for Economic Co-operation and Development (OECD) on Good Laboratory Practice and is National Association of Testing Authorities, Australia (NATA) accredited and Therapeutic Goods Administration licensed. And through the specialist clinical trial business unit, provides a comprehensive range of clinical trial laboratory services across local, central and global laboratory operations. SydPath provides comprehensive trial services covering phase I to IV research programs, to international and domestic companies across North America, Europe, Asia, and Australasia. The trials range from company sponsored drug trials, blood and tissue banks, and investigator initiated research.
Volunteers The volunteers who dedicate themselves to St Vincent’s Hospital are an energetic group ranging in age from 18- to 93-years, with some travelling from as far as the Southern Highlands and Central Coast for their roles. The 160 volunteers at St Vincent’s Hospital are proud to be part of the volunteer team of 450 who work across all St Vincents & Mater Health Sydney (SV&MHS) facilities and each volunteer gives an average of six hours per week. Their roles are varied but all make a difference: from serving red frogs and freckles to grateful staff in the Little Shop, to walking with patients in the aged care ward to help keep them mobile and engaged, or helping with administration support in departments. In 2010/2011, the Darlinghurst campus volunteers contributed 23,000 working hours, extending and enhancing the work of the staff, caring for patients, and helping to achieve the SV&MHS mission.
Annual Review 2010/11
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SydPath is comprised of several divisions:
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