Originally Published IVD Technology June 2003
INDUSTRY NEWS
POCT improves ER efficiencyImplementing a point-of-care testing (POCT) program within a hospital emergency room can decrease the turnaround time for test results and the length of stay for patients undergoing these tests. According to a study published in the Archives of Pathology and Laboratory Medicine, clinicians were satisfied with not only the turnaround times but also the accuracy of these POC test results.
The study was conducted at Massachusetts General Hospital (Boston), which implemented a pilot POCT program in its emergency department. For this study, the test turnaround time and patient length of stay were measured for the patients who received glucose testing, urine dipstick, pregnancy testing, and cardiac markers. A total of 369 patients were evaluated before and during the POCT program.
The study found that after instituting POCT, the turnaround time for each of the tests declined an average of 87% (see Table I). There was also a trend toward decreased length of stay during the POCT program, except for the patients who received glucose testing. While the differences were not significant for any individual test, when the tests were combined, the decreased length of stay was, on average, 41 minutes. In addition, the study found that, based on quality assurance surveys, clinicians were equally satisfied with the accuracy of test results from both the hospital's central laboratory and the POCT laboratory. However, these surveys showed clinician dissatisfaction with the central lab's test turnaround time and increased satisfaction with the POCT program's turnaround time.
| Test | Turnaround Time before POCT (min) |
Turnaround Time during POCT (min) |
Change
in Turnaround time after Initiating POCT |
| Urinalysis | 40 | 4 | 90% |
| Pregnancy testing | 78 | 5 | 94% |
| Glucose testing | 10 | 6 | 60% |
| Cardiac markers | 110 | 17 | 84.5% |
| Average | 59.5 | 8 | 86.6% |
| Table I. Turnaround times for test results before and during the implementation of a point-of-care testing (POCT) program. Source: Archives of Pathology and Laboratory Medicine. | |||
Industry analysts believe that more clinical studies need to be conducted to demonstrate the advantages of POCT.
"The lack of outcome studies has hampered the ability of IVD manufacturers to prove the many benefits that POCT has to offer," says Emery Stephans, president of Enterprise Analysis Corp. (Stamford, CT) and the former industrial liaison committee chairman of the point-of-care division of the American Association for Clinical Chemistry. "So the outcomes from studies such as this one are a big plus."
Analysts believe that these studies provide valuable information to IVD manufacturers about the importance of POCT.
"The POC market is continually growing and is presently at a crossroads in which IVD manufacturers are starting to think about the next generation of POC devices," says Stephans. "Manufacturers are thinking about how to make their POC devices easier to use, with less administrative overhead. These studies provide encouragement."
For more information about this study, access the Archives of Pathology and Laboratory Medicine Web site at http://www.cap.org/html/publications/archives.html.
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