Abstract
BackgroundIn this study, we hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination.MethodsA single centre observational study was performed in ED non-ambulatory patients. Blood testing was performed either with POC instruments for blood gases and chemistry panel, full blood count, and CRP, or at central laboratory, or as a combination of both. Blood draw and POCTs were performed by experienced nurses.ResultsDuring the 4-week study period, 1759 patients underwent sample testing (POCT: n = 160, central lab: n = 951; both n = 648). Median waiting time for blood sampling was 19 min less in POCT than central laboratory (0:52 (95% confidence interval (CI) 0:46–1:02) vs. 1:11 (95% CI 1:05–1:14), p < 0.001). POCT results were available faster in both discharge groups, as expected. When imaging was not required, patients in POCT group were discharged home 55 min faster (4:57 (95% CI 3:59–6:17) vs. 5:52 (95% CI 5:21–6:35), p = 0.012) and 1 h 22 min faster when imaging was performed (5:48 (95% CI 5:26–6:18) vs. 7:10 (95% CI 6:47–8:26), p = 0.010). Similar reduction in sampling time and LOS was not seen among those admitted to hospital.ConclusionsPOCT shortened the laboratory process and made results available faster than the central lab. This allowed patients to be discharged home quicker. Thus, with proper training and education of the ED care team, POCT can be used as an effective tool for improving patient flow.
Highlights
In this study, we hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination
This study focuses on non-ambulatory patients who needed blood sampling (Fig. 1)
Patients discharged home were younger than those admitted to hospital ward and had more patients analyzed by POC only in relation to patients admitted to hospital (Table 1)
Summary
We hypothesized that point of care testing (POCT) would reduce length of stay (LOS) in emergency department (ED) when compared to central laboratory testing and be a factor in patient discharge destination. The laboratory turn-around time for results from central laboratories (CL) can be over 60 min, Many studies on POCT, focused on selected tests and limited patient populations, have suggested reduced length of stay (LOS) [2,3,4]. A recent study by Singer et al focusing on critical care patient population reported reduced LOS using similar iSTAT POCT equipment as used in this study [5]. Some have reported that POCT strategy alone has not necessarily improved LOS or that it has had effect on only a certain group of patients [6]. The full benefit of POCT is acquired when it is implemented
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