Continuous Quality Improvement for Point-of-Care Testing Using Background Monitoring of Duplicate Specimens

Abstract

Abstract Context.—Despite compliance with quality control standards, concerns remain as to the accuracy and reliability of point-of-care testing. Objective.—To assess a practical method for quality improvement using the context in which point-of-care testing is done. Design.—Quality measures for point-of-care testing, making use of natural duplication of results obtained by other testing methods, were used to monitor testing quality and evaluate quality improvement interventions. Setting.—Five adult intensive care units (total of 88 beds) in a large academic medical center, using point-of-care testing for blood gases, electrolytes, and hematocrit levels. Participants.—Nurses performing bedside testing and laboratory personnel assigned the responsibility for supervising their performance. Interventions.—Quality of testing was monitored continuously, and, where problems were identified, training and support interventions implemented, and their effects evaluated. Main Outcome Measures.—Improvement in correla...