Faster Is Better—It’s Rarely That Simple!

Abstract

With the enormous popularity of audioconferences, meetings, and special inserts in nonarchived journals regarding point-of-care testing (POCT), it is clear that laboratorians are struggling with questions about implementing and managing POCT. Yet there is a paucity of serious studies in the peer-reviewed literature that address the benefits of POCT. In this issue, Nichols et al. (1) present a study that examined the impact of POCT implementation on patient waiting time for interventional cardiology procedures. This study provides an example of the proper way to address decisions regarding the implementation of POCT. The authors established an hypothesis about the impact of POCT in their setting, implemented POCT, examined a measurable outcome, and then made adjustments to patient management and workflow when simple implementation of POCT did not substantiate their hypothesis. The bottom line from this study is that despite the initial intuition that faster laboratory values would be better, it took more than just fast laboratory data to obtain the desired benefit. These authors found that simply moving the point of testing from the central laboratory to the clinical service did not improve patient waiting time until significant changes in workflow were made. The predictions of the second phase of their study [when the potential time-savings of POCT vs central laboratory turnaround time (TAT) were determined] suggested that 92% of patients requiring either renal function or coagulation tests could meet their scheduled procedure time with POCT. By contrast, at baseline, only 8% and 29% …