Management Challenges for Point-of-Care Coordinators in Delivering Training and Competency Programs

Abstract

The roles and responsibilities of point-of-care (POC) coordinators are numerous and ever expanding. The ordering and dispatch of reagents and consumables, confirming lot numbers and expiry dates, managing stock wastage, maintenance of quality testing result sheets, management and provision of feedback on quality testing data, verification of patient results, managing device errors, device maintenance and repair, and managing compliance and regulatory issues (to mention just a few tasks) place substantial demands on the POC coordinator’s time. With the support of industry, the ability to automate many of these manually intensive tasks should be a goal to which all managers of POC networks strive. In practice, the nature and extent of the challenges faced by POC coordinators often depend on the clinical, cultural, and geographic setting in which the POC testing network operates. The 2 largest POC testing models that our unit coordinates are the QAAMS (Quality Assurance for Aboriginal and Torres Strait Islander Medical Services) Program and the Northern Territory POC Testing Program. The QAAMS Program is a national POC testing model for diabetes management operating in more than 160 indigenous medical services across mainly rural and remote Australia. 1Y3 The Northern Territory Program provides POC testing for acute and chronic diseases in 41 remote indigenous health centers in the territory. 4 Because of the extreme geographic isolation of many of these health services and given that the POC device operators who conduct patient testing in these programs may be one of several different health professional groups, the POC coordinators and supporting scientific staff responsible for these programs face unique challenges with the management of operator training and competency assessment in particular. This aspect of delivering these models therefore forms the basis of this editorial. Organization of POC training sessions for health professional staff from remote communities can be very difficult. Because of the competing time demands on staff in remote health services, not all staff are able to attend on-site training sessions delivered by the POC coordinator; conversely, the cost of flying remote staff to a central location (capital city) for training is prohibitive, and health center managers are reluctant to allow staff the additional time away from the service. Staff turnover rates in remote health centers are also high, 5 and it is often difficult to maintain continuity of patient and quality POC testing during periods when services are understaffed or when there are no trained operators available at remote services. Hard copies of manual training resources such as primary training manuals and posters summarizing quick guides on how to perform patient and quality testing are often misplaced when staff turn over, leaving the next POC operator without key reference material. The ability of the POC coordinator to deliver immediate on-site training sessions when new staff replacements arrive is compromised by the demands of distance and time. For this reason, training for our large networks has evolved in recent years to include a range of flexible automated and electronic options, which aim to simplify the manual workload and the travel and time demands on the POC coordinator and provide a more sustainable means for the delivery of training. In the QAAMS Program, Web-streamed videos of training are now available through a password-protected ‘‘Participant Only’’ section of the Web site. These videos systematically take the participant through the principles and practice of POC testing for this program and can be viewed at any time that is convenient for the trainee device operator. The full training manual, poster sets, training EDITORIAL