A point-of-care chemistry test for reduction of turnaround and clinical decision time.
نویسندگان
چکیده
PURPOSE Our study compared clinical decision time between patients managed with a point-of-care chemistry test (POCT) and patients managed with the traditional central laboratory test (CLT). BASIC PROCEDURE This was a randomized controlled multicenter trial in the emergency departments (EDs) of 5 academic teaching hospitals. We randomly assigned patients to POCT or CLT stratified by the Emergency Severity Index. A POCT chemistry analyzer (Piccolo; Abaxis, Inc, Union City, Calif), which is able to test liver panel, renal panel, pancreas enzymes, lipid panel, electrolytes, and blood gases, was set up in each ED. Primary and secondary end point was turnaround time and door-to-clinical-decision time. MAIN FINDINGS The total 2323 patients were randomly assigned to the POCT group (n = 1167) or to the CLT group (n = 1156). All of the basic characteristics were similar in the 2 groups. The turnaround time (median, interquartile range [IQR]) of the POCT group was shorter than that of the CLT group (14, 12-19 versus 55, 45-69 minutes; P < .0001). The median (IQR) door-to-clinical-decision time was also shorter in the POCT compared with the CLT group (46, 33-61 versus 86, 68-107 minutes; P < .0001). The proportion of patients who had new decisions within 60 minutes was 72.8% for the POCT group and 12.5% for the CLT group (P < .0001). CONCLUSIONS A POCT chemistry analyzer in the ED shortens the test turnaround and ED clinical decision times compared with CLT.
منابع مشابه
Lean six sigma process improvement in specimen receiving to improve stat chemistry turnaround times
Objective: As a consequence of stat turnaround times (TATs) chronically exceeding 60 minutes, our laboratory was facing pressure to divert limited resources toward the implementation of an emergency department satellite laboratory. Peer-reviewed literature in clinical laboratory quality assurance and improvement indicates that between 60-70% of errors occur at the pre-analytical level. Thus...
متن کاملClinical evaluation of serial blood processing at point of care.
The Axial Separation Module (ASM), which separates whole-blood specimens serially in Axial Process Containers (APC), was evaluated for clinical performance at the University of Virginia Health Sciences Center (UVA HSC) in a community-based outpatient laboratory (North Ridge Clinic). We hypothesized that moving the task of blood separation to point of care would reduce specimen turnaround time w...
متن کاملHow Much Can We Save the Cost from Shifting from Single - Test Strip to Multiple - Test Strip in Point of Care Testing Analysis for Common Clinical Chemistry Parameters ?
متن کامل
Outcomes assessment for point-of-care testing.
“Outcomes Assessment” has become one of the enduring buzzwords of the decade. But it often seems to be like the weather: Everyone talks about it, but relatively few do anything about it. As clinical laboratory scientists, we have repeatedly challenged ourselves to demonstrate that laboratory results affect patient outcome. Yet very few well-done studies have been published. (How many times have...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- The American journal of emergency medicine
دوره 29 5 شماره
صفحات -
تاریخ انتشار 2011