Integrating Point-of-care Testing Into a Community Emergency Department: A Mixed-methods Evaluation
| Autor: | Mark S. Zocchi, Jesse M. Pines, Charles Z Marriott, Caitlin Carter, Matthew Bernard, Leah S. Honigman Warner |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Point-of-care testing 030204 cardiovascular system & hematology Central laboratory 03 medical and health sciences 0302 clinical medicine Qualitative analysis Medicine Humans Qualitative Research business.industry Diagnostic Tests Routine Qualitative interviews 030208 emergency & critical care medicine Interrupted Time Series Analysis General Medicine Emergency department Length of Stay Middle Aged Laboratory results Troponin Laboratory Test Result Point-of-Care Testing Emergency medicine Emergency Medicine Observational study Female business Emergency Service Hospital |
| Zdroj: | Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 25(10) |
| ISSN: | 1553-2712 |
| Popis: | OBJECTIVE Point-of-care testing (POCT) is a commonly used technology that hastens the time to laboratory results in emergency departments (ED). We evaluated an ED-based POCT program on ED length of stay (LOS) and time to care, coupled with qualitative interviews of local ED stakeholders. METHODS We conducted a mixed-methods study (2012-2016) to examine the impact of POCT in a single, community ED. The quantiative analysis involved an observational before-after study comparing time to laboratory test result (POC troponin or POC chemistry) and ED LOS after implementation of POCT, using a propensity-weighted interrupted time series analysis (ITSA). A complementary qualitative analysis involved five semistructured interviews with staff using grounded theory on the benefits and challenges to ED POCT. RESULTS A total of 47,399 ED visits were included in the study (24,705 in the preintervention period and 22,694 in the postintervention period). After POCT implementation, overall laboratory testing increased marginally from 61% to 62%. Central laboratory troponin and chemistry declined by > 50% and was replaced by POCT. Prior to POCT implementation, time to troponin and chemistry had declined steadily due to other improvements in laboratory efficiency. After POCT implementation, there was an immediate 20-minute further decline (p |
| Databáze: | OpenAIRE |
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