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Clinical Chemistry, Vol 42, 711-717, Copyright © 1996 by American Association for Clinical Chemistry
CA Parvin, SF Lo, SM Deuser, LG Weaver, LM Lewis and MG Scott
Washington University School of Medicine, Division of Laboratory Medicine, St. Louis, MO 63110, USA.
We prospectively investigated whether routine use of a point-of-care testing (POCT) device by nonlaboratory operators in the emergency department (ED) for all patients requiring the available tests could shorten patient length of stay (LOS) in the ED. ED patient LOS, defined as the length of time between triage (initial patient interview) and discharge (released to home or admitted to hospital), was examined during a 5-week experimental period in which ED personnel used a hand- held POCT device to perform Na, K, Cl, glucose (Gluc), and blood urea nitrogen (BUN) testing. Preliminary data demonstrated acceptable accuracy of the hand-held device. Patient LOS distribution during the experimental period was compared with the LOS distribution during a 5- week control period before institution of the POCT device and with a 3- week control period after its use. Among nearly 15 000 ED patient visits during the study period, 4985 patients (2067 during the experimental period and 2918 during the two control periods) had at least one Na, K, Cl, BUN, or Gluc test ordered from the ED. However, no decrease in ED LOS was observed in the tested patients during the experimental period. Median LOS during the experimental period was 209 min vs 201 min for the combined control periods. Stratifying patients by presenting condition (chest pain, trauma, etc.), discharge/admit status, or presence/absence of other central laboratory tests did not reveal a decrease in patient LOS for any patient subgroup during the experimental period. From these observations, we consider it unlikely that routine use of a hand-held POCT device in a large ED such as ours is sufficient by itself to impact ED patient LOS.
The following articles in journals at HighWire Press have cited this article:
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C. van Heyningen, I. D. Watson, and A. E. Morrice Point-of-Care Testing Outcomes in an Emergency Department Clin. Chem., March 1, 1999; 45(3): 437 - 438. [Full Text] [PDF]
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C. P. Price The Evolution of Immunoassay as Seen Through the Journal Clinical Chemistry Clin. Chem., October 1, 1998; 44(10): 2071 - 2074. [Full Text] [PDF]
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P. M. Rainey Outcomes Assessment for Point-of-Care Testing Clin. Chem., August 1, 1998; 44(8): 1595 - 1596. [Full Text] [PDF]
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M. L. Kilgore, S. J. Steindel, and J. A. Smith Evaluating stat testing options in an academic health center: therapeutic turnaround time and staff satisfaction Clin. Chem., August 1, 1998; 44(8): 1597 - 1603. [Abstract] [Full Text] [PDF]
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