The Effect of Point of Care Testing on Clinical Decision Making in an Emergency Department

A Point of Care Testing (PoCT) laboratory for the analysis of wide range of biochemistry and haematology tests has established at Emergency Department at the Kent and Canterbury Hospital. OBJECTIVE: To evaluate the speed at which test results were available comparing turn around time between PoCT and main pathology laboratory and whether this had an effect on clinical decision making was undertaken. DESIGN AND METHODS: Blood samples from 47 patients were sent randomly either to the main laboratory for analysis or to the PoCT facility in the Emergency Department. RESULTS AND DISCUSSION: The results of samples analysed in the PoCT laboratory were available 54 minutes faster and senior clinical decision time reduced by 38 minutes when compared to the main laboratory. Delays in clinical decision occurred when samples initially analysed in the PoCT laboratory required further pathology tests only available in the main laboratory. A further suggestion for the inclusion of checking Troponin I, D-Diemers, Salicylates, clotting screen and alcohol levels would have been useful if done to reduce decision making time thus improving patient management. Opening times of the PoCT were limited (10-17hours), small number of patients included in the study (n=47) and generic outcome measures such as mortality were not addressed. CONCLUSION: This small study shows a significant benefit of PoCT on clinical outcomes by significant decrease in time by early availability of the blood test results compared to the main pathology laboratory making clinical decision quicker.