Rapid progression for POC pathology testing

Point-of-care pathology testing is becoming increasingly common as the clinical and financial benefits are realised in both the primary and secondary care settings. Historically, glucose meters, urine dip sticks and blood gas analysis started the trend and more tests are now becoming available, as a plethora of devices are developed specifically for use at the point of patient care. As the array of available tests increases, more clinicians are looking to point-of-care testing to give them the flexibility they need in their working day in order to make patient pathways as efficient as possible. Point-of-care testing can be used to monitor chronic disease and, in the acute setting, to provide timely pathology results to resolve clinical issues such as: Is the patient in a steady state? Are they deteriorating? Are they responding to, or tolerating, medication? As an example, a timely result obtained from a point-ofcare analyser in an A&E department can assist lean working principles significantly, and might make the difference between achieving or failing on the latest Government-directed quality standards. With results available in minutes rather than hours, doctors are able to make more informed decisions on whether to admit or discharge a patient without delay, not only saving on costly and unnecessary admissions, but also making optimal use of clinicians time.

Effective testing

In order to be effective, point-of-care testing must be embedded into the patient management process. This aspect must be fully explored during the approval stages of a business case to ensure that the clinicians requesting the use of point-ofcare testing equipment recognise and fully embrace their responsibility to use results in a timely fashion, in order to improve the management of patients and make cost savings. Clinicians at Frimley Park Hospital in Surrey have adopted this approach and are reaping the benefits of a well-established service. The point-of-care testing policy at Frimley Park was ratified in 2002 and the use of point-of-care testing equipment has grown to over 700 devices located throughout primary and secondary care, supported by a team of trained medical technical officers supervised by biomedical scientists. The service includes cover for over 100 GPs, eight community hospitals, three remote private hospitals and two prisons. “We currently support 24 different device models from 11 different suppliers and, although many are the usual blood glucose meters and urine analysis machines, the list also includes blood gases, CO-oximetry, sodium, potassium, calcium, chloride, glucose, lactate, creatinine, full blood counts and five part differential, troponin I, HbA1C, microalbumin, INRs – very common now as GPs are given incentives to do their own testing – ACT, CRP, pregnancy tests, bilirubin, cholesterol/lipid profile, haemoglobin, D-dimer and foetal fibronectin. While each device is placed to offer a unique solution to a specific issue, the input of all stakeholders is sought, including serious consideration of the reasons for not using the central laboratory service.