A Randomized Controlled Trial to Assess the Impact of Upfront Point-of-Care Testing on Emergency Department Treatment Time. Issue 3 (19th June 2018)

• Record Type: Journal Article
• Authors: Goldstein, Lara; Wells, Mike; Vincent-Lambert, Craig
• Is Part Of: American journal of clinical pathology. Volume 150:Issue 3(2018)
• Page Start: 224
• Page End: 234
• Publication Date: 2018-06-19
• Subjects: Point-of-care testing -- Point-of-care systems -- Emergency department; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqy042
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: To compare standard emergency department (ED) workflow to a protocolized pathway using upfront point-of-care (POC) tests performed prior to doctor evaluation to determine if this could produce a significant reduction in treatment time. Methods: We performed a prospective, randomized, controlled trial. Patients were randomized to receive the standard of care or one of the enhanced workflow pathways with POC tests. Results: There were 1, 044 patients enrolled. All workflows, except electrocardiogram and low-dose x-ray (LODOX), exceeded the outcome measure (20% reduction in treatment time). It was significantly shorter compared with the control workflow if the patient received any (i-STAT + CBC)–containing workflows ( P = .0001, P = .020, P = .0009, P = .011), as well as the i-STAT + LODOX workflows ( P = .0001, P = .034). Conclusions: The full benefit of POC testing can be realized if it is implemented prior to doctor evaluation, as part of a standardized procedure in the ED. This allows for a more rapid availability of investigation results subsequently leading to decreased treatment times.