Implementing and managing point-of-care testing (POCT) can be a love-hate relationship. When applied to the correct clinical scenario and supported with adequate resources, POCT positively impacts workflows and improves outcomes. Conversely, when mismanaged from lack of infrastructure or resources, POCT frustrates both operators and managers, creating a laboratory compliance nightmare.
Thankfully with new guidance from AACC Academy, POCT is about get a lot more manageable. The scientific session on Tuesday, December 15 at 11:00 am Central, “Management of Point-of-Care Testing: An AACC Academy Guidance Document” details updated recommendations relevant to 2020 POCT challenges.
Speaker James Nichols, PhD, describes leveraging proficiency testing and data management to improve the quality of a POCT program. AACC Academy’s recommendation to perform proficiency testing and external quality assessment for waived testing at multiple locations can drive quality and improve operator competency. “This really gives every site the ability to evaluate their performance with a peer group,” says Nichols, who also notes how different the landscape of POCT is now compared to when the Academy’s original document was written. “The number of point-of-care sites, of operators, and of point-of-care instruments is unsustainable with what people were doing 10 years ago.”
This makes digital management of a POCT program a necessity. Nichols adds that with the COVID-19 pandemic, POCT has become more important even for virtual visits when patients aren’t coming to hospitals. Patients and physicians are utilizing results from home glucose monitoring, continuous glucose meters, and home prothrombin time/international normalized ratio testing. Documenting this data in patients’ charts falls under the umbrella of POCT compliance.
Another speaker, Ellis Jacobs, MD, describes the steps outlined for laboratories to evaluate and select POCT devices. The considerations that go into purchasing a POCT device are very different now than they were in 2006 when the original document was written. Clinical utilization, financial impact, and data security are now real driving forces for decision-making. “Performing a thorough needs assessment is now crucial for a proper evaluation,” he says.
Secondly, Jacobs explains the role operator education plays in process and in improvement. Competency has become a very important element of not only POCT compliance but also a program’s success. “We now have evidence to back up the theory that competency really impacts quality,” he says. The solution to a quality POCT program is grounded in simple ideas and plain old common sense, according to Jacobs.
Speaker David Alter, MD, evaluates the evidence available supporting the idea that POCT indeed improve outcomes. He states that outside of influenza testing, limited information exists to benchmark outcomes. While this remains frustrating for those in the field, he states that attendees should feel validated in their current approaches to justifying POCT and that most everyone shares common challenges.
Alter also emphasizes that an interdisciplinary POCT committee is a “must have” for success. Bringing all stakeholders together is essential to creating a program that meets everyone’s needs.
This new AACC Academy guidance document focuses on the key issue that really defines modern day POCT: Management. Gone are the days when increased speed justified decreased accuracy.
Attendees will leave this presentation empowered with the most up-to-date evidence-based recommendations to support proper management of POCT programs, a very welcomed addition to help tame the wild, wild west of POCT.