Effect of Troponin I Point-of-Care Testing on Emergency Department Throughput Measures and Staff Satisfaction

ADVANCED EMERGENCY NURSING JOURNAL,
Koehler et al 2013;
35:270-277

201

Objectives: Impact of point of care (POC) troponin testing on turnaround times, door-to-troponin result time, ED Length of Stay (LOS) in patients with chest pain, and staff satisfaction with POC testing was evaluated. 

Findings: Average door-to-troponin result time reduced significantly from 105 to 51 minutes with POC testing. Average LOS decreased from 290 to 255 minutes however this change was not significant. High satisfaction among ED staff members was reported.

Early Point-of-Care Testing at Triage Reduces Care Time in Stable Adult Emergency Department Patients

THE JOURNAL OF EMERGENCY MEDICINE,
Singer et al 2018;
55:172-178

104
(52 patients and 52 matched controls)

Objectives: Value of early point of care testing (POCT) at the time of patient triage prior to physician evaluation in the Emergency Department (ED) was evaluated at a tertiary care medical center. POCT was available for basic metabolic panel, troponin I, lactate, International Normalized Ratio (INR), or urine pregnancy test. 

Findings: ED care times reduced by approximately 1 hour with early POCT at triage compared with traditional core laboratory testing. Approximately 6% of the patients were immediately transferred to critical care areas to be seen by an ED physician. Slightly more than half of the treating physicians felt that early POCT at the time of initial assessment improved patient care, by changing the focus of their evaluation or leading to earlier treatment or disposition. In this study, although ED care times were reduced, total ED length of stay was not reduced.

Does Rapid Assessment Shorten the Amount of Time Patients Spend in the Emergency Department?

BRITISH JOURNAL OF HOSPITAL MEDICINE,
Jarvis* et al 2014;
75:648-651

*Dr. Jarvis no longer works as a consultant at Calderdale Royal Hospital and he is currently employed by Abbott Laboratories. 

4,622

Objectives: Traditional patient triage (nurse-led triage model with blood samples analyzed in a centralized hospital laboratory) was compared with a consultant-supported rapid assessment model (EDIT model) with blood samples analyzed using the i-STAT System as the point of care (POC) solution in the Emergency Department (ED) of a district general hospital.

Findings: The combination of consultant-led early assessment and point of care testing reduced the time from patient arrival in the ED to disposition decision by 41% when compared with traditional patient triage. Level of improvement which can be attributed to POC or clinicians assessing the patients within minutes of their arrival in the ED remains unclear.

Time is Money— The Economic Impact of Point of Care on the Emergency Department of a Tertiary Care University Hospital

POINT OF CARE, 
Schilling 2014; 
13:21-23

 41

Objectives: Economic value of point of care testing (POCT) was assessed in a Swedish Emergency Department. Direct cost of POCT vs. central laboratory and indirect costs such as reduction in waiting time was analyzed. i-STAT CHEM8+, CG4+, and cTnI cartridges were used.

Findings: For similar tests, there was a direct cost saving of US $111/patient with POCT as compared to central laboratory. Indirect cost savings were US $72.75/patient, including staffing costs and time saving. These findings might not reflect the findings in other clinical settings. Numbers should be recalculated in the actual local setting to reveal if the direct savings of POCT testing can be realized at the respective hospital.

Effect of Troponin I Point-of-Care Testing on Emergency Department Throughput Measures and Staff Satisfaction

ADVANCED EMERGENCY NURSING JOURNAL,
Koehler et al 2013;
35:270-277

201

Objectives: Impact of point of care (POC) troponin testing on turnaround times, door-to-troponin result time, ED Length of Stay (LOS) in patients with chest pain, and staff satisfaction with POC testing was evaluated. 

Findings: Average door-to-troponin result time reduced significantly from 105 to 51 minutes with POC testing. Average LOS decreased from 290 to 255 minutes however this change was not significant. High satisfaction among ED staff members was reported.