Optimizing Quality Practices in Point-of-Care Testing

Abstract With testing in health care becoming more decentralized to include the patient bedside, quality assurance in point-of-care testing (POCT) assumes immense significance in optimizing clinical outcomes. However, complex regulatory requirements, training of testing personnel, and implementation of a uniform quality policy in varied locations across the hospital pose the greatest challenges in achieving the desired result. Although 70 POCT instruments were being used across our hospital, there was no structured program in place. In accordance with the requirements of the Joint Commission (JCI) accreditation, efforts were made to bring the supervision of POCT under the supervision of the laboratory. Initial internal audits revealed absence of quality assurance policies, inadequate documentation, and lack of uniformity in POCT practices across the hospital. Standard operating procedures on uniform POCT practice, quality control, and critical values were formulated. Training of testing personnel was conducted. Internal quality control and proficiency testing programs were designed and implemented. Periodic evaluation revealed a paradigm shift in the attitude of the testing personnel and the treating physicians toward POCT. It helped in ensuring strict adherence to quality practices in POCT and increased confidence in the reported results. This impacted positive clinical outcomes. Although, on one hand, the implementation of a structured POCT program facilitated the accreditation by the Joint Commission, it also helped us achieve uniformity and a high level of quality in POCT across the hospital. A multidisciplinary organizational approach for POCT under the direct supervision of the laboratory improved the quality of patient care.