Point-of-Care Testing: A Process to Engage Multidiscipline Health Care Providers in Role Definition

Abstract

Point-of-care testing (POCT), laboratory tests performed near the patient, is pushing the boundaries of our traditional notions of scope of practice. The demand for more rapid results; the availability of technologically advanced, easy-to-use POCT devices; and laboratory staff shortages are shifting test performance away from the laboratory to POCT performed by direct health care providers. Whereas testing conducted in the laboratory is performed by qualified medical laboratory technologists and is highly regulated, POCT is often performed by nonlaboratory operators with limited training and minimal knowledge of good laboratory practice. Our objective: collaboratively validate and implement a process and tools to clarify POCT roles and responsibilities. We identified several prerequisites to success, including clear definition of POCT roles, management of the associated responsibilities, and a process to engage the direct health care providers performing POCT. Strategies used included obtaining support from the organization's quality council and professional practice groups; recruiting stakeholders from acute, rural, and community settings; forming a POCT working group to collaborate and make recommendations; and piloting the recommendations before full implementation. Working from a generic template, members of the group developed a POCT process map outlining several streams of activities, defining the roles and responsibilities required to deliver quality POCT results. The streams included the POCT testing process, quality assurance, training and competency, service change activity, and information connectivity. The process has been successfully piloted and is currently being implemented across the region. If all supporting prerequisites for success are met, then transitioning the processes should assure sustainable quality practice.