An increased reliance on point-of-care testing (POC) in recent years has led many healthcare organizations to appoint POC coordinators. That coordinator's role, of course, is to ensure that testing services outside of the core laboratory not only meet the highest standards around quality and efficiency, but also maintain compliance with state and federal regulations, and with the expectations of its various accrediting agencies. It's an important job in a high-stakes environment, and it's one that will only become more important in the future as health systems provide more outpatient care.
With that in mind, we asked Barbara Goldsmith, PhD, FACB, Chair of Medical Laboratory Sciences and Biotechnology at Thomas Jefferson University Hospital and director of the organization's POC program, for her thoughts on the challenges that POC coordinators face and ways their employers might better support them. Here's a look at what she had to say.
The biggest issue most POC coordinators struggle with involves the unrelenting stream of new requests for testing services, Goldsmith says. Such requests, in her experience, come in “almost daily" and each one requires a close look at the particular circumstances, and a decision based on technical and financial feasibility. “If you don't have connectivity," for example, “it limits your ability to offer certain tests at certain locations," Goldsmith says. A POC coordinator who lacks the right resources—the technology that's needed or formal backing from the C-suite—can quickly become overwhelmed, she adds.
Thomas Jefferson Hospital recently settled on a two-pronged approach to POC coordination that helps Goldsmith do her work efficiently and effectively. First, she says, they developed a point-of-care “justification form" that must be completed as part of any POC-testing request; and then they created a point-of-care steering committee consisting of representatives from departments across the organization.
When someone comes to their coordinator with a POC-testing request now, that person submits a form and schedules a meeting with the committee, knowing he or she will need to make a case to key stakeholders. “It's, 'We need this and this is why, and this is what it will cost,'" she explains. If it's determined they have the resources to support the new testing service—and that POC testing will improve patient care—chances are the request will be granted. But either way, Goldsmith says, this “vetting process" allows them to make a well-informed decision and prevents POC testing where it may not be warranted.
In the end, Goldsmith says, the POC coordinator must weigh the needs of the institution and its clinicians and patients against the technical, regulatory, and logistical challenges associated with testing itself. “The goal is to maintain quality and maintain good practices and competency [when testing takes place] outside the lab," she says. When a POC coordinator is empowered by her employer to limit POC testing services to the places where they can really make a difference, she can focus her energy—and her time on the job—on surpassing expectations in all of these areas. Yes, Goldsmith admits, an empowered POC coordinator may ultimately cause adoption of POC testing to slow down, but that's better than rushing to add testing services that aren't necessary, and it's better for POC testing overall.
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