Building Quality into Point-of-Care Testing Programs: Recommendations for POCT Coordinators and New Service Providers

Recent advances in point-of-care testing (POCT) technology have reduced the time it takes to obtain results and have enabled certain types of tests to be performed in a wider variety of settings. Examples of new POCT service providers include long-term care facilities, pharmacies, emergent care clinics, and physician offices. Conducting POCT in new settings presents challenges that must be considered and addressed to maximize test accuracy, comply with government regulations, and ensure patient safety.

In a POCT program, the collection and analysis of patient samples occur at the site of care, rather than in a clinical laboratory. Point-of-care tests, such as those used to assess blood glucose levels or screen for anemia, tend to be less complex than standard laboratory tests and provide a faster turnaround time, allowing care determinations to be made more quickly.

POCT results can be compromised, however, if program oversight is insufficient, operator training is inadequate, or quality assurance processes are deficient. The overall reliability, simplicity, and automation of many point-of-care tests may cause some healthcare administrators to underestimate the risk of operator-related POCT errors. In new service provider settings in particular, the likelihood of errors can be greater since many operators lack formal training in activities such as handling biological samples or test reagents. But even established POCT programs must include appropriate measures to guard against testing errors.

Responsibility for maintaining program quality will ideally be assigned to a POCT coordinator who has formal education and clinical experience in laboratory science. This individual can help administrators understand clinical needs, coordinate POCT services and locations, standardize technology selection and maintenance, and facilitate and monitor user training and competency assessments to achieve a high level of testing accuracy.

Failure to establish and follow appropriate processes could lead to tests being performed incorrectly, specimens...