Abstract
Objectives
Special investigations (e.g. blood tests, electrocardiograms, x-rays) play an integral role in
patient management in the emergency department (ED). Having results immediately available
prior to assessing a patient may lead to improved efficiency. This could be instituted by
utilizing point-of-care (POC) testing with an alternative ED workflow, but the implementation
would be dependent on acceptance by the end-users. The aim of this study was to assess
doctors’ perceptions of POC testing in the ED when the normal treatment pathway was modified
to use upfront POC tests performed prior to doctor evaluation in an effort to decrease
treatment times.
Methods
A prospective, randomized, controlled trial was performed in the ED where medical patients
received either the normal ED workflow pathway or one of the enhanced workflow pathways
with POC tests in various combinations prior to doctor evaluation. At the end of the study
period, doctors were invited to participate in an anonymous survey to gauge their opinions
on the implementation of the early POC testing.
Results
Overall, the doctors surveyed were very satisfied with use of upfront POC in the ED. One
hundred per cent of the 28 doctors surveyed found it helpful to assess patients who already
had test results available and would want it to be permanently available. Normalized satisfaction
scores were more favorable for combinations of 3 or more tests (0.7–1.0) as
opposed to combinations with 2 or less tests (0.3–0.7). There was a preference for combinations
that included comprehensive blood results.
Conclusion
The implementation of workflow changes to assist doctors in the ED can potentially make
them more productive. End-user buy-in is essential in order for the change to be successful...