Point-of-care testing makes big difference

Ongoing initiatives in the ED at Middle Tennessee Medical Center (MTMC) in Murfreesboro have led to improved patient flow. One of the more successful initiatives involved the purchase of units from i-STAT Corp. for point-of-care testing. MTMC purchased 10 units at a cost of about $5,000 each, and two of them stay in the ED. The system allows the physician to receive results from bedside testing with handheld computers.

"Our whole streamlining flow initiative tried to identify system problems we had that impaired patient flow, and one area was the lab," explains Kevin H. Beier, MD, FAAEM, a physician in the ED. "When we did a CT scan with contrast, for example, we had to wait on kidney function results, like creatinine." Now, he says, the unit can do bedside creatinine tests, as well as urine pregnancy tests.

"Instead of waiting an hour for test results, we can get them back in three to five minutes," says Beier. "You just get a small drop of blood and insert the cartridge in the testing unit."

In July, a lab phlebotomist was hired for the ED as well, to make sure other lab tests are sent off and received quickly. The cost came out of the lab budget. Monty Gooch, RN, BSN, director of emergency services, says, "We have tracked the times, and we are saving around 10%-15% compared to previous times."


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