POCT and Laboratory Medicine / Accreditation

POCT and Laboratory Medicine / Accreditation

Diagnostic Accreditation Program
POCT and Lab Medicine
Presentation by: Arun K. Garg PhD, MD, FRCPC
Medical Director, Lab Medicine/Pathology
Fraser Health/RCH
330 E. Columbia Street
New Westminster

Point of Care Testing Accreditation (POTC)

Colin Semple ART
Accreditation & Research Development Officer
Diagnostic Accreditation Program of BC


Forces Changing Lab Medicine
Intitutional Testing

In vivo Point of Care Testing
* Institutional Acute Care

* Traditional Lab Services – ER, ICU, OR, Wards, Ambulance
* Physician office
* Ambulatory clinics
* Community clinics
* Pharmacies
* Long-term/Extended Care
* Home Care
* Ambulance
* Glucose meters
* Urinalysis
* Blood gases/electrolytes
* Coagulation studies
* Rapid Bacterial Strips
* Glycalated HbA1c
* Cardiac BioMarkers
* Hormones, Pregnancy testing
* Non blood skin reflectance - bilirubin

Some examples:

Cost
Therapeutic Turnaround Time
Medical Quality/Outcome
Forces of POCT
Acute Care and POCT
Chronic Care and POCT
Technology and POCT
Challenges of POCT
POCT and Non Lab Personnel
General Principles
Scientific/Technical
(Pre-Analytical – Post)
Fraser Health and POCT
References
Point of Care Testing-Definition
For accreditation purposes:
Accreditation Standards

2006-7 Draft standards developed
08/2007 Standards released for testing
03/2008 Revisions to POCT Standards
05/2008 Advisory Committee Approval
05/2008 Board Approval

Advisory Committees
POCT Accreditation Standards
On-site survey protocols (technical)
Talk to the laboratory staff involved in POCT oversight: overview, QC, PT
Speak with a nurse educator
POCT QC: selection, review
Laboratory medical leader’s role in POCT
Method/Instrument Selection/Validation
Roles and Responsibilities
Overall responsibility for POCT is assigned to the facility or regional laboratory leader or designate
The Laboratory Medical Leader defines the scope of POCT in consultation with the MAC, interdisciplinary practice groups or other appropriate groups.
Roles and Responsibilities
Accreditation surveys
“Rogue” POCT issues
Method and instrument selection, evaluation and validation
Roles and responsibilities
Training and competence testing
Documentation
Quality Control and Proficiency Testing
Instrument maintenance and monitoring
Reagents, chemicals and supplies
Results, records and reporting processes
Training/Orientation/Competence Testing
Documented Procedures
Quality Control
QC policies
Survey information
Proficiency Testing
Advisory Committees
Proficiency Testing
Mandated analytes:
Instruments and equipment
Reagents and Supplies
Recording of Results
Summary


AACC Annual Meeting
Washington DC
July 27-31, 2008

International POCT Symposium
Critical and Point of Care Testing: Managing Technology for the Benefit of all Populations
September 18-20, 2008 Barcelona, Spain


POCT and Laboratory Medicine/Accreditation.ppt