Use of a Comprehensive Metabolic Panel Point-of-Care Test to Reduce Length of Stay in the Emergency Department: A Randomized Controlled Trial
Study objective Awaiting results from laboratory testing may sometimes be a rate-limiting step in emergency department (ED) throughput prolonging length of stay and contributing to crowding. We determine whether introduction of a comprehensive metabolic panel point-of-care test can reduce ED length...
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Published in | Annals of emergency medicine Vol. 61; no. 2; pp. 145 - 151 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Mosby, Inc
01.02.2013
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Subjects | |
Online Access | Get full text |
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Summary: | Study objective Awaiting results from laboratory testing may sometimes be a rate-limiting step in emergency department (ED) throughput prolonging length of stay and contributing to crowding. We determine whether introduction of a comprehensive metabolic panel point-of-care test can reduce ED length of stay compared with traditional central laboratory testing. Methods We performed a randomized, controlled trial among 10,244 noncritically ill ED patients aged 15 years and older whose physicians ordered a comprehensive metabolic panel at a single, large, academic, urban medical center. Participants were randomly assigned to performance of a comprehensive metabolic panel by a point-of-care test (n=5,154) or central laboratory testing (n=5,090). The primary outcome was length of stay in the ED. Results A point-of-care test reduced median ED length of stay among all study patients by 22 minutes (median 350 minutes [interquartile range 206 to 1,002 minutes] with point-of-care test versus median 372 minutes [interquartile range 217 to 1,150 minutes] with central laboratory testing; median difference 22 minutes; 95% confidence interval [CI] 4 to 40 minutes). A point-of-care test also reduced ED length of stay in patients discharged to home (256 versus 268 minutes; median difference 12 minutes; 95% CI 2 to 22 minutes) and with an Emergency Severity Index triage level of 3 (333 versus 355 minutes; median difference 22 minutes; 95% CI 4 to 40 minutes). Conclusion Use of a point-of-care test for a comprehensive metabolic panel reduced ED length of stay compared with central laboratory testing in the adult ED of a single academic center. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-News-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 0196-0644 1097-6760 |
DOI: | 10.1016/j.annemergmed.2012.07.021 |