Design, implementation and initial assessment of the Northern Territory Point‐of‐Care Testing Program

• Published in: The Australian journal of rural health Vol. 20; no. 1; pp. 16 - 21
• Main Authors: Shephard, Mark D.S, Spaeth, Brooke, Mazzachi, Beryl C, Auld, Malcolm, Schatz, Steven, Loudon, John, Rigby, Janet, Daniel, Vinod
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.02.2012; Wiley Subscription Services, Inc
• Subjects: Acutely; Efficacy; First year; governance; Health care facilities; health care workers; Health centres; Health facilities; Humans; i-STAT; Laboratories; Northern Territory; Nursing; Occupational health; Operators; Pathology; patients; point-of-care; Point-of-Care Systems - standards; Point-of-Care Systems - utilization; Program Development; remote; Retention; Rural Health Services; satisfaction; Service provision; stakeholders; Statistical analysis; surveys; Territories; Territory; Viability; Northern Territory
• ISSN: 1038-5282; 1440-1584
• DOI: 10.1111/j.1440-1584.2011.01243.x

Objective: The objective of the study was to improve pathology services in selected remote health centres from the Northern Territory (NT) through the implementation of a quality managed point‐of‐care pathology testing (POCT) service. Design: Study of the efficacy of the POCT service after 1 year and qualitative survey of POCT device operators. Setting: The study was set in thirty‐three remote health centres in the NT administered by the NT Department of Health. Participants: Remote health centre staff at participating remote health centres participated in the study. Interventions: The introduction of the i‐STAT device to perform on‐site POCT. Main outcome measures: The main outcome measures used in the study were the number of remote staff trained, volume of testing performed and satisfaction of POCT device operators. Results: One hundred and sixty‐four health professional staff were trained to perform i‐STAT POCT during the first year of the program. A total of 2290 POCT tests were performed on the i‐STAT. The volume of testing consistently increased across the year. Tests for international normalised ratio were the most frequently performed (averaging 70 tests per month). Stakeholder satisfaction with the i‐STAT device was high, with a statistically significant improvement in satisfaction levels with pathology service provision being reported after the introduction of POCT. Greater than 80% of respondents stated POCT was more convenient than the laboratory service and assisted in the stabilisation of acutely ill patients. Conclusions: The NT POCT Program has been operationally effective and well received by staff working as i‐STAT POCT operators in remote health centres. Retention of remote health centre staff is the most significant challenge to ensuring the program's long‐term viability.