Evaluation of rapid point-of-care creatinine testing in the radiology service of a large academic medical center: Impact on clinical operations and patient disposition

2012 ◽  
Vol 413 (1-2) ◽  
pp. 88-92 ◽  
Author(s):  
Elizabeth Lee-Lewandrowski ◽  
Connie Chang ◽  
Kimberly Gregory ◽  
Kent Lewandrowski
Keyword(s):  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Patient Disposition ◽  
Radiology Service ◽  
Academic Medical

scholarly journals The Accuracy of Point-of-Care Creatinine Testing in the Emergency Department

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Moises Moreno ◽  
Adam Schwartz ◽  
Ronald Dvorkin
Keyword(s):  
Emergency Department ◽  
Risk Stratification ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Risk Category ◽  
Sample Population ◽  
Significant Discrepancy ◽  
Academic Medical

Objective. To determine the accuracy of Point-Of-Care testing (PoCT) creatinine values when compared to standard central laboratory testing (IDMS) and to demonstrate if and how a discrepancy could lead to improper risk stratification for contrast induced nephropathy (CIN). Methods. We conducted a descriptive retrospective chart review of patients seen in the Emergency Department of a single suburban, community, and academic medical center. We included patients who presented to the department between March 2013 and September 2014 who had blood samples analyzed by both PoCT and IDMS. Results. Mean IDMS creatinine values were 0.23 mg/dL higher when compared with i-Stat values. 95% of the time, the IDMS creatinine value was variable and ranged from −0.45 mg/dL to +0.91 mg/dL when compared to the i-Stat creatinine. When using i-Stat creatinine values to calculate GFR, 47 out of 156 patients had risk category variations compared to using the IDMS value. This affected 30.1% of the total eligible sample population (22.9% to 37.3% with 95% CI). Conclusion. We found a significant discrepancy between PoCT and IDMS creatinine values and found that this discrepancy could lead to improper risk stratification for CIN.

Implementation of a Point-of-Care Satellite Laboratory in the Emergency Department of an Academic Medical Center

2003 ◽  
Vol 127 (4) ◽  
pp. 456-460 ◽  
Author(s):  
Elizabeth Lee-Lewandrowski ◽  
Daniel Corboy ◽  
Kent Lewandrowski ◽  
Julia Sinclair ◽  
Steven McDermot ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Test Accuracy ◽  
Central Laboratory ◽  
Urine Dipstick ◽  
Academic Medical ◽  
Clinician Satisfaction ◽  
Satisfaction Surveys

Abstract Context.—Emergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS). Objectives.—To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center. Setting.—The ED of the Massachusetts General Hospital, Boston, Mass. Design and Outcome Measures.—Evaluation of physician satisfaction, turnaround time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy. Results.—Blood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase–MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decreased for patients who received pregnancy testing, urine dipstick, and cardiac markers. Although these differences were not significant for individual tests, when the tests were combined, the decreased LOS was, on average, 41.3 minutes (P = .006). Clinician satisfaction surveys documented equivalent satisfaction with test accuracy between the central laboratory and the POCT laboratory. These surveys also documented dissatisfaction with central laboratory TAT and increased satisfaction with TAT of the POCT program (P < .001). Conclusions.—The POCT satellite laboratory decreased test TAT and decreased ED LOS. There was excellent satisfaction with test accuracy and TAT.

Description of a point-of-care testing program in a large urban academic medical center: Technologies, management and program cost

2021 ◽  
Vol 522 ◽  
pp. 127-131
Author(s):  
Elizabeth-Lee Lewandrowski ◽  
Kimberly Gregory ◽  
Jeannette Le ◽  
Lee Goldstein ◽  
Kent Lewandrowski
Keyword(s):  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Point Of Care Testing ◽  
Testing Program ◽  
Program Cost ◽  
Academic Medical

scholarly journals Implementation of Point-of-Care Rapid Urine Testing for Drugs of Abuse in the Emergency Department of an Academic Medical Center

2008 ◽  
Vol 129 (5) ◽  
pp. 796-801 ◽  
Author(s):  
Kent Lewandrowski ◽  
James Flood ◽  
Christine Finn ◽  
Bakhos Tannous ◽  
Alton B. Farris ◽  
...  
Keyword(s):  
Emergency Department ◽  
Drugs Of Abuse ◽  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Academic Medical ◽  
Urine Testing

scholarly journals A Survey from a Large Academic Medical Center

2015 ◽  
Vol 06 (02) ◽  
pp. 305-317 ◽  
Author(s):  
J.M. Homan ◽  
J.J. Cimino ◽  
S.G. Peters ◽  
B.W. Pickering ◽  
V. Herasevich ◽  
...  
Keyword(s):  
Medical Center ◽  
Point Of Care ◽  
Academic Medical Center ◽  
Original Research ◽  
Literature Searching ◽  
Knowledge Resources ◽  
Patient Interaction ◽  
Literature Searches ◽  
Academic Medical ◽  
Clinical Scenarios

Summary Objective: To better understand the literature searching preferences of clinical providers we conducted an institution-wide survey assessing the most preferred knowledge searching techniques. Materials and Methods: A survey regarding literature searching preferences was sent to 1862 unique clinical providers throughout Mayo Clinic. The survey consisted of 25 items asking respondents to select which clinical scenarios most often prompt literature searches as well as identify their most preferred knowledge resources. Results: A total of 450 completed surveys were returned and analyzed (24% response rate). 48% of respondents perform literature searches for more than half of their patient interactions with 91% of all searches occurring either before or within 3 hours of the patient interaction. When a search is performed 57% of respondents prefer synthesized information sources as compared to only 13% who prefer original research. 82% of knowledge searches are performed on a workstation or office computer while just 10% occur on a mobile device or at home. Conclusion: Providers in our survey demonstrate a need to answer clinical questions on a regular basis, especially in the diagnosis and therapy domains. Responses suggest that most of these searches occur using synthesized knowledge sources in the patient care setting within a very short time from the patient interaction. Citation: Ellsworth MA, Homan JM, Cimino JJ, Peters SG, Pickering BW, Herasevich V. Point-of-care knowledge-based resource needs of clinicians: A survey from a large academic medical center. Appl Clin Inf 2015; 6: 305–317http://dx.doi.org/10.4338/ACI-2014-11-RA-0104

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