Development of an accreditation program for Point of Care Testing (PoCT) in general practice

2011 ◽  
Vol 35 (2) ◽  
pp. 230 ◽  
Author(s):  
Rosy Tirimacco ◽  
Briony Glastonbury ◽  
Caroline O. Laurence ◽  
Tanya K. Bubner ◽  
Mark D. Shephard ◽  
...  

Objectives. To describe the development and evaluation of an accreditation program for Point of Care Testing (PoCT) in general practice, which was part of the PoCT in general practice (GP) Trial conducted in 2005–07 and funded by the Australian Government. Setting and participants. Thirty general practices based in urban, rural and remote locations across South Australia, New South Wales and Victoria, which were in the intervention arm of the PoCT Trial were part of the accreditation program. A PoCT accreditation working party was established to develop an appropriate accreditation program for PoCT in GP. A multidisciplinary accreditation team was formed consisting of a medical scientist, a general practitioner or practice manager, and a trial team representative. Methodology and sequence of events. To enable practices to prepare for accreditation a checklist was developed describing details of the accreditation visit. A guide for surveyors was also developed to assist with accreditation visits. Descriptive analysis of the results of the accreditation process was undertaken. Outcomes. Evaluation of the accreditation model found that both the surveyors and practice staff found the process straightforward and clear. All practices (i.e. 100%) achieved second-round accreditation. Discussion and lessons learned. The accreditation process highlighted the importance of ongoing education and support for practices performing PoCT. What is known about the topic? Currently there is no rebate for Point of Care testing in Australia. Before the Australian Government can consider a rebate it has to be shown that PoCT is safe for patient care. Implementation of a quality framework and an accreditation model for PoCT is vital to ensure that clinical care is not compromised by use of this technology. What does this paper add? This paper provides a model for PoCT accreditation that meets requirements of both the GP and scientific community. It reports on the first government-funded PoCT in general practice trial and illustrates what needs to be considered if the Government decides to fund PoCT in general practice. What are the implications for practitioners? Description of a PoCT accreditation process highlights to practitioners what is entailed in following the interim standards for PoCT currently available. This study is an important piece of work as it shows that PoCT in general practice can be performed safely within a quality framework that meets scientific accreditation requirements.

2009 ◽  
Vol 190 (11) ◽  
pp. 624-626 ◽  
Author(s):  
Tanya K Bubner ◽  
Caroline O Laurence ◽  
Angela Gialamas ◽  
Lisa N Yelland ◽  
Philip Ryan ◽  
...  

Author(s):  
Mark Shephard ◽  
Anne Shephard ◽  
Les Watkinson ◽  
Beryl Mazzachi ◽  
Paul Worley

Background From 2005 to 2007 the Australian Government funded a multicentre, clustered randomized controlled trial to determine the clinical effectiveness, cost-effectiveness, satisfaction and safety of point of care testing (PoCT) in general practice (GP). PoC tests measured (and devices used) in the trial were haemoglobin A1c and urine albumin:creatinine ratio (DCA 2000), lipids (Cholestech LDX) and international normalized ratio (CoaguChek S). Methods An internal quality control (QC) program was developed as part of a quality management framework for the trial. PoCT device operators were provided with a colour-coded QC Result Sheet and QC Action Sheet for on-site recording and interpreting of their results. Within-practice imprecision for QC testing was calculated and compared with the analytical goals for imprecision set prior to the trial. Results The average participation rate for QC testing was 91% or greater. Median within-practice imprecision met the analytical goals for all PoC tests, except for high-density lipoprotein-cholesterol (HDL-C) where observed performance was outside the minimum goal for one level and one lot number of QC. Most practices achieved the imprecision goals for all analytes, with the principal exception of HDL-C. Conclusions Results from QC testing indicate that PoCT in the GP trial met the analytical goals set for the trial, with the exception of HDL-C.


Pathology ◽  
2009 ◽  
Vol 41 ◽  
pp. 18-19
Author(s):  
Justin Beilby ◽  
Caroline Laurence ◽  
Angela Gialamas ◽  
Lisa Yelland ◽  
Tanya Bubner ◽  
...  

Pathology ◽  
2010 ◽  
Vol 42 (2) ◽  
pp. 155-159 ◽  
Author(s):  
Lisa N. Yelland ◽  
Angela Gialamas ◽  
Caroline O. Laurence ◽  
Kristyn J. Willson ◽  
Philip Ryan ◽  
...  

2020 ◽  
Vol 70 (697) ◽  
pp. e555-e562 ◽  
Author(s):  
Simon de Lusignan ◽  
Uy Hoang ◽  
Harshana Liyanage ◽  
Manasa Tripathy ◽  
Ivelina Yonova ◽  
...  

BackgroundMolecular point-of-care testing (POCT) for influenza in primary care could influence clinical care and patient outcomes.AimTo assess the feasibility of incorporating influenza POCT into general practice in England.Design and settingA mixed-methods study conducted in six general practices that had not previously participated in respiratory virology sampling, which are part of the Royal College of General Practitioners Research and Surveillance Centre English sentinel surveillance network, from February 2019 to May 2019.MethodA sociotechnical perspective was adopted using the Public Health England POCT implementation toolkit and business process modelling notation to inform qualitative analysis. Quantitative data were collected about the number of samples taken, their representativeness, and the virology results obtained, comparing them with the rest of the sentinel system over the same weeks.ResultsA total of 312 POCTs were performed; 276 were used for quantitative analysis, of which 60 were positive for influenza and 216 were negative. The average swabbing rate was 0.4 per 1000 population and swab positivity was between 16.7% (n = 14/84) and 41.4% (n = 12/29). Given a positive influenza POCT result, the odds ratio of receiving an antiviral was 14.1 (95% confidence intervals [CI] = 2.9 to 70.0, P<0.001) and of receiving an antibiotic was 0.4 (95% CI = 0.2 to 0.8, P = 0.01), compared with patients with a negative result. Qualitative analysis showed that it was feasible for practices to implement POCT, but there is considerable variation in the processes used.ConclusionTesting for influenza using POCT is feasible in primary care and may improve antimicrobial use. However, further evidence from randomised trials of influenza POCT in general practice is needed.


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