Clinical Outcomes of Point-of-Care Testing in the Interventional Radiology and Invasive Cardiology Setting

rapid test results, but its impact on patient care is not well documented. We investigated the ability of POCT to decrease inpatient and outpatient waiting times for cardiovascular procedures. Methods: We prospectively studied, over a 7-month period, 216 patients requiring diagnostic laboratory test-ing for coagulation (prothrombin time/activated partial thromboplastin time) and/or renal function (urea nitro-gen, creatinine, sodium, and potassium) before elective invasive cardiac and radiologic procedures. Overall pa-tient management and workflow were examined in the initial phase. In phase 2, we implemented POCT but utilized central laboratory results for patient manage-ment. In phase 3, therapeutic decisions were based on POCT results. The final phase, phase 4, sought to optimize workflow around the availability of POCT. Patient wait and timing of phlebotomy, availability of laboratory results, and therapeutic action were moni-tored. Split sampling allowed comparability of POCT and central laboratory results throughout the study. Results: In phase 1, 44 % of central laboratory results were not available before the scheduled time for proce-dure (n 5 135). Mean waiting times (arrival to proce-dure) were 188 6 54 min for patients who needed renal testing (phase 2; n 5 14) and 171 6 76 min for those needing coagulation testing (n 5 24). For patients need-ing renal testing, POCT decreased patient wait times (phases 3 and 4 combined, 141 6 52 min; n 5 18; P 5 0.02). For patients needing coagulation testing, wait times improved only when systematic changes were made in workflow (phase 4, 109 6 41 min; n 5 12; P 5 0.01). Conclusions: Although POCT has the potential to pro-vide beneficial patient outcomes, merely moving testing from a central laboratory to the medical unit does not guarantee improved outcomes. Systematic changes in patient management may be required