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Point of Care Testing to Improve Timeliness of Care for ED Patients requiring CT Scan with Contrast
Leanne Wood RN MS, Nursing Director of the ED; Julie Roby, acting Laboratory Director; Margaret Tully RN MS, ED Nursing Educator; Kathy Davidson RN MS MBA, CNO/COO; Deborah Wayler MD, Director of
Laboratory Services at BID-N; Peter Smulowitz MD, Director of Emergency Services at BID-N
BID-Needham
Introduction/Problem
Patient throughput in Emergency Rooms (ED) is a challenge in ED’s nationwide. Excessive wait times in ED’s
affects safe patient care, efficient patient movement through other hospital departments, and is a significant
patient and family dissatisfier. Numerous process improvement projects have been aimed at reducing the length
of stay in ED’s with varying success.
One of the sources of dissatisfaction cited by patients in the BID-N ED is the wait time for testing and test
resulting.
Turn around times (TAT) for CT with contrast were reviewed for steps in workflow and the associated times at
each step. All CT testing with contrast requires identifying the patient’s creatinine level prior to completing the
study. This process required drawing the lab specimen, sending to the lab and awaiting the lab result value prior
to sending the patient for the CT test. iSTAT, point of care testing device, is a method to test blood creatinine
using the device in the ED. The lab specimen can be drawn by ED staff and the POC testing can provide
accurate results within a much shorter period of time. This can reduce the time to patient ready for CT scanning.
The purpose of this improvement project was to determine if POC creatinine testing could facilitate a more rapid
time to decision-making and CT testing.
The Interventions
Initial baseline turn around time data collected
Orientation and training re: use of iSTAT POC technology
POC testing started September 2016
Regular monitoring of process flow
Ongoing evaluation of the process
TAT for CT with contrast added to ED scorecard monitoring
Results/Progress to Date
Aim/Goal
Overall goal of this project was to reduce the time to CT testing for patients requiring CT with contrast
while maintaining patient safety and clinical outcome.
• Maintain accuracy of lab results
• Reduce wait time for test resulting
• Facilitate more efficient ED throughput, including time to discharge and time to admit patients from the
ED
• More time-efficient decisions re: consultations
• More timely dispositions to inpatient services, OR, home
• Improved overall throughput in ED
• Improved patient satisfaction
The Team
Leanne Wood RN MS, Nursing Director of the ED; Julie Roby, acting Laboratory Director; Margaret Tully RN
MS, ED Nursing Educator; Kathy Davidson RN MS MBA, CNO/COO; Deborah Wayler MD, Director of
Laboratory Services at BID-N; Peter Smulowitz MD, Director of Emergency Services at BID-N
•
•
•
•
•
Successful implementation of POC testing
Even with steadily increased patient volume in ED, TAT for CT with contrast decreased
Over 18 months, overall TAT decreased by > 12%
Accuracy of POC testing consistent and reliable
Time to discharge time improved
For more information, contact:
Leanne Wood RN,MS lwood3@bidneedham.org
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Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Silverman Symposium
Description
An account of the resource
Each year the Silverman Symposium poster session offers BIDMC staff and affiliates the opportunity to share experiences and learn about efforts to improve Quality and Safety.
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Silverman Poster
Primary Contact
If you would like more information about this project, contact this person. Make email address clickable.
Leanne Wood (<a href="mailto:lwood3@bidneedham.org">lwood3@bidneedham.org</a>)
Department
Any departments listed on the poster or identified in the spreadsheet.
Quality and Safety
Laboratory Services
Emergency Department
Nursing
BIDMC Location
The BIDMC location where the poster team resides if identified in spreadsheet. If not identified, choose BIDMC.
BID-Needham
Project Team
Leanne Wood
Julie Roby
Margaret Tully
Kathy Davidson
Deborah Wayler
Peter Smulowitz
Carolyn Gifford
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Point of Care Testing to Improve Timeliness of Care for Patients Requiring CT Scan with Contrast
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
Format
The file format, physical medium, or dimensions of the resource
pdf
Effectiveness
Efficiency
Patient and Family-Centeredness
Safety
Timeliness