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El Assil A, Benkirane S, El Kettani Y, Cherif Chefchaouni A, Mamad H, Rahali Y, Masrar A. Turnaround Time of the Hematology Results of Cancer Patients During the COVID-19 Pandemic: An Opportunity to Initiate a Quality Improvement Process. Cureus 2024; 16:e61149. [PMID: 38933641 PMCID: PMC11200148 DOI: 10.7759/cureus.61149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Turnaround time (TAT) is a crucial clinical parameter that reflects the performance of a laboratory especially in the context of oncology and the COVID-19 pandemic. Based on the Lean Six Sigma methodology, we performed a retrospective analysis of the TAT of the complete blood count (CBC) of cancer patients with the aim of reducing this delay in the future. MATERIALS AND METHODS Over one month of the COVID-19 pandemic, a retrospective evaluative audit was carried out on the TAT of the CBC in an oncology department. The root causes of failures of the overall analysis process were detected. The initiation of an improvement approach was implemented through the creation of an improvement flowchart and a new request form. The hospital information system (HIS) data were exported to Microsoft Excel® (Microsoft Corporation, Redmond, Washington, United States). Using the collected data, the mean, standard deviation, median, and interquartile range were calculated using IBM SPSS Statistics for Windows, Version 23, (Released 2015; IBM Corp., Armonk, New York, United States). All time intervals were expressed in minutes. RESULTS Among 263 intra-laboratory TATs analyzed, the median intra-lab TAT was 56 minutes (interquartile range (IQR): 36-80 minutes). A total of 82% of the analyses were performed in less than 90 minutes with a predominance of the interval 30-59 at 42.9%. The main causes of failures were essentially the lack of time stamping of the samples as well as the lack of real-time communication between the biologists and the clinicians. The proposed improvement model is currently being approved by all practitioners whose main items are as follows: At the clinical department level, distinguish the request forms but also the labels of the samples of the oncology hospital by a particular color, indication of clinical signs and sampling time on the request forms and on the HIS. At the laboratory level, create a specific chain for oncology department samples, alarm notification on the HIS, and rapid telecommunication of results for vital situations. CONCLUSION The intra-lab TAT of our study is biologically acceptable. Because our work is limited by the phases outside the control of the laboratory, it should lead to a continuous improvement project.
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Affiliation(s)
- Asmae El Assil
- Central Laboratory Hematology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Souad Benkirane
- Central Laboratory Hematology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Yasmine El Kettani
- National Institute of Oncology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Ali Cherif Chefchaouni
- National Institute of Oncology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Hassane Mamad
- Central Laboratory Hematology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Younes Rahali
- National Institute of Oncology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
| | - Azlarab Masrar
- Central Laboratory Hematology, Ibn Sina University Hospital Center, Rabat, MAR
- Faculty of Medicine and Pharmacy, Mohammed V University, Rabat, MAR
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Effectiveness of a Mobile App in Reducing Therapeutic Turnaround Time and Facilitating Communication between Caregivers in a Pediatric Emergency Department: A Randomized Controlled Pilot Trial. J Pers Med 2022; 12:jpm12030428. [PMID: 35330427 PMCID: PMC8948631 DOI: 10.3390/jpm12030428] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 01/27/2023] Open
Abstract
For maintaining collaboration and coordination among emergency department (ED) caregivers, it is essential to effectively share patient-centered information. Indirect activities on patients, such as searching for laboratory results and sharing information with scattered colleagues, waste resources to the detriment of patients and staff. Therefore, we conducted a pilot study to evaluate the initial efficacy of a mobile app to facilitate rapid mobile access to central laboratory results and remote interprofessional communication. A total of 10 ED residents and registered nurses were randomized regarding the use of the app versus conventional methods during semi-simulated scenarios in a pediatric ED (PED). The primary outcome was the elapsed time in minutes in each group from the availability of laboratory results to their consideration by participants. The secondary outcome was the elapsed time to find a colleague upon request. Time to consider laboratory results was significantly reduced from 23 min (IQR 10.5–49.0) to 1 min (IQR 0–5.0) with the use of the app compared to conventional methods (92.2% reduction in mean times, p = 0.0079). Time to find a colleague was reduced from 24 min to 1 min (i.e., 93.0% reduction). Dedicated mobile apps have the potential to improve information sharing and remote communication in emergency care.
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Mutema L, Chapanduka Z, Musaigwa F, Mashigo N. In-depth investigation of turn-around time of full blood count tests requested from a clinical haematology outpatient department in Cape Town, South Africa. Afr J Lab Med 2021; 10:1318. [PMID: 34007817 PMCID: PMC8111617 DOI: 10.4102/ajlm.v10i1.1318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 01/06/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The performance of laboratories can be objectively assessed using the overall turn-around time (TAT). However, TAT is defined differently by the laboratory and clinicians; therefore, it is important to determine the contribution of all the different components making up the laboratory test cycle. OBJECTIVE We carried out a retrospective analysis of the TAT of full blood count tests requested from the haematology outpatient department at Tygerberg Academic Hospital in Cape Town, South Africa, with an aim to assess laboratory performance and to identify critical steps influencing TAT. METHODS A retrospective audit was carried out, focused on the full blood count tests from the haematology outpatient department within a period of 3 months between 01 February and 30 April 2018. Data was extracted from the National Health Laboratory Service laboratory information system. The time intervals of all the phases of the test cycle were determined and total TAT and within-laboratory (intra-lab) TAT were calculated. RESULTS A total of 1176 tests were analysed. The total TAT median was 275 (interquartile range [IQR] 200.0-1537.7) min with the most prolonged phase being from authorisation to review by clinicians (median 114 min; IQR: 37.0-1338.5 min). The median intra-lab TAT was 55 (IQR 40-81) min and 90% of the samples were processed in the laboratory within 134 min of registration. CONCLUSION Our findings showed that the intra-lab TAT was within the set internal benchmark of 3 h. Operational phases that were independent of the laboratory processes contributed the most to total TAT.
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Affiliation(s)
- Leonard Mutema
- Department of Haematological Pathology, Tygerberg Hospital, National Health Laboratory Service and Stellenbosch University, Cape Town, South Africa
- Department of Internal Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Zivanai Chapanduka
- Department of Haematological Pathology, Tygerberg Hospital, National Health Laboratory Service and Stellenbosch University, Cape Town, South Africa
| | - Fungai Musaigwa
- Department of Haematological Pathology, Tygerberg Hospital, National Health Laboratory Service and Stellenbosch University, Cape Town, South Africa
| | - Nomusa Mashigo
- Department of Haematological Pathology, Tygerberg Hospital, National Health Laboratory Service and Stellenbosch University, Cape Town, South Africa
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Singh S, Dhawan A, Karhana S, Bhat M, Dinda AK. Quantum Dots: An Emerging Tool for Point-of-Care Testing. MICROMACHINES 2020; 11:E1058. [PMID: 33260478 PMCID: PMC7761335 DOI: 10.3390/mi11121058] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 01/03/2023]
Abstract
Quantum dots (QDs) are semiconductor crystals in the nanodimension having unique optical and electronic properties that differ from bulk material due to quantum mechanics. The QDs have a narrow emission peak, size-dependent emission wavelength, and broad excitation range which can be utilized for diverse biomedical applications such as molecular imaging, biosensing, and diagnostic systems. This article reviews the current developments of biomedical applications of QDs with special reference to point-of-care testing.
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Affiliation(s)
| | | | | | | | - Amit Kumar Dinda
- Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India; (S.S.); (A.D.); (S.K.); (M.B.)
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Leïchlé T, Nicu L, Alava T. MEMS Biosensors and COVID-19: Missed Opportunity. ACS Sens 2020; 5:3297-3305. [PMID: 32975110 PMCID: PMC7574628 DOI: 10.1021/acssensors.0c01463] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/25/2020] [Indexed: 12/18/2022]
Abstract
The acceleration of climatic, digital, and health challenges is testing scientific communities. Scientists must provide concrete answers in terms of technological solutions to a society which expects immediate returns on the public investment. We are living such a scenario on a global scale with the pandemic crisis of COVID-19 where expectations for virological and serological diagnosis tests have been and are still gigantic. In this Perspective, we focus on a class of biosensors (mechanical biosensors) which are ubiquitous in the literature in the form of high performance, sensitive, selective, low-cost biological analysis systems. The spectacular development announced in their performance in the last 20 years suggested the possibility of finding these mechanical sensors on the front line of COVID-19, but the reality was quite different. We analyze the cause of this rendez-vous manqué, the operational criteria that kept these biosensors away from the field, and we indicate the pitfalls to avoid in the future in the development of all types of biosensors of which the ultimate goal is to be immediately operational for the intended application.
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Affiliation(s)
- Thierry Leïchlé
- GeorgiaTech-CNRS Joint
International Laboratory, School of Electrical and Computer
Engineering, Atlanta, Georgia 30332,
United States
- LAAS-CNRS,
Université de Toulouse, CNRS, Toulouse,
31400, France
| | - Liviu Nicu
- LAAS-CNRS,
Université de Toulouse, CNRS, Toulouse,
31400, France
| | - Thomas Alava
- Université Grenoble
Alpes, CEA, LETI, Grenoble 38054,
France
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van den Elsen SH, Sturkenboom MG, Akkerman O, Barkane L, Bruchfeld J, Eather G, Heysell SK, Hurevich H, Kuksa L, Kunst H, Kuhlin J, Manika K, Moschos C, Mpagama SG, Muñoz Torrico M, Skrahina A, Sotgiu G, Tadolini M, Tiberi S, Volpato F, van der Werf TS, Wilson MR, Zúñiga J, Touw DJ, Migliori GB, Alffenaar JW. Prospective evaluation of improving fluoroquinolone exposure using centralised therapeutic drug monitoring (TDM) in patients with tuberculosis (PERFECT): a study protocol of a prospective multicentre cohort study. BMJ Open 2020; 10:e035350. [PMID: 32554740 PMCID: PMC7304807 DOI: 10.1136/bmjopen-2019-035350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Global multidrug-resistant tuberculosis (MDR-TB) treatment success rates remain suboptimal. Highly active WHO group A drugs moxifloxacin and levofloxacin show intraindividual and interindividual pharmacokinetic variability which can cause low drug exposure. Therefore, therapeutic drug monitoring (TDM) of fluoroquinolones is recommended to personalise the drug dosage, aiming to prevent the development of drug resistance and optimise treatment. However, TDM is considered laborious and expensive, and the clinical benefit in MDR-TB has not been extensively studied. This observational multicentre study aims to determine the feasibility of centralised TDM and to investigate the impact of fluoroquinolone TDM on sputum conversion rates in patients with MDR-TB compared with historical controls. METHODS AND ANALYSIS Patients aged 18 years or older with sputum smear and culture-positive pulmonary MDR-TB will be eligible for inclusion. Patients receiving TDM using a limited sampling strategy (t=0 and t=5 hours) will be matched to historical controls without TDM in a 1:2 ratio. Sample analysis and dosing advice will be performed in a centralised laboratory. Centralised TDM will be considered feasible if >80% of the dosing recommendations are returned within 7 days after sampling and 100% within 14 days. The number of patients who are sputum smear and culture-negative after 2 months of treatment will be determined in the prospective TDM group and will be compared with the control group without TDM to determine the impact of TDM. ETHICS AND DISSEMINATION Ethical clearance was obtained by the ethical review committees of the 10 participating hospitals according to local procedures or is pending (online supplementary file 1). Patients will be included after obtaining written informed consent. We aim to publish the study results in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03409315).
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Affiliation(s)
- Simone Hj van den Elsen
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke Gg Sturkenboom
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Onno Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
| | - Linda Barkane
- Department of Multidrug Resistant Tuberculosis, Riga East University Hospital TB and Lung Disease Clinic, Riga, Latvia
| | - Judith Bruchfeld
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Geoffrey Eather
- Department of Respiratory Medicine and Metro South Clinical Tuberculosis Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Scott K Heysell
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA
| | - Henadz Hurevich
- The Republican Scientific and Practical Center for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Liga Kuksa
- Department of Multidrug Resistant Tuberculosis, Riga East University Hospital TB and Lung Disease Clinic, Riga, Latvia
| | - Heinke Kunst
- Department of Respiratory Medicine, Blizard Institute, Queen Mary University of London, Barts Health NHS Trust, London, UK
| | - Johanna Kuhlin
- Division of Infectious Diseases, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Katerina Manika
- Pulmonary Department, Respiratory Infections Unit, G. Papanikolaou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Charalampos Moschos
- Drug-Resistant Tuberculosis Unit, 'Sotiria' Hospital for Chest Diseases, Athens, Greece
| | - Stellah G Mpagama
- Kibong'oto Infectious Diseases Hospital, Kilimanjaro, United Republic of Tanzania
| | - Marcela Muñoz Torrico
- Clínica de Tuberculosis, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | - Alena Skrahina
- The Republican Scientific and Practical Center for Pulmonology and Tuberculosis, Minsk, Belarus
| | - Giovanni Sotgiu
- Department of Medical, Surgical and Experimental Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari, Sassari, Italy
| | - Marina Tadolini
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Simon Tiberi
- Department of Infection, Blizard Institute, Queen Mary University of London, Barts Health NHS Trust, London, UK
| | - Francesca Volpato
- Department of Medical and Surgical Sciences, Unit of Infectious Diseases, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Tjip S van der Werf
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Malcolm R Wilson
- Department of Respiratory Medicine and Metro South Clinical Tuberculosis Service, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Joaquin Zúñiga
- Laboratory of Immunobiology and Genetics, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
- Tecnologico de Monterrey, Escuela de Medicina y Ciencias de Salud, Mexico City, Mexico
| | - Daan J Touw
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Giovanni B Migliori
- Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri IRCCS, Tradate, Italy
| | - Jan-Willem Alffenaar
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Fanshawe TR, Glogowska M, Edwards G, Turner PJ, Smith I, Steele R, Croxson C, Bowen JST, Hayward GN. Pre-analytical error for three point of care venous blood testing platforms in acute ambulatory settings: A mixed methods service evaluation. PLoS One 2020; 15:e0228687. [PMID: 32012203 PMCID: PMC6996845 DOI: 10.1371/journal.pone.0228687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/20/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Point of care blood testing to aid diagnosis is becoming increasingly common in acute ambulatory settings and enables timely investigation of a range of diagnostic markers. However, this testing allows scope for errors in the pre-analytical phase, which depends on the operator handling and transferring specimens correctly. The extent and nature of these pre-analytical errors in clinical settings has not been widely reported. METHODS We carried out a convergent parallel mixed-methods service evaluation to investigate pre-analytical errors leading to a machine error reports in a large acute hospital trust in the UK. The quantitative component comprised a retrospective analysis of all recorded error codes from Abbott Point of Care i-STAT 1, i-STAT Alinity and Abbott Rapid Diagnostics Afinion devices to summarise the error frequencies and reasons for error, focusing on those attributable to the operator. The qualitative component included a prospective ethnographic study and a secondary analysis of an existing ethnographic dataset, based in hospital-based ambulatory care and community ambulatory care respectively. RESULTS The i-STAT had the highest usage (113,266 tests, January 2016-December 2018). As a percentage of all tests attempted, its device-recorded overall error rate was 6.8% (95% confidence interval 6.6% to 6.9%), and in the period when reliable data could be obtained, the operator-attributable error rate was 2.3% (2.2% to 2.4%). Staff identified that the most difficult step was the filling of cartridges, but that this could be improved through practice, with a perception that cartridge wastage through errors was rare. CONCLUSIONS In the observed settings, the rate of errors attributable to operators of the primary point of care device was less than 1 in 40. In some cases, errors may lead to a small increase in resource use or time required so adequate staff training is necessary to prevent adverse impact on patient care.
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Affiliation(s)
- Thomas R. Fanshawe
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Margaret Glogowska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - George Edwards
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Philip J. Turner
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Ian Smith
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Rosie Steele
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | | | - Jordan S. T. Bowen
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Gail N. Hayward
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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Li FF, Xie Y, Shi BY, Niu M, Guo H, Cao Y, Liu BL, Yan RN, Su XF, Wu JD, Zhang DF, Chen LM, Ma JH. The real world of blood glucose point-of-care testing (POCT) system running in China teaching hospital. Expert Rev Med Devices 2018; 15:445-451. [PMID: 29737214 DOI: 10.1080/17434440.2018.1473031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND The blood glucose point-of-care testing (POCT) system is important in the decision-making process involving patients suspected of having hypoglycemia. To investigate the real world of the POCT system being used in teaching hospitals in China. METHODS The survey was conducted by Hisend Research Group from May 2015 to July 2015 in four teaching hospitals in China. The survey questions were referred to the ISO 15197:2013 standard requirements for the use of the POCT system in a hospital setting. RESULTS A total of 170 subjects were included from 4 hospitals, which included nursing staff, nurse unit managers, employees from the department of medical instruments, and staff members employed by the clinical laboratories in the Tianjin Metabolism Hospital, Nanjing First Hospital, First Affiliated Hospital of Dalian Medical University, and the First hospital affiliated with the Xi'an Transportation University. The average score for the four hospitals surveyed in this study was 66.6, which varied from 46.1 to 79.7. The main factors influencing the scores were the multiple choices of blood-glucose meters, and the quality control assessment. CONCLUSION Our data indicates that the real world use of the POCT system in hospital settings in China needs more closer adherence to a quality management framework.
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Affiliation(s)
- Feng-Fei Li
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Yun Xie
- b 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Key Laboratory of Hormone and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology , Tianjin Medical University , Tianjin , China
| | - Bing-Yin Shi
- c Department of Endocrinology , First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , China
| | - Min Niu
- d Department of Endocrinology , First Affiliated Hospital of Dalian Medical University , Dalian , China
| | - Hui Guo
- c Department of Endocrinology , First Affiliated Hospital of Xi'an Jiaotong University , Xi'an , Shaanxi , China
| | - Yan Cao
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Bing-Li Liu
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Reng-Na Yan
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Xiao-Fei Su
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Jin-Dan Wu
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Dan-Feng Zhang
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
| | - Li-Ming Chen
- b 2011 Collaborative Innovation Center of Tianjin for Medical Epigenetics, Key Laboratory of Hormone and Development (Ministry of Health), Metabolic Disease Hospital & Tianjin Institute of Endocrinology , Tianjin Medical University , Tianjin , China
| | - Jian-Hua Ma
- a Department of Endocrinology , Nanjing First Hospital, Nanjing Medical University , Nanjing , China
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Thabit H, Hovorka R. Bridging technology and clinical practice: innovating inpatient hyperglycaemia management in non-critical care settings. Diabet Med 2018; 35:460-471. [PMID: 29266376 DOI: 10.1111/dme.13563] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2017] [Indexed: 12/17/2022]
Abstract
Emerging evidence shows that suboptimal glycaemic control is associated with increased morbidity and length of stay in hospital. Various guidelines for safe and effective inpatient glycaemic control in the non-critical care setting have been published. In spite of this, implementation in practice remains limited because of the increasing number of people with diabetes admitted to hospital and staff work burden. The use of technology in the outpatient setting has led to improved glycaemic outcomes and quality of life for people with diabetes. There remains an unmet need for technology utilisation in inpatient hyperglycaemia management in the non-critical care setting. Novel technologies have the potential to provide benefits in diabetes care in hospital by improving efficacy, safety and efficiency. Rapid analysis of glucose measurements by point-of-care devices help facilitate clinical decision-making and therapy adjustment in the hospital setting. Glucose treatment data integration with computerized glucose management systems underpins the effective use of decision support systems and may streamline clinical staff workflow. Continuous glucose monitoring and automation of insulin delivery through closed-loop systems may provide a safe and efficacious tool for hospital staff to manage inpatient hyperglycaemia whilst reducing staff workload. This review summarizes the evidence with regard to technological methods to manage inpatient glycaemic control, their limitations and the future outlook, as well as potential strategies by healthcare organizations such as the National Health Service to mediate the adoption, procurement and use of diabetes technologies in the hospital setting.
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Affiliation(s)
- H Thabit
- Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - R Hovorka
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Yarmohammadian MH, Rezaei F, Haghshenas A, Tavakoli N. Overcrowding in emergency departments: A review of strategies to decrease future challenges. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2017; 22:23. [PMID: 28413420 PMCID: PMC5377968 DOI: 10.4103/1735-1995.200277] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/07/2016] [Accepted: 11/29/2016] [Indexed: 01/20/2023]
Abstract
Emergency departments (EDs) are the most challenging ward with respect to patient delay. The goal of this study is to present strategies that have proven to reduce delay and overcrowding in EDs. In this review article, initial electronic database search resulted in a total of 1006 articles. Thirty articles were included after reviewing full texts. Inclusion criteria were assessments of real patient flows and implementing strategies inside the hospitals. In this study, we discussed strategies of team triage, point-of-care testing, ideal ED patient journey models, streaming, and fast track. Patients might be directed to different streaming channels depending on clinical status and required practitioners. The most comprehensive strategy is ideal ED patient journey models, in which ten interrelated substrategies are provided. ED leaders should apply strategies that provide a continuous care process without deeply depending on external services.
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Affiliation(s)
- Mohammad H Yarmohammadian
- Health Management and Economics Research Center, Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Rezaei
- Health Management and Economics Research Center, Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Haghshenas
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Nahid Tavakoli
- Health Management and Economics Research Center, Faculty of Management and Medical Informatics, Isfahan University of Medical Sciences, Isfahan, Iran
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Luppa PB, Bietenbeck A, Beaudoin C, Giannetti A. Clinically relevant analytical techniques, organizational concepts for application and future perspectives of point-of-care testing. Biotechnol Adv 2016; 34:139-60. [DOI: 10.1016/j.biotechadv.2016.01.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/15/2016] [Accepted: 01/17/2016] [Indexed: 01/19/2023]
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12
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Mahdaviazad H, Javidialesaadi F, Hosseinzadeh M, Masoompour SM. Turnaround Times for Hematology and Chemistry Tests in the Emergency Department: Experience of a Teaching Hospital in Iran. ACTA ACUST UNITED AC 2016. [DOI: 10.17795/semj37101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Srinivasan B, Tung S. Development and Applications of Portable Biosensors. ACTA ACUST UNITED AC 2015; 20:365-89. [DOI: 10.1177/2211068215581349] [Citation(s) in RCA: 122] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Indexed: 02/01/2023]
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14
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Abel G. Current status and future prospects of point-of-care testing around the globe. Expert Rev Mol Diagn 2015; 15:853-5. [DOI: 10.1586/14737159.2015.1060126] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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15
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Rajendran R, Rayman G. Point-of-care blood glucose testing for diabetes care in hospitalized patients: an evidence-based review. J Diabetes Sci Technol 2014; 8:1081-90. [PMID: 25355711 PMCID: PMC4455482 DOI: 10.1177/1932296814538940] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Glycemic control in hospitalized patients with diabetes requires accurate near-patient glucose monitoring systems. In the past decade, point-of-care blood glucose monitoring devices have become the mainstay of near-patient glucose monitoring in hospitals across the world. In this article, we focus on its history, accuracy, clinical use, and cost-effectiveness. Point-of-care devices have evolved from 1.2 kg instruments with no informatics to handheld lightweight portable devices with advanced connectivity features. Their accuracy however remains a subject of debate, and new standards for their approval have now been issued by both the International Organization for Standardization and the Clinical and Laboratory Standards Institute. While their cost-effectiveness remains to be proved, their clinical value for managing inpatients with diabetes remains unchallenged. This evidence-based review provides an overall view of its use in the hospital setting.
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Bell R, Harr K, Rishniw M, Pion P. Survey of point-of-care instrumentation, analysis, and quality assurance in veterinary practice. Vet Clin Pathol 2014; 43:185-92. [DOI: 10.1111/vcp.12142] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Regan Bell
- College of Veterinary Medicine; Washington State University; Pullman WA USA
| | - Kendal Harr
- Urika, LLC; Mukilteo WA USA
- Veterinary Information Network; Davis CA USA
| | | | - Paul Pion
- Veterinary Information Network; Davis CA USA
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17
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Moore C. Point-of-care tests for infection control: should rapid testing be in the laboratory or at the front line? J Hosp Infect 2013; 85:1-7. [PMID: 23916892 DOI: 10.1016/j.jhin.2013.06.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 06/08/2013] [Indexed: 01/05/2023]
Abstract
BACKGROUND A point-of-care test (POCT) offers a rapid result to manage a patient immediately. The presumed simplicity of such tests belies observed variation between personnel in performing and interpreting results when not appropriately trained. The number of point-of-care devices being developed for the diagnosis of infectious diseases is increasing; by understanding the limitations associated with their use, such tests for infection control purposes may be possible. AIM To review the expanding repertoire of POCTs for the diagnosis of infectious diseases and to assess their utility as tools to aid in the reduction of hospital-acquired infection and outbreak management. METHODS A systematic review using PubMed and Scopus of published literature on the subject of POCTs for the diagnosis of infectious diseases. FINDINGS Although the number of publications describing POCTs is increasing, there remains a paucity of literature describing their use in a clinical setting. Of the literature reviewed, POCTs for the diagnosis of respiratory syncytial virus and norovirus have the greatest utility in an infection control setting, although the data suggest that sensitivity and training issues might be a problem. The future generation of POCT devices is likely to be molecular-based, improving sensitivity but at a significant cost to the user. CONCLUSIONS POCTs have a role in infection control but currently the lack of good, consistent clinical data surrounding their use outside of the laboratory is a limiting factor in their implementation.
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Affiliation(s)
- C Moore
- Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff CF14 4XW, UK.
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18
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Bissonnette L, Bergeron MG. Multiparametric technologies for the diagnosis of syndromic infections. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.clinmicnews.2012.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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19
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Bissonnette L, Bergeron MG. Infectious Disease Management through Point-of-Care Personalized Medicine Molecular Diagnostic Technologies. J Pers Med 2012; 2:50-70. [PMID: 25562799 PMCID: PMC4251365 DOI: 10.3390/jpm2020050] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 04/13/2012] [Accepted: 04/28/2012] [Indexed: 12/13/2022] Open
Abstract
Infectious disease management essentially consists in identifying the microbial cause(s) of an infection, initiating if necessary antimicrobial therapy against microbes, and controlling host reactions to infection. In clinical microbiology, the turnaround time of the diagnostic cycle (>24 hours) often leads to unnecessary suffering and deaths; approaches to relieve this burden include rapid diagnostic procedures and more efficient transmission or interpretation of molecular microbiology results. Although rapid nucleic acid-based diagnostic testing has demonstrated that it can impact on the transmission of hospital-acquired infections, we believe that such life-saving procedures should be performed closer to the patient, in dedicated 24/7 laboratories of healthcare institutions, or ideally at point of care. While personalized medicine generally aims at interrogating the genomic information of a patient, drug metabolism polymorphisms, for example, to guide drug choice and dosage, personalized medicine concepts are applicable in infectious diseases for the (rapid) identification of a disease-causing microbe and determination of its antimicrobial resistance profile, to guide an appropriate antimicrobial treatment for the proper management of the patient. The implementation of point-of-care testing for infectious diseases will require acceptance by medical authorities, new technological and communication platforms, as well as reimbursement practices such that time- and life-saving procedures become available to the largest number of patients.
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Affiliation(s)
- Luc Bissonnette
- Département de microbiologie-infectiologie et d'immunologie, Faculté de médecine, Université Laval, Centre de recherche du CHUQ, 2705 Laurier blvd., Québec City (Québec), G1V 4G2, Canada.
| | - Michel G Bergeron
- Département de microbiologie-infectiologie et d'immunologie, Faculté de médecine, Université Laval, Centre de recherche du CHUQ, 2705 Laurier blvd., Québec City (Québec), G1V 4G2, Canada.
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Gill D, Galvin S, Ponsford M, Bruce D, Reicher J, Preston L, Bernard S, Lafferty J, Robertson A, Rose-Morris A, Stoneham S, Rieu R, Pooley S, Weetch A, McCann L. Laboratory sample turnaround times: do they cause delays in the ED? J Eval Clin Pract 2012; 18:121-7. [PMID: 20860595 DOI: 10.1111/j.1365-2753.2010.01545.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Blood tests are requested for approximately 50% of patients attending the emergency department (ED). The time taken to obtain the results is perceived as a common reason for delay. The objective of this study was therefore to investigate the turnaround time (TAT) for blood results and whether this affects patient length of stay (LOS) and to identify potential areas for improvement. METHODS A time-in-motion study was performed at the ED of the John Radcliffe Hospital (JRH), Oxford, UK. The duration of each of the stages leading up to receipt of 101 biochemistry and haematology results was recorded, along with the corresponding patient's LOS. RESULTS The findings reveal that the mean time for haematology results to become available was 1 hour 6 minutes (95% CI: 29 minutes to 2 hours 13 minutes), while biochemistry samples took 1 hour 42 minutes (95% CI: 1 hour 1 minute to 4 hours 21 minutes), with some positive correlation noted with the patient LOS, but no significant variation between different days or shifts. CONCLUSIONS With the fastest 10% of samples being reported within 35 minutes (haematology) and 1 hour 5 minutes (biochemistry) of request, our study showed that delays can be attributable to laboratory TAT. Given the limited ability to further improve laboratory processes, the solutions to improving TAT need to come from a collaborative and integrated approach that includes strategies before samples reach the laboratory and downstream review of results.
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Affiliation(s)
- Dipender Gill
- Medical Sciences Division, University of Oxford, Oxford, UK
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21
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Kutter APN, Mauch JY, Riond B, Martin-Jurado O, Spielmann N, Weiss M, Bettschart-Wolfensberger R. Evaluation of two devices for point-of-care testing of haemoglobin in neonatal pigs. Lab Anim 2011; 46:65-70. [PMID: 22087030 DOI: 10.1258/la.2011.011086] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In veterinary medicine, point-of-care testing (POCT) techniques have become popular, since they provide immediate results and only small amounts of blood are needed. However, their accuracy is controversial. Pigs are often used for research purposes and accurate measurement of haemoglobin (Hb) is important during invasive procedures. The aim of this study was to evaluate two different Hb POCT devices in neonatal pigs. A prospective study with 57 pigs of 3-6 weeks of age, weighing 4.1-6.2 kg (median 5.1 kg) was performed. Fifty-seven blood samples were analysed for Hb using a conductivity-based and a photometrical POCT device and compared with a photometrical reference method. Statistical analysis was performed with Bland-Altman analysis, Spearman correlation and Passing-Bablok regression analysis. Hb values ranged from 32 to 108 g/L (median 80 g/L) using the reference method. The bias of the photometrical method (HemoCue(®)) to the reference method was -1 g/L, with limits of agreement (LOA) of -7 to 6 g/L. The conductivity-based method (i-STAT(®)) had a bias of -15 g/L with LOA from -24 to -6 g/L. There was a significant association between protein values and the bias of i-STAT versus CellDyn (r(2) = 0.27, P < 0.05) but not with the bias of HemoCue versus CellDyn (r(2) = 0.001, P = 0.79). The lower the protein values were, the lower the Hb values were measured by the i-STAT. The conductivity-based measurement of Hb constantly underestimated Hb values, whereas the photometrical method demonstrated a better accuracy and is therefore more reliable for on-site measurement of Hb in pigs.
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Affiliation(s)
- Annette P N Kutter
- Section of Anaesthesiology, Equine Department, Winterthurerstr. 260, 8057 Zurich, Switzerland.
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Oredsson S, Jonsson H, Rognes J, Lind L, Göransson KE, Ehrenberg A, Asplund K, Castrén M, Farrohknia N. A systematic review of triage-related interventions to improve patient flow in emergency departments. Scand J Trauma Resusc Emerg Med 2011; 19:43. [PMID: 21771339 PMCID: PMC3152510 DOI: 10.1186/1757-7241-19-43] [Citation(s) in RCA: 162] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2011] [Accepted: 07/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. METHODS A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. RESULTS The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. CONCLUSIONS Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.
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Affiliation(s)
- Sven Oredsson
- Department of Emergency Medicine, Helsingborg Hospital, Helsingborg, Sweden.
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Breil B, Fritz F, Thiemann V, Dugas M. Mapping turnaround times (TAT) to a generic timeline: a systematic review of TAT definitions in clinical domains. BMC Med Inform Decis Mak 2011; 11:34. [PMID: 21609424 PMCID: PMC3125312 DOI: 10.1186/1472-6947-11-34] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Accepted: 05/24/2011] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Assessing turnaround times can help to analyse workflows in hospital information systems. This paper presents a systematic review of literature concerning different turnaround time definitions. Our objectives were to collect relevant literature with respect to this kind of process times in hospitals and their respective domains. We then analysed the existing definitions and summarised them in an appropriate format. METHODS Our search strategy was based on Pubmed queries and manual reviews of the bibliographies of retrieved articles. Studies were included if precise definitions of turnaround times were available. A generic timeline was designed through a consensus process to provide an overview of these definitions. RESULTS More than 1000 articles were analysed and resulted in 122 papers. Of those, 162 turnaround time definitions in different clinical domains were identified. Starting and end points vary between these domains. To illustrate those turnaround time definitions, a generic timeline was constructed using preferred terms derived from the identified definitions. The consensus process resulted in the following 15 terms: admission, order, biopsy/examination, receipt of specimen in laboratory, procedure completion, interpretation, dictation, transcription, verification, report available, delivery, physician views report, treatment, discharge and discharge letter sent. Based on this analysis, several standard terms for turnaround time definitions are proposed. CONCLUSION Using turnaround times to benchmark clinical workflows is still difficult, because even within the same clinical domain many different definitions exist. Mapping of turnaround time definitions to a generic timeline is feasible.
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Affiliation(s)
- Bernhard Breil
- Institute of Medical Informatics, University of Münster, Domagkstraße 9, 48149 Münster, Germany.
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Zydron CT, Woodworth A, Storrow AB. The future of point-of-care testing in emergency departments. ACTA ACUST UNITED AC 2011; 5:175-81. [PMID: 23484496 DOI: 10.1517/17530059.2011.567263] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Emergency physicians and administrators continue to face operational challenges as they attempt to increase emergency department (ED) efficiency and throughput to meet the growing demand for emergency health services. Point-of-care (POC) testing technology can provide clinicians with accurate and reliable results with at least a 50% reduction in turnaround time. Despite the near perfect alignment of POC technology goals with ED operational strategy, there has been a relatively slow adoption of comprehensive POC systems. The authors discuss current market trends for the POC products in the ED and review trends in outcomes data (including operational, clinical and financial). The authors also discuss observed managerial obstacles to implementation. The goal of this paper is to provide readers with a business psychology perspective on the current challenges that organizations face in adopting a new technology and provide an evaluation of the key drivers that influence institutional-level decisions to implement an ED-based POC system. The reader will gain an understanding of the dynamic forces that are slowing the adoption of POC technology. Also, the reader is provided with the authors' future perspectives for POC testing in emergency medicine. The current healthcare system is putting a lot of pressure on EDs to be able to provide efficient care using advanced diagnostic tests. Clinicians and administrators alike must understand the gaps between the clinician's perceived benefit of POC testing and the inconsistent literature on the operational and clinical outcomes before adopting POC systems in ED.
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Affiliation(s)
- Courtney T Zydron
- Vanderbilt Medical Center, Department of Emergency Medicine , 703 Oxford House, 1313 21st Avenue South, Nashville, TN 37232-4700 , USA +1 615 936 0093 ; +1 615 936 1316 ;
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Kupstat A, Kumke MU, Hildebrandt N. Toward sensitive, quantitative point-of-care testing (POCT) of protein markers: miniaturization of a homogeneous time-resolved fluoroimmunoassay for prostate-specific antigen detection. Analyst 2011; 136:1029-35. [DOI: 10.1039/c0an00684j] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Bissonnette L, Bergeron MG. Diagnosing infections--current and anticipated technologies for point-of-care diagnostics and home-based testing. Clin Microbiol Infect 2010; 16:1044-53. [PMID: 20670286 DOI: 10.1111/j.1469-0691.2010.03282.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In recent years, we have witnessed many transitions in healthcare systems around the globe. For example, population expansion and ageing, and the human immunodeficiency virus (HIV)-AIDS epidemics, have exerted pressure to decentralize the practice of healthcare outside of traditional settings to bring care to those in need. Upstream of patient management, diagnosis is aimed at adequately orienting medical decisions, and considerable efforts have been made to make this process faster and more efficient. However, there are several diseases and medical conditions that may/will benefit from technologies and tests that can be performed closer to the patient, at the point of care or even in the home. In this review, and in light of the paradox that technology and assay developers and healthcare officials must take into consideration for advancing human health in developed and developing countries, we present an overview of rapid diagnosis of infectious diseases at the point of care and of technologies that may contribute to enhancement of the worldwide point-of-care testing market.
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Affiliation(s)
- L Bissonnette
- Département microbiologie-infectiologie et immunologie, Faculté de médecine, Université Laval, Montreal, Quebec, Canada
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