Point-of-Care Testing in the Private Hospital Setting in Thailand: A Status Report From the Phyathai Two Hospital

Abstract

To promote appropriate point-of-care testing (POCT) in private Thai hospitals, the authors evaluated a model of POCT operations in Phyathai Two Hospital, a medium-size private hospital with a 350-bed capacity and approximately 1500 outpatient visits per day. They started POCT for blood glucose testing in all clinical areas including critical care. They then added blood gas analysis and activated clotting time in the cardiac care unit and operating room. They also provided hematocrit in the intensive care unit. All POCT instruments were registered and tested for precision and accuracy before implementation. They provided all the sites with a standard operating procedure, together with the reporting and billing system, written quality control manual, personnel training, and maintenance scheduling. Laboratory coordinators were arranged to visit every POCT site periodically and as needed. The authors found that their POCT model was easy to manage and beneficial in providing rapid, precise, and accurate test results for therapeutic decisions. However, POCT needed a well-organized team and required the cooperation of doctors, nurses, and laboratory personnel. Laboratory personnel have to provide training for nurses and visit POCT sites periodically for daily quality control and maintenance. The authors suggest that doctors request POCT only when medically necessary. Nurses are required to perform tests and report the results to doctors. In addition, the authors established the need for a POCT committee composed of doctors, nurses, laboratory personnel, and an executive administrator. Furthermore, medical and economic efficiency should be studied.