Sustained quality and service delivery in an expanding point-of-testing network in remote Australian Primary Health Care

Susan J Matthews, Brooke Spaeth, Lauren Duckworth, Janet N Richards, Emma Prisk, Malcolm Auld, Tina Quirk, Rodney Omond, Mark D. S. Shephard

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Context.-Since 2008, the Northern Territory Point-of-Care Testing Program has improved patient access to pathology testing for acute and chronic disease management for remote health services. Objective.-To evaluate the analytical quality, service delivery, and clinical utility of an expanding remote point-of-care testing network. Design.-Four years (2016-2019) of data on analytical quality, test numbers, and training statistics and 6 months of clinical point-of-care testing data from Abbott i-STATs at remote health services throughout the Northern Territory were analyzed to assess analytical performance, program growth, and clinical utility. Results.-From 2016 to 2019, point-of-care test numbers increased, with chemistry and blood gas testing more than doubling to 8500 and 6000 tests, respectively, troponin I testing almost doubling (to 6000), and international normalized ratio testing plateauing at 8000 tests. Participation in quality control and proficiency testing was high, with quality comparable to laboratory-based analytical goals. A shift toward flexible training and communication modes was noted. An audit of point-of-care test results demonstrated elevated creatinine, associated with chronic kidney disease management, as the most common clinically actionable patient result. Conclusions.-The Northern Territory Point-of-Care Testing Program provides high quality point-of-care testing within remote primary health services for acute and chronic patient management and care. Clinical need, sound analytical performance, flexibility in training provision, and effective support services have facilitated the sustainability of this expanding point-of-care testing model in the remote Northern Territory during the past 11 years.

    Original languageEnglish
    Article number2020-0107-OA
    Pages (from-to)1381-1391
    Number of pages11
    JournalArchives of Pathology and Laboratory Medicine
    Volume144
    Issue number11
    DOIs
    Publication statusPublished - Nov 2020

    Keywords

    • Point-of-care testing
    • Northern Territory (NT)
    • acute disease
    • Sustainable
    • remote
    • Australian
    • Primary health care

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