Illinois, Indiana, and Michigan, our April meeting will provide an
excellent educational opportunity for all who attend.
Quality in the Lab;
Inpatient Hyperglycemia; Connectivity
and More Discussed at the
April 5, 2006
Meeting of the
Tri-State POC Network!
The spring meeting for 2006 was held at the Doubletree Hotel
in Alsip, Illinois on Wednesday, April 5 from 8:30 AM to
4:00 PM. The meeting was attended by 40 registered
healthcare professionals and representatives from: Bayer,
Hemocue, Instrumentation Laboratory, Lifescan, MAS, and
The meeting commenced with opening remarks by Joanne
McEldowney, RN. Members of the core group include: Wendy
Denk, Ingalls Hospital, Harvey, IL; Joanne McEldowney, RN,
Univ of Illinois – Chicago, Chicago, IL; Gil Salas, Univ of
Illinois – Chicago, Chicago, IL.
The session started with a presentation by Nikola Bauman, PhD
from the University of Illinois, Chicago. Her topic,
Quality in the Clinical Laboratory: Points for Quality in
POCT, covered the areas of Laboratory errors from
Pre-analytical to Post-analytical. She said it is hard to
determine the error rate for lab errors but the greatest
percentage of errors (60%) occurs in the pre-analytical
step, followed by 25% post-analytical and 15% analytic.
Examples for pre-analytic: sample integrity, incorrect
order, identification; analytic include equipment, sample
mix-up, interfering substances; post-analytic include
reporting and clerical errors. POCT has more control over
the pre-analytic step, as one person is responsible from
start to finish. However, although the sample transport
issue is eliminated, there are multiple users and
instruments and the quality of the sample is hard to
identify, as the volumes are so small. In the analytic step,
recognizing out of range, QC and knowing what type of QC
material to use can also lead to errors. Post-analytical
errors include improper data entry and the reporting or
analysis of the test result. Sources of POCT errors include
operator incompetence, no adherence to procedure and
uncontrolled reagents and equipment. And how can we make
things better? – continual competence assessment of all
operators, proficiency testing and appropriate quality
Our second speaker, David Baldwin, MD, was sponsored by Roche
and presented: Management of Inpatient Hyperglycemia: How
are we transforming our Academic Medical Center? Dr.
Baldwin presented research data from Rush University Medical
Center and explained the potential benefits of improving
glucose control in the hospital: reduce mortality, reduce
morbidity and reduce costs of care. Based on their
research, they developed insulin protocols for both pre and
post CABG and Inpatient Diabetes Management Guidelines. The
HBA1C is generally used as a monitoring tool but its use is
moving towards being a diagnostic tool and has been found to
be about 80% effective.
The two afternoon sessions focused on connectivity and the
use of middleware and POC. In the first session, Jose
Castanon, Informatics Product Manager with Lifescan,
presented Improving POCT with End-to-End Connectivity.
The steps for Integrated Intelligence include: capture data,
data delivery, transform data, and distribute data. To
capture data, you want to ensure the correct patient so he
recommends implementing the use of barcodes. Data delivery
may be either through a network/modem or wireless network.
To transform the data, you should have a rules based system
with extensive reporting capabilities and
integration/interface. And finally, to distribute data, you
want to provide faster access to information. IT
considerations include: the obsolescence of downtime,
standards and policies, security, and infrastructure.
Our final speaker, Becky Clarke from Telcor, discussed
Middleware and Point of Care. What is middleware? It is
software that serves as an intermediary between system
software and application, such as, interface engines, data
links, BB systems, billing outreach systems and POC
systems. The value of Middleware Solutions include quick
deployment, doesn’t have to change when the LIS changes,
freedom to select “best of breed”. The perfect Middleware
POC Solution is truly open for all testing outside
the laboratory, is hardware independent, is scalable,
provides a commitment for continued product enhancements, is
LIS independent, and offers functionality.
Prior to the conclusion of the day, there was a mini raffle
in which three lucky attendees walked away with a gift.
Congratulations to Linda Voss, Meryl Short and S. Patel!
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