MINUTES FROM OUR DECEMBER 4, 2002 MEETING
at the Radisson Hotel, Merrillville, IN

POC Using the ESA Lead Care Analyzer

Quality Improvement/Quality Assurance in POCT

Vendor Fair

Preparing Your POCT for a CAP Accreditation Inspection

Next Meeting

The third meeting in 2002 of the Tri-State POC Network serving Illinois, Indiana and Michigan took place at the Radisson Hotel in Merrillville, Indiana on Wednesday, December 4, 2002 from 8:00 AM to 3:00 PM.  

The meeting was attended by 60 registered healthcare professionals as well as representatives from the program sponsors and vendors:

The meeting commenced with the introduction of the core group and opening remarks by Darlene Sobucki, founder of the Tri-State POC Network.  

Members of the core group include: 

The first presenter for the day was Barb Jung, sales rep for both the Hemocue and the ESA Lead Care Analyzer.  Barb’s presentation, “POC Using the ESA Lead Care Analyzer”, included why the test is performed, symptoms of the disease, testing schedule, type of specimen used, and available proficiency testing (free through Wisconsin State Labs).  She also sated that less than 20% of Medicaid children are being screened even though testing is required for children 1 – 16 years old. 

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Lou Ann Wyer (sponsored by Abbott Diagnostics) discussed the importance of “Quality Improvement/Quality Assurance in POCT”.  Lou Ann manages 3000 operators in 5 facilities of the Sentara Healthcare System and was named POCC of the Year by AACC. She recommends following the NCCLS Model for Quality Health Plan and to provide an annual survey to the Nursing staff about how the POCT program is doing.

Quality indicators should include High risk/high volume tests and customer service issues. Examples of indicators: patient ID, number of re-runs for either patient testing or QC testing, and dating of reagents.  She also recommends monitoring MD notification of panic results by performing an audit in Medical Records.  As for treatment issues, if treatment is not given within 8 hours based on POCT then the test should be performed in the lab only.

Once a process improvement has been identified, steps need to be taken to demonstrate an action to improve the process.  In her facility, self-learning packets are given in which the employee(s) researches the error, identifies how it occurred, the impact on the patient, and steps to take so the error won’t occur again.  A test is included at the end of the exercise.  Lou Ann also stresses the importance of rewarding success with each demonstrated improvement.  Establishing timeliness is a must.

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From 10:30 to 12:30, attendees visited the twenty-three vendor tables at the Network’s first Vendor Fair.  This was an opportunity to see the various POC testing devices available, try a little hands on, meet the reps, and gather lots of information to take back to the various facilities.  It also gave the vendors the opportunity to learn what is important to the end user.  Kudos to Darlene Sobucki for organizing the event and many thanks to the vendors who participated.

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Following lunch, we listened to Adrienne Malta from CAP present  “Preparing Your POCT for a CAP Accreditation Inspection”.  Adrienne presented at the first Network Meeting in November 2001, so we were thrilled to have her back for our first anniversary.

Adrienne outlined the steps on how to prepare for your inspection, starting with the application all the way to the actual inspection.  As always, proficiency testing and quality control head the list of what an inspector will review, followed by reagents, manuals/procedures and personnel competency records. She recommends mock inspections to determine if any deficiencies exist so corrections can be implemented.

Changes to the November 22, 2002 POCT Checklist include: reorganization of the checklists into 5 sections as well as AMR/CRR changes (Analytic Measurement Range and Clinical Measurement Range). Considerable time was spent with the discussion about  AMR/CRR/Calibration Verification.

New to the checklist is the Physician Performed Testing section which is not the same as the CLIA-88 term ‘provider performed microscopy”.  PPT is defined by CAP as testing that is personally performed by a physician in conjunction with the physical examination or treatment of a patient such as: KOH preparations, amniotic fluid pH, gastric biopsy. Policies that outline the nature and scope of laboratory testing personally performed by the physician need to be written as well as procedure manuals, establishing a QI program, training, credentialing or competency program and result reporting system.

Alternative Test Systems encompasses newer technologies and testing performed by non-traditional analytic methods and specimens, including unusual specimen type (breath testing for H. pylori), in vivo monitoring devices based on traditional specimen types (Bleeding time, blood gases) and no specimen physically removed from a patient (transcutaneous bilirubin measurements). And yes, manuals, QC procedures, etc are required.

The next meeting will be April 2, 2003 at the Radisson Hotel, Merrillville, IN.

Thank you to Wendy Denk, MT (ASCP) for submitting this information.