Implementation of a point-of-care satellite laboratory in the emergency department of an academic medical center. Impact on test XXXX and @entity1 emergency department length of stay.

@entity1 @entity908 @entity341 @entity1054 @entity413
CONTEXT: @entity341 ( @entity341 ) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and @entity341 @entity1 length of stay (LOS). OBJECTIVES: To investigate the impact of a point-of-care testing (POCT) satellite laboratory in the @entity341 of a large academic medical center. SETTING: The @entity341 of the Massachusetts General Hospital, Boston, Mass. DESIGN AND OUTCOME MEASURES: Evaluation of physician satisfaction, @entity1054 ( @entity1054 ), and @entity341 LOS before and after implementation of a POCT laboratory. @entity341 LOS was measured by @entity1 chart audits. @entity1054 was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test @entity1054 and test accuracy. RESULTS: Blood @entity413 , urine @entity1 chorionic gonadotropin, urine dipstick, @entity908 kinase-MB, and troponin tests were performed in the @entity341 POCT laboratory. Test @entity1054 declined an average of 87% after the institution of POCT. The @entity341 LOS decreased for @entity1 who received pregnancy testing, urine dipstick, and cardiac markers. Although these differences were not significant for individual tests, when the tests were combined, the decreased LOS was, on average, 41.3 minutes (P =.006). Clinician satisfaction surveys documented equivalent satisfaction with test accuracy between the central laboratory and the POCT laboratory. These surveys also documented dissatisfaction with central laboratory @entity1054 and increased satisfaction with @entity1054 of the POCT program (P <.001). CONCLUSIONS: The POCT satellite laboratory decreased test @entity1054 and decreased @entity341 LOS. There was excellent satisfaction with test accuracy and @entity1054 .
