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Point of Care Testing

Laboratory Services

Alberta Health Services provides point of care testing in a number of ways and at a number of locations.

Definition of Point of Care

Point of Care Testing (POCT) refers to those analytical patient testing activities provided outside the physical facilities of the clinical laboratory. POCT may not require permanent dedicated space. POCT is typically performed by clinical personnel whose primary training is not in the clinical laboratory sciences.

Performance Goals of POCT

Performance goals for Point of Care programs will be defined by the AHS POC Network.  The following are some examples:

  • provide accurate and timely analyses
  • provide reports that are useful to the clinician while treating the patient
  • make the best possible use of people, equipment, and reagents in the interest of efficiency
  • manage use of point of care

Standards for Point of Care Testing

Point of Care testing within Alberta Health Services refers to College of Physicians and Surgeons standards and guidelines in relation to Point of Care Testing.

  • CPSA standards (See Section 25 of CPSA Major Laboratory Standards and Guidelines)

Quality Assurance, Quality Management and Risk Management

Quality Assurance (standard 27.6 – CPSA)

A Quality Assurance plan will be defined by the AHS POC Network and will consider the following:

Consensus Performance expectations:
For example:

  • to cover the pre analytical, analytical and post analytical service components
  • to include vigorous consultation with customers, physicians , and other healthcare workers

Consensus Metrics:
For example:

  • periodic audits to determine that the service is meeting established performance expectations
  • performance comparisons to that of a central laboratory
  • periodic review of the service patterns against established benchmarks

Quality Management and Risk Management

The international standard, ISO 22870 Point-of-care – Requirements for quality and competence * introduction states that risk to the patient and to the facility can be managed by a well-designed, fully implemented, Quality Management system that provides for:

  • Evaluation of new or alternative POCT instruments and systems
  • Evaluation and approval of end-user proposals and protocols
  • purchase and installation of equipment
  • maintenance of consumable supplies and reagents
  • training, certification, and recertification of POCT system operators
  • QC and QA

References:
*International Organization of Standardization.  Point-of-care testing (POCT) – requirements for quality and competence, Document ISO 22870:2006.  Geneva, Switzerland: ISO, 2006:11pp.

Data Management and Patient Identification (TBD)

Changes to POCT
If you would like to request a change regarding point of care testing or provide feedback through the Lab Suggestions process, please email labsuggestions@albertahealthservices.ca.

Application of POCT

The application of POCT will be organized into the following clinical areas:

  • Transcutaneous Bilirubin Testing
  • Cardiac Biomarkers for Acute Coronary Syndromes
  • Coagulation
  • Critical Care
  • Diagnosis and Management of Diabetes Mellitus
  • Drugs and Ethanol
  • Infectious Disease
  • Occult Blood
  • Intraoperative Parathyroid Hormone
  • pH Testing
  • Renal Function Testing
  • Reproductive Testing