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Point-of-care testing in the overcrowded emergency department - can it make a difference?
Intensive Care Unit, Royal Alexandra Hospital and University of the West of Scotland, UK .
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care in Linköping.
2014 (English)In: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 18, no 6, 692- p.Article, review/survey (Refereed) Published
Abstract [en]

Emergency departments (EDs) face several challenges in maintaining consistent quality care in the face of steadily increasing public demand. Improvements in the survival rate of critically ill patients in the ED are directly related to the advancement of early recognition and treatment. Frequent episodes of overcrowding and prolonged waiting times force EDs to operate beyond their capacity and threaten to impact upon patient care. The objectives of this review are as follows: (a) to establish overcrowding as a threat to patient outcomes, person-centered care, and public safety in the ED; (b) to describe scenarios in which point-of-care testing (POCT) has been found to ameliorate factors thought to contribute to overcrowding; and (c) to discuss how POCT can be used directly, and indirectly, to expedite patient care and improve outcomes. Various studies have shown that overcrowding in the ED has profound effects on operational efficiency and patient care. Several reports have quantified overcrowding in the ED and have described a relationship between heightened periods of overcrowding and delays in treatment, increased incidence of adverse events, and an even greater probability of mortality. In certain scenarios, POCT has been found to increase the number of patients discharged in a timely manner, expedite triage of urgent but non-emergency patients, and decrease delays to treatment initiation. This review concludes that POCT, when used effectively, may alleviate the negative impacts of overcrowding on the safety, effectiveness, and person-centeredness of care in the ED.

Place, publisher, year, edition, pages
2014. Vol. 18, no 6, 692- p.
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Clinical Medicine Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-115910DOI: 10.1186/s13054-014-0692-9ISI: 000355092500105PubMedID: 25672600Scopus ID: 2-s2.0-84924274597OAI: oai:DiVA.org:liu-115910DiVA: diva2:797333
Available from: 2015-03-23 Created: 2015-03-23 Last updated: 2017-12-04

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Schilling, Ulf Martin

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