LEÓN JUSTEL, ANTONIO, Bustos C.N. , Noval-Padillo J.A. , Perez S.M. , Gomez M.D.A. , Valencia N.J. , Garrido Castilla J.M. , Muñoz M.D. , Rivera Vizcaino M.A. , Heredia L.A. , Moreno E.G. , Fontan M.E.R. , Mariscal C.B. , Montavez J.M.G. , Sanchez-Mora C.
No
Clin Chem Lab Med
Article
Científica
01/01/2025
2-s2.0-85213331735
Objectives: Emergency department (ED) crowding is a widespread problem that positions patients at risk. The desire to improve the ED throughput requires novel approaches. Point-of-care testing (POCT) has emerged as useful technology that could contribute to create more efficient patient flow and better timeliness in the ED. The main objective of our study is to demonstrate, in a multicenter study, that POCT benefits care timeliness in the ED. Methods: We conducted a multicenter and cluster randomized study. A total of 3,200 patients. We randomly assigned patients to a POCT group or Central Laboratory Group. The primary outcome was the ED time to clinical decision. The secondary outcome included the length of stay and the laboratory turnaround time. Readmission within the seven after discharge was also calculated. Results: The primary finding of this study is a strategy based on POCT that aims to significantly improve care timeliness in the ED. We found significant reductions in all outcomes regardless of presentation reason, patient disposition or hospital type. Time to clinical decision decreased by 75.2 min (205–129.8), length of stay by 77.5 min (273.1–195.6) and laboratory turnaround time by 56.2 min (82.2–26) in the POCT group. No increase in readmission was found. Conclusions: Our strategy represents a good approach to optimize timeliness in the ED. It should be seen as a starting point for further operational research focusing on POCT for improving throughput and reducing crowding in the ED. © 2025 Walter de Gruyter GmbH. All rights reserved.
Adult; Aged; Emergency Service, Hospital; Female; Humans; Length of Stay; Male; Middle Aged; Patient Readmission; Point-of-Care Testing; Time Factors; adult; adverse drug reaction; article; controlled study; crowding (area); diagnosis; emergency ward; female; hospital readmission; human; length of stay; major clinical study; male; multicenter study; point of care testing; randomized controlled trial; side effect; system analysis; timeliness; turnaround time; aged; clinical trial; hospital emergency service; length of stay; middle aged; time factor