Oxford Academic Health Science Network study demonstrates POCT in emergency paediatric units improves quality of care
A study has ruled that the HORIBA Microsemi CRP point-of-care (POC) analyser enables more-rapid clinical decision-making in emergency paediatric units, saving time and reducing costs.
The findings were undertaken and published as a case study by the Oxford Academic Health Science Network (AHSN) and reveal that using POCT as a replacement for laboratory tests resulted in earlier decision-making in approximately 75% of cases across three hospital sites.
Economic analysis across these sites found that this could result in net annual cost savings due to reduced staff time, as well as faster decisions on antibiotic use.
The multi-site evaluation study centred on emergency paediatric units at John Radcliffe Hospital in Oxford, Stoke Mandeville Hospital in Aylesbury, and Wexham Park Hospital in Slough; with the aim of assessing if POCT in such units can improve quality of care.
The AHSN selected HORIBA’s Microsemi CRP as the point-of-care device for evaluation as it is a unique automated analyser able to simultaneously measure C-Reactive Protein (CRP) with full blood count (FBC).
Both parameters are commonly used in conjunction in paediatric emergency care to assist with clinical decision making, CRP being a proxy indicator for the presence, or absence, of bacterial infection.
CRP tests are usually performed in the hospital laboratory and, once the sample is received in the lab, results can take up to 60 to 90 minutes. But the time from needle to result can be considerably longer.
The study found the mean delay between the POCT result and the laboratory result being available was three hours five minutes. Results are available from the Microsemi CRP within four minutes for FBC + CRP, meaning that a decision on subsequent care, including admissions or discharge, can be made far more quickly. For example, for children discharged from Stoke Mandeville Hospital, an earlier decision could have been made in 87% of cases, saving an average of 109 minutes per case.
Prior to use in the study, HORIBA’s Microsemi CRP analyser was validated by the hospital laboratories at all three study sites, which found its CRP and blood count results to be accurate when compared to laboratory values.
Key conclusions from the study found that overall the POC test was useful in decision-making for children with abdominal pain, fever, limp and petechial rash and could have enabled earlier decision-making in 75% of cases. It could also have shortened the time to decision making on antibiotic use.
York Health Economics Consortium undertook the economic analysis across the three hospitals for the study. From this, in addition to finding net cost savings from reduced staff input, there are also potential savings from quicker treatment decisions, when a delay could have adverse effects on a patient’s condition.
Other benefits noted include reduced waiting time for patients, families and carers. This can, in turn, improve patient flow, particularly key at peak times.