Can the Introduction of Point-of-Care Testing for Renal Function in the Emergency Department Reduce Overcrowding?

BACKGROUND: Overcrowding in the emergency department (ED) is a common phenomenon. The aim of this study was to quantify the impact introducing point-of-care testing (POCT) for renal function has on the length of time patients spend in the ED. METHODS: A prospective, observational cohort study was conducted in an ED in the United Kingdom. The study consisted of 2 consecutive phases. Patients that attended the ED during phase 1 had their renal function investigated using the hospital’s centralized laboratory analyzer. Phase 2 patients requiring renal function analysis were investigated in the ED using a bedside POCT analyzer. The time from patient arrival in the ED to the time the patient was ready to move onto the next destination of care was recorded. RESULTS: Twenty-five thousand seven hundred nine patients attended the ED during the whole study period. Ten thousand eight hundred sixty-eight patients were eligible for the study. Phase 1 contained 3835 patients, and phase 2 had 7033 patients. A 15.5% reduction in the median time for patients to be declared ready to leave the ED was demonstrated. The median time for phase 1 was 129 minutes compared with 109 minutes for phase 2 (P = 0.0025). CONCLUSIONS: This study demonstrates that using POCT for renal function in the ED was significantly quicker than using a centralized hospital laboratory. The use of a bedside POCT device enables clinicians to make informed clinical decisions in a timelier manner. This research was supported by a grant from Abbott Point of Care.