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An Integrated Team Approach to POCTAn Integrated Team Approach to POCT
Tony CambridgeTony Cambridge
POCT Co-OrdinatorPOCT Co-Ordinator
Plymouth Hospitals NHS TrustPlymouth Hospitals NHS Trust
The ServiceThe Service 16 Blood Gas Analysers16 Blood Gas Analysers 230 Glucose meters230 Glucose meters 70 Urinalysis sites70 Urinalysis sites 6 Hemocues6 Hemocues 20 Urine Pregnancy sites20 Urine Pregnancy sites 30 INR meters30 INR meters 12 Blood Ketone meters12 Blood Ketone meters Some ESR sites (inc GPs)Some ESR sites (inc GPs)
Activity-Activity- Training and Training and
CompetencyCompetency AuditAudit Quality AssuranceQuality Assurance DocumentationDocumentation Maintenance and Maintenance and
TroubleshootingTroubleshooting Non-conformanceNon-conformance Corrective actionCorrective action
Bragging rights- How big is your Bragging rights- How big is your POCT team?POCT team?
1 person? 3 people? Hundreds of staff?1 person? 3 people? Hundreds of staff? What constitutes a POCT team?What constitutes a POCT team? We can’t fund a team! It’s too expensive.We can’t fund a team! It’s too expensive.
Derriford POCT team – 4.5 wteDerriford POCT team – 4.5 wte Hospital staff >6000, external site staff?Hospital staff >6000, external site staff? How can we govern the service?How can we govern the service?
Pooled ResourcesPooled Resources
Who are the stakeholders?Who are the stakeholders?
Whose responsibility is POCT?Whose responsibility is POCT?
Who should take ownership?Who should take ownership?
Integrated team approachIntegrated team approach
Integrated Team?Integrated Team?
POCT teamPOCT team
UsersUsers
Should they be treated as separate?Should they be treated as separate?
What can the user do to aid the service?What can the user do to aid the service?
Who else should be involved?Who else should be involved?
Who to include?Who to include? POCT teamPOCT team MDLP and cascade MDLP and cascade
trainerstrainers Blood Transfusion Blood Transfusion
Nursing TeamNursing Team Diabetes TeamDiabetes Team Peninsula POCT Peninsula POCT
networknetwork Blood Gas TechniciansBlood Gas Technicians NICU technicianNICU technician
Critical Care TeamCritical Care Team Supplier TrainersSupplier Trainers Medical Equipment Medical Equipment
Management Service Management Service (MEMS)(MEMS)
Training and Training and Development TeamDevelopment Team
Procurement (PPSA)Procurement (PPSA)
The Plymouth Model Incorporates
InfrastructureInfrastructure Trust Clinical Governance Effective Care Group POCT Governance Group
POCT Team
Blood Transfusion Nurses Diabetes Team
Critical Care Team Blood Gas Technicians MEMS Neonatal Team
Training Department Managerial Communication
Peninsula POCT Group Medical Devices Strategy Group Medical Device Link Practitioner Group NICU Equipment Meeting
Communication LinksCommunication Links
Absolutely essentialAbsolutely essential
POCT Governance Group (2 months)POCT Governance Group (2 months) POCT management/clinical team meetings POCT management/clinical team meetings
(regularly)(regularly) MDSG (2 months)MDSG (2 months) MDLP meetings (2 months)MDLP meetings (2 months) NICU Equipment MeetingNICU Equipment Meeting Peninsula POCT meetings (2-3 per year)Peninsula POCT meetings (2-3 per year)
Communication AidsCommunication Aids
Dedicated InboxDedicated Inbox Trust Daily EmailTrust Daily Email Vital Signs- Weekly trust emailVital Signs- Weekly trust email POCT Newsletter- every quarterPOCT Newsletter- every quarter QuestionnaireQuestionnaire Staffnet POCT pageStaffnet POCT page Trust website Pathology POCT pageTrust website Pathology POCT page eLearning systemeLearning system GP LeafletGP Leaflet
Utilising the Existing InfrastructureUtilising the Existing Infrastructure
Time consuming tasks-Time consuming tasks-• TrainingTraining• Competency AssessmentCompetency Assessment• AuditAudit• MaintenanceMaintenance• EQA and IQCEQA and IQC• Non-conformance follow upNon-conformance follow up
TrainingTraining
Daily training performed by POCT staffDaily training performed by POCT staff POCT team participate in clinical education POCT team participate in clinical education
days across the trustdays across the trust Blood Transfusion NursesBlood Transfusion Nurses MDLP and cascade trainers train regularly MDLP and cascade trainers train regularly
and send completed training sheet to POCTand send completed training sheet to POCT Supplier training days, monthlySupplier training days, monthly
CompetencyCompetency
Competency assessed through eLearning for Competency assessed through eLearning for most POCT tests which reduces man hours most POCT tests which reduces man hours requiredrequired
POCT team assess competency as part of POCT team assess competency as part of initial training but also EQA resultsinitial training but also EQA results
Appointed staff on site can also assess Appointed staff on site can also assess competencycompetency
All records held on trust training databaseAll records held on trust training database
AuditAudit
POCT team has an audit calendar in our POCT team has an audit calendar in our QMS (Qpulse)QMS (Qpulse)
Internal/ExternalInternal/External 6 monthly audits by suppliers6 monthly audits by suppliers Blood Transfusion NursesBlood Transfusion Nurses Self audit tools sent outSelf audit tools sent out Findings held in QMS as per CPA Findings held in QMS as per CPA
requirementsrequirements
MaintenanceMaintenance
Some sites have ‘super users’ who are Some sites have ‘super users’ who are trained by POCT to perform some remedial trained by POCT to perform some remedial tasks and troubleshootingtasks and troubleshooting
Connectivity software reduces man hoursConnectivity software reduces man hours Modern equipment requires less Modern equipment requires less
interventionintervention MEMSMEMS
EQA and IQCEQA and IQC
Insist on nominated leads for POCT at each Insist on nominated leads for POCT at each sitesite
Use them to co-ordinate quality assuranceUse them to co-ordinate quality assurance Better complianceBetter compliance More chance of resolving issuesMore chance of resolving issues Essential link between staff and POCT teamEssential link between staff and POCT team
Non-conformance follow upNon-conformance follow up
NCWs raised in QMS against offending siteNCWs raised in QMS against offending site Details sent to nominated individual for Details sent to nominated individual for
actionaction Corrective action taken by users of the Corrective action taken by users of the
serviceservice POCT team monitors future performancePOCT team monitors future performance Actions also generated at POCT Governance Actions also generated at POCT Governance
Group to be addressed by group members, Group to be addressed by group members, not POCT teamnot POCT team
How big is your team?How big is your team?
As large as you want it to beAs large as you want it to be Involve and empower key hospital staffInvolve and empower key hospital staff Get staff to invest their time in POCTGet staff to invest their time in POCT Explain the benefitsExplain the benefits Detail the alternativeDetail the alternative Keep communication links open and activeKeep communication links open and active Praise good performancePraise good performance
