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POCT Team – What the Heck Do They Do?POCT Team – What the Heck Do They Do?
Tony CambridgePOCT Co-Ordinator
Lead BMSPlymouth Hospitals NHS Trust
What is POCT?What is POCT?
Any test performed outside of the traditional laboratory, near the patient, the result of which may change the management of the patient.
A Bit of BackgroundA Bit of Background
2000- POCT section was part of the Chemistry Special Investigations section
2006- POCT section created with a section lead (BMS3), deputy (BMS2), BMS and ATO staff with rotation of BMS staff through the laboratory
2008- Rotation of staff through the POCT team removed
2009- Workforce redesign. Reduction of state registered staff in favour of associate practitioners
2011- Further changes to the team including addition of an ATO
2012- (January) CPA Pre-Assessment visit(July) CPA 2 day Assessment (3 assessors)
2012- (November) Received 3 certificates of accreditation
The ServiceThe Service
16 Blood Gas Analysers 230 Glucose meters (50 Inform
II) 70+ Urinalysis sites 6 Hemocues 20 Urine Pregnancy sites 30 INR meters 15 Blood Ketone meters Some ESR sites (inc GPs)
Activity-Training and CompetencyAuditQuality AssuranceDocumentationMaintenance and TroubleshootingNon-conformanceCorrective action
What Makes An Effective POCT Team?What Makes An Effective POCT Team?
ListenActReviewLearn
Engage
Quality, Safety and Governance
Integrated Team Approach?Integrated Team Approach?
POCT team
Users
Should they be treated as separate?What can the user do to aid the service?
Who else should be involved?
Who to include?Who to include?
POCT teamMDLP and cascade
trainersBlood Transfusion
Nursing TeamDiabetes TeamBlood Gas TechniciansNICU technician
Critical Care TeamSupplier TrainersMedical Equipment
Management Service (MEMS)
Training and Development Team
Procurement (PPSA)Peninsula POCT
network
Governance StructureGovernance Structure
Safety and Quality Committee
Quality Governance and
Improvement Group
POCT Governance Group Medical Devices Strategy Group
POCT Team
EscalationReport
Communication LinksCommunication Links
Absolutely essential
1. Good Clinical and Managerial Support and Engagement2. Belief and Trust3. Clear Plan4. Transparency5. Accountability
POCT Governance Group (2 months) POCT management/clinical team meetings (regularly) MDSG (2 months) MDLP meetings (2 months) NICU Equipment Meeting Peninsula POCT meetings (2-3 per year)
Communication AidsCommunication Aids
Dedicated Inbox Trust Daily Email Vital Signs- Weekly trust email POCT Newsletter- every quarter Questionnaire Staffnet POCT page Trust website Pathology POCT page eLearning system GP Leaflet
Work with suppliersWork with suppliers
We have learned to:Tap into their experience with:
◦Communication aids◦Marketing - CLABS◦Promotion – publications◦Service design◦Optimising connectivity◦Word of mouth ◦Sharing best practice
Utilising the Existing InfrastructureUtilising the Existing Infrastructure
Time consuming tasks-◦Training◦Competency Assessment◦Audit◦Maintenance◦EQA and IQC◦Non-conformance follow up
TrainingTraining
Daily training performed by POCT staff
Clinical education days across the trust
Blood Transfusion Nurses
MDLP and cascade trainers train regularly and send completed training sheet to POCT
Supplier training days, monthly
CompetencyCompetency
Competency assessed through eLearning for POCT tests which reduces man hours required
Competency as part of initial training but also EQA results
Appointed staff can also assess competency
All records held on trust training database (OLM)
AuditAudit
POCT team has an audit calendar in our QMS (Qpulse)
Internal/External
6 monthly audits by suppliers
Self audit tools sent out
Findings held in QMS as per CPA requirements
Datix incidents
MaintenanceMaintenance
Some sites have ‘super users’ who are trained by POCT to perform some remedial tasks and troubleshooting
Connectivity software reduces man hours – looking at next generation data manager software
Modern equipment requires less intervention
MEMS
Currently looking at cartridge based BGAs
EQA and IQCEQA and IQC
Insist on nominated leads for POCT at each site
Use them to co-ordinate quality assurance
Better compliance
More chance of resolving issues
Essential link between staff and POCT team
Non-conformance follow upNon-conformance follow up
NCWs raised in QMS against offending site
Details sent to nominated individual for action
Corrective action taken by users of the service
POCT team monitors future performance
Actions also generated at POCT Governance Group to be addressed by group members, not POCT team
Reviewing EffectivenessReviewing Effectiveness
We perform a periodic review of the POCT service ( every 3 months)
Annual Management Review
Trends in Non-Conformance
Action Plans
Root Cause Analysis
All held in the QMS
Example-
WEQAS set 80% return rate, we set 90% KPI
Training Numbers by Month
Training Numbers by Year
Problems we encounterProblems we encounter
Email: [email protected]
