A randomized trial to assess the efficacy of point-of-care testing in decreasing length of stay in a pediatric emergency department

Abstract

Objectives: To compare the effect of point-of-care (POC) testing versus traditional laboratory methods on length of stay in a pediatric emergency department (ED).

Methods: This study was a prospective, randomized, controlled trial of patients solely requiring blood work that a POC device was capable of performing. Two hundred twenty-five patients presenting to a tertiary hospital ED in an urban setting enrolled after informed consent. Of all patients studied, 114 were randomized to the POC group, 111 to routine laboratory analysis. Exact times of critical phases of management and patient flow were recorded by dedicated research assistants. Medical management decisions were made at the discretion of the supervising physicians.

Results: Similar waiting periods were noted in both groups for time spent in the waiting room, time waiting for first physician contact, and time waiting for blood draw. Significantly less time was required for results to become available to physicians when POC testing was used (65.0 minutes; P < 0.001). Significant decrease in overall length of stay was also noted, with patients randomized to the POC group spending an average of 38.5 minutes (P < 0.001) less time in the ED.

Conclusions: Point-of-care testing can significantly decrease the length of stay in select pediatric patients in an ED setting. Point-of-care devices may prove to facilitate patient flow during busiest periods of service demand.