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. 2023 Aug 3;18(8):e0288906.
doi: 10.1371/journal.pone.0288906. eCollection 2023.

Point-of-care PCR testing of SARS-CoV-2 in the emergency department: Influence on workflow and efficiency

David Fistera  1 , Katja Kikull  2 , Joachim Risse  1 , Anke Herrmann  3 , Matthias Brachmann  2 , Clemens Kill  1
Affiliations

Point-of-care PCR testing of SARS-CoV-2 in the emergency department: Influence on workflow and efficiency

David Fistera et al. PLoS One. .

Abstract

Problem: Regarding transmissible viral diseases such as those caused by SARS-CoV-2 virus, one of the key challenges is isolation management until final diagnosis. This study investigates the influence of SARS-CoV-2 point-of-care (POC) PCR on workflow and efficiency in an emergency department (ED) of a tertiary university hospital.

Method: An analysis of 17,875 ED patients receiving either SARS-CoV-2 POC PCR (rapid PCR, 11,686 patients) or conventional laboratory SARS-CoV-2 PCR (conventional PCR, 6,189 patients) was performed. The pathways for both groups were mapped and compared, and process times from admission to diagnosis were measured. Effects on resource management within the ED were quantified. Direct costs due to isolation, loss of capacities, and revenues were calculated for inpatients.

Results: The mean time from admission to result was 1.62 h with rapid PCR and 16.08 h with conventional PCR (p < 0.01), reducing the isolation time by 14.46 h. In the first 2 h after testing, test results were available for > 75% of the rapid PCR group and none of the conventional PCR group. Ninety percent of the results were available within 3 h for the rapid PCR and within 21 h for the conventional PCR group. For the conventional PCR group, an increase in direct costs of €35.74 and lost revenues of €421.06 for each inpatient case was detected.

Conclusion: Rapid PCR significantly reduces the time-to-results and time for isolation relative to conventional PCR. Although testing costs for rapid PCR are higher, it benefits workflow, reduces total costs, and frees up ward capacity.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Two diagnostic pathways for ED patients with conventional PCR vs. rapid PCR.
CT = computed tomography; ED = Emergency Department; MTS = Manchester triage Scale; PCR = Polymerase chain reaction.
Fig 2
Fig 2. Cumulated percentage of test results in specific periods.
Fig 3
Fig 3. Cost comparison of one inpatient in different cost categories.
See this image and copyright information in PMC

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