Move from patient-focused care model to point-of-care testing: transitioning of laboratory services

During the past several years, the Clinical Laboratories of the Lee Memorial Health System (LMHS) have been involved extensively in adjusting the delivery systems for the provision of clinical laboratory services as the industry, competitive market, and health system moved through periods of rapid transition. This environment has allowed the opportunities for laboratory services to be provided through a variety of delivery models: central laboratory, point-of-service testing, and point-of-care testing. The Orthopedic Center at Lee Memorial Hospital was designed as a patient-focused care center and operated as a "mini hospital," housing most of the services required to care for the System's orthopedic patients, including a point-of-service (decentralized) laboratory. LMHS decided to conduct a trial of hand-held chemistry analyzers in the Orthopedic Center. The analyzer's test cost and ease of operation were as expected; however, it was found that the analyzers were not appropriate for continued use in the Orthopedic Center. Responsibility for testing for the Orthopedic Center was returned to the Central Laboratory. With the exception of certain traditional point-of-care procedures, the Central Laboratories now provide laboratory services for all of the facilities' patient care areas.