Implementation of point-of-care testing and a temporary influenza ward in a Dutch hospital

Area of Science:

• Healthcare Management
• Infectious Disease Control
• Clinical Diagnostics

Background:

• Seasonal influenza epidemics strain hospital resources, leading to capacity issues and financial losses.
• Patient isolation for influenza occupies beds, causing cancellations of admissions and elective surgeries.
• Improving emergency department (ED) patient flow during flu season is crucial for hospital efficiency.

Purpose of the Study:

• To evaluate the impact of a clinical pathway incorporating point-of-care testing (POCT) for influenza on hospital patient flow.
• To assess the effectiveness of POCT in reducing unnecessary patient isolation and improving resource allocation during influenza epidemics.

Main Methods:

• Implementation of a clinical pathway for acute respiratory tract infections in the ED.
• Integration of nurse- and receptionist-operated, PCR-based influenza POCT.
• Establishment of a temporary ward for influenza-positive patients and retrospective observational analysis.

Main Results:

• POCT significantly reduced time from ED presentation to sample collection (194 vs 47 min) and to result (1094 vs 62 min).
• Hospital patient flow improved, with a decreased percentage of admitted influenza-positive patients (91% vs 73%) and shorter lengths of stay (median 5.86 vs 4.61 days).
• Approximately 430 patient-days of unnecessary isolation were prevented over 18 weeks, with estimated savings of €400,000.

Conclusions:

• Hospitals should consider implementing POCT for influenza to enhance patient flow during epidemics.
• The integrated clinical pathway and POCT demonstrate a successful strategy for mitigating the impact of seasonal influenza.
• Optimizing patient flow through rapid diagnostics like POCT can lead to substantial cost savings and improved hospital capacity.