Recommendations for the integration of standardized quality indicators for glucose point-of-care testing

Quality indicator (QI) monitoring is essential to quality assurance for point of care testing (POCT). QI standardization is needed in the POCT field to provide clear guidance to hospitals and produce National and International benchmarks. A central aim was to standardize POCT QIs with existing QIs of the MQI program recommended by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) for central laboratory testing for integration in Comparison programs.

Process mapping and risk assessment of the POC glucose testing process were used to establish potential QI. Group consensus was used to rank each potential QI based on the ability to retrieve data for the specific QI. Higher scores were attributed to QI where data could be retrieved electronically and automatically. The highest scoring QI were chosen for follow-up. Members of the working group (authors) were asked to submit data from their own institutions for each QI to evaluate the feasibility of monitoring each QI and to develop preliminary benchmarks.

Five QI recommendations are provided for glucose POCT, including: positive patient identification, operator training, internal quality control monitoring, external quality assessment and critical results follow-up. Preliminary QI data are presented along with implementation strategies and challenges associated with each recommended QI.

This study builds upon previous work by the Canadian Society of Clinical Chemists in developing a process to establish QIs for POCT based on process mapping and risk assessment. The recommended QIs are applicable to most other types of POCT, in addition to glucose testing.