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Published on: February 16, 2011
Healthcare professionals' perspectives on point-of-care testing quality and access in Australian healthcare services:
Jacqueline Prestedge1,2, Alissar El-Murr3, Deborah A Williamson3,4
1Department of Infectious Diseases, The University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia jacqueline.prestedge@unimelb.edu.au.
Objectives:
To explore healthcare professionals' perceptions and experiences with point-of-care testing (PoCT) implementation within Australia's healthcare system and identify potential strategies for effective governance and improvements to regulation and guidelines that facilitate coordinated integration of quality PoCT into healthcare systems.
Design:
A descriptive qualitative study with thematic analysis with codes derived inductively from the transcriptions and a structured framework analysis using the six building blocks of the WHO Health Systems Framework exploring barriers and enablers to PoCT implementation.
Settings:
Healthcare settings in Australia.
Participants:
Healthcare workers with patient care responsibilities and healthcare administrators with oversight or regulatory responsibility for a service. 18 participants were interviewed with four from hospitals, four from primary care, three from community care, three from pathology laboratories, two from emergency care and two from pharmacy settings.
Results:
Healthcare professionals' perspectives on PoCT implementation were grouped into three main themes: (1) community-centric pathology testing, (2) connectivity and continuity of care and (3) quality and governance. Participants identified insufficient health system financing and health information systems as significant barriers to PoCT implementation. Improved practical guidance for workforce training and health service delivery to interpret the current regulation outside of laboratory settings was viewed as a potential enabler to establishing PoCT within healthcare services.
Conclusion:
Participants reflected that Australia has several examples of successful PoCT programmes providing patient-centred pathology to improve healthcare equity. However, the lack of information systems, funding, workforce training and diagnostic strategies prohibits the implementation of PoCT at-scale. It was recommended that adequately financing PoCT to encompass costs for testing, quality management and workforce training would incentivise services to obtain accreditation and ensure quality healthcare delivery. Despite the potential of PoCT to improve equitable healthcare access and patient outcomes, health system strengthening is required to integrate PoCT effectively across Australian healthcare services.
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