Point-of-care testing may reduce length of stay but not emergency department crowding

摘要

It seems intuitive that point-of-care testing should reduce emergency department (ED) length of stay for patients requiring blood tests and that this should reduce ED crowding. However, empirical evidence is required to determine whether theoretical promise is borne out in practice. Well-powered randomized trials are usually the best way of demonstrating the effect of changes in practice but are challenging to undertake. The authors of the related article deserve great credit for completing this large robust study that provides an unbiased and precise estimate of the effect of using point-of-care testing on length of stay in their institution. They have shown that a 46-minute reduction in median turnaround time translates into a 22-minute reduction in length of stay. Many other factors influence length of stay, so it is perhaps not surprising that the effect of reduced turnaround times is attenuated. Indeed, as described in the discussion, other trials of point-of-care testing have shown that reduced turnaround times are often not translated into reduced length of stay. This suggests that the effect of point-of-care testing varies between settings and depends on the extent to which other factors influence length of stay.