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Special Reports |

The Laboratory-Clinical Interface*: Point-of-Care Testing

Gerald J. Kost, MD, PhD; Sharon S. Ehrmeyer, PhD; Bart Chernow, MD, FCCP; James W. Winkelman, MD; Gary P. Zaloga, MD; R. Phillip Dellinger, MD, FCCP; Terry Shirey, PhD
Author and Funding Information

*From the University of California (Dr. Kost), Davis, CA; the University of Wisconsin (Dr. Ehrmeyer), Madison, WI; the Johns Hopkins University School of Medicine (Dr. Chernow), Baltimore, MD; Brigham and Women’s Hospital/Harvard Medical School (Dr. Winkelman), Boston, MA; Bowman Gray School of Medicine (Dr. Zaloga), Winston-Salem, NC; Rush-Presbyterian-St. Luke’s Medical Center/Rush Medical College (Dr. Dellinger), Chicago, IL; and NOVA Biomedical (Dr. Shirey), Waltham, MA. Supported, in part, by educational grants from the American College of Chest Physicians and NOVA Biomedical.

Correspondence to: Bart Chernow, MD, FCCP, Vice Dean for Research and Technology, Professor of Medicine, Anesthesia and Critical Care, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Suite 124, Baltimore, MD 21205-2196; e-mail: bchernow@jhmi.edu



Chest. 1999;115(4):1140-1154. doi:10.1378/chest.115.4.1140
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Abbreviations: CAP = College of American Pathologists; CLIA = Clinical Laboratory Improvement Amendments; ED = emergency department; HCFA = Health Care Financing Administration; JCAHO = Joint Commission on Accreditation of Healthcare Organizations; LAP = Laboratory Accreditation Program; LOS = length of stay; NCCLS = National Committee for Clinical Laboratory Standards; OR = operating room; POC = point of care; QA = quality assurance; QC = quality control

Point-of-care (POC) testing refers to the performance of diagnostic testing at or near the site of patient care rather than in the traditional central laboratory. Bedside diagnostic blood testing has been demonstrated1 to be capable of achieving accuracy, rapidity, and usefulness in blood conservation. POC testing is truly a “work in progress” that is affected by numerous regulatory, managerial, quality, and “turf” issues. Sites for POC testing include areas of the hospital that provide care to patients in the most urgent need of rapid diagnosis and therapy. These sites include the emergency department (ED), the operating room (OR), critical care units, and certain outpatient areas.2 Bedside glucose testing is another common form of POC testing. This article focuses on the use of analyzers for patient care testing. Evaluation of monitors such as blood gas monitors is found elsewhere.34

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