Plenary Session – Bringing Laboratory Medicine to the Patient
Science Out of The Hospital into the Community – Was I Mad?
Dr Nicky Fleming, Consultant, Biomedical Scientist, Primary Care NHS
Developing scientific services in primary care has been pioneering work, and starting 24 years ago was step into the unknown. The services had to be: necessary, make a positive difference to the patients, and be of the same high quality as hospital based services. Change can be challenging, scary, exasperating, and ultimately very rewarding. Wherever I have developed and implemented new services the outcomes have been beneficial to the patients, to the commissioners, the GPs, the nurses and the medical support staff. It has been worth it! I believe passionately Healthcare scientists should be a driving force in healthcare provision – we have so much to offer.
Think like a Patient, Act like a Taxpayer
Ann O’Shea, Head of Service, Primary Care and Community Healthcare Dublin South, Kildare and West Wicklow
In this presentation I will cover my own background as a Medical Laboratory Scientist and refresh and remind people what the life of a Medical Laboratory Scientist was like in the 80’s. The current role I hold is in Community Services and in this presentation I will define what this service entails in terms of HSE service provision. I will outline the structures currently in place for the delivery of Community services and give more detail on what is involved in the Primary Care Directorate.
I will discuss my work and experience to date on the Diagnostics in Community proposal and look forward to the Sláinte Care report in terms of what this means for service users outside the Acute Hospitals. Will we all as healthcare service providers, managers and policy makers manage to Act like the patient and Think like the Taxpayer? That is the question.
Point of Care- National Perspective
Ber Jackson, POCT Manager, Naas General Hospital
Point of Care testing covers any analysis performed outside of the laboratory setting. It is typically performed by non laboratory trained staff including medical, nursing, pharmacist, physiotherapist and the patient may also perform self testing. The settings include sites within the acute hospital, in the community in Pharmacies, GP practices and testing may also occur at National Events or in workplaces provided by agencies such as Irish Heart Foundation.
Growth in the in vitro diagnostics area has provided a myriad of testing equipment and analyses. The testing equipment can range from complex multi analyses such as blood gas equipment and small benchtop analysers to single use cartridge devices which are then disposed. Complexity of the devices for testing invariably means that they are more costly than analyses performed in a central laboratory. Testing at the bedside can provide rapid results in emergency settings to guide treatment. However, there are assumptions that the service is underpinned by a quality management system as exists in the laboratory, the users are trained in the use of the equipment and the result will be comparable to a similar test performed in the laboratory.
While extensive guidance publications exist, unfortunately quality management systems for Point of Care testing are in place in only a few acute sites and governance is more often adhoc without any designated coordinator and generally incorporated into the workload of already stretched Clinical Chemistry Departments.