Introducing point-of-care testing into a rural hospital setting: thematic analysis of interviews with providers

Abstract

INTRODUCTION: Hauora Hokianga Enterprises Trust, an integrated Primary Health Organisation (PHO), which provides primary and intermediate/secondary care to a remote rural community, introduced point-of-care (POC) testing at Rawene Hospital in June 2008. Previously, all laboratory tests were undertaken in Whangarei, with a one to three day turn-around for results. This study aimed to identify the perceived impact of POC testing on clinicians and the community. METHOD: Face-to-face interviews were conducted with 13 health professionals working at Rawene Hospital. The qualitative data analysis computer programme Atlas.ti v5.2 was used to assist the thematic analysis. FINDINGS: Three overall themes captured the main issues with introducing POC testing: (1) POC testing increased clinicians’ confidence, certainty and assurance in their daily practice; (2) POC testing improved diagnostic certainty and this impacted on patients and their families/whanau; (3) the challenges associated with POC testing included increased workload, pressure to up-skill, over-testing, and continuing professional education gaps. CONCLUSION: POC testing is an invaluable technological adjunct for improving clinical decisions and culturally safe care provided to a remote rural community, but it brings challenges to care providers in managing higher workloads and pressures to up-skill. POC testing can improve the acute medical care (access and quality) provided to an economically-deprived, predominantly Maori, rural community. KEYWORDS: Hospitals, rural; point-of-care systems; rural health