• Elizabeth Lee-Lewandrowski, Daniel Corboy, Kent Lewandrowski, Julia Sinclair, Steven McDermot, and Theodore I Benzer.
• Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Mass 02114, USA.
• Arch. Pathol. Lab. Med. 2003 Apr 1;127(4):456-60.

ContextEmergency department (ED) overcrowding has reached crisis proportions in the United States. Many hospitals are seeking to identify process reengineering efforts to reduce crowding and ED patient length of stay (LOS).ObjectivesTo investigate the impact of a point-of-care testing (POCT) satellite laboratory in the ED of a large academic medical center.SettingThe ED of the Massachusetts General Hospital, Boston, Mass.Design And Outcome MeasuresEvaluation of physician satisfaction, turnaround time (TAT), and ED LOS before and after implementation of a POCT laboratory. ED LOS was measured by patient chart audits. TAT was assessed by manual and computer audits. Clinician satisfaction surveys measured satisfaction with test TAT and test accuracy.ResultsBlood glucose, urine human chorionic gonadotropin, urine dipstick, creatine kinase-MB, and troponin tests were performed in the ED POCT laboratory. Test TAT declined an average of 87% after the institution of POCT. The ED LOS decreased for patients who received pregnancy testing, urine dipstick, and cardiac markers. Although these differences were not significant for individual tests, when the tests were combined, the decreased LOS was, on average, 41.3 minutes (P =.006). Clinician satisfaction surveys documented equivalent satisfaction with test accuracy between the central laboratory and the POCT laboratory. These surveys also documented dissatisfaction with central laboratory TAT and increased satisfaction with TAT of the POCT program (P <.001).ConclusionsThe POCT satellite laboratory decreased test TAT and decreased ED LOS. There was excellent satisfaction with test accuracy and TAT.

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