Point of Care Testing Services Delivery: Policy Analysis using a Nigerian Tertiary Institution.

Abstract

Background: For many years, all or majority of laboratory testing was performed in central laboratories. This was necessary due to complexity of testing. However, with computer technology and the need to reduce turnaround time of results, testing has emerged from the laboratory to the patient’s bedside, pharmacy, physician’s office, home etc. This testing is called point of care testing (POCT).With this move outside the laboratory walls, some problems are bound to occur that were hitherto exist in the laboratory. The service providers (hospital management) and the testing personnel are faced with the task of trying to explain these problems.

Objective of the study: To critically do a policy analysis of the problems of point of care testing with the aim of identifying the causes of these problems and make recommendations to the policy makers. Setting: The Niger Delta University Teaching Hospital, a tertiary Institution in Nigeria.

Method: Anderson’s normative policy analysis model was used to analyze the policy guidelines and procedures of sample collection, analysis and generation of results.

Results: The policy analysis shows that problems of POCT service delivery are triangular with the patients at the base (receiving end) of the triangle. The most important finding of this analysis is that, there is no formal POCT service policy to guide the service providers (hospital management) and testing personnel (non-laboratory staff, nurses, clinicians etc).The problems from the POCT services are solved through the use of circular letters, likened to the administrative incremental model of decision making.

Conclusion: There is a need to have a formal policy. A formal policy on POCT delivery will guide the testing personnel, service providers and policy makers in solving POCT problems. It will also create opportunities for the evaluation of these services on a continuous basis to enhance improved health care delivery.

Keywords: Point of Care Testing, Service Delivery, Policy Analysis.