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Out-of-hours primary care often involves making high-risk decisions without knowing the patient nor much of their medical history.

Decision-making is crucial in determining whether care, particularly for older frail patients who require home visits for assessment, should be escalated to the hospital without delay or not. Delays are known to be associated with an increased risk of poor outcomes for conditions such as infections and acute kidney injury. On the flip-side, inappropriate admission to hospital care is expensive and can pose other risks, such as infection or functional decline.

Results from point of care blood testing could support OOH healthcare professional’s decision making regarding the best location for patient care.

As part of a service improvement project we introduced POC tests from handheld devices in OOH Primary care home visits in Oxfordshire.

Now, our evaluation of this project has been published in the BMJ Open.

While we found that POC tests were not successfully adopted by the OOH services in Oxfordshire, our evaluation did identify three main learnings:

  1. When tests were used, clinicians felt they were beneficial in a number of ways, including helping to decide where and when further care would be required, and facilitating communication with hospital colleagues
  2. Adoption of POC devices would likely be improved by using a whole team approach and developing standard operating procedures / protocols for their use.
  3. Patients report an improved subjective experience

To read more of our findings visit the publication here:

Hayward GDixon SGarland S, et al Point-of-care blood tests during home visits by out-of-hours primary care clinicians; a mixed methods evaluation of a service improvement 
BMJ Open 2020;10:e033428. doi: 10.1136/bmjopen-2019-033428
To find out more about the project, view the video above or on YouTube here.

With thanks to the Health Foundation and Oxford AHSN who helped fund and support the work, and to our hosts Oxford Health NHS Foundation Trust.