The Health Planning Commission informed that POCT is no longer streaking and officially entered the clinical department!

Medical Network September 11th, on-site rapid inspection, also known as point-of-care testing (POCT), refers to a method of detection at the sampling site, using portable analytical instruments and supporting reagents to quickly obtain test results. POCT has the characteristics of rapid and easy to use. It has developed rapidly in recent years. A large number of POCT instruments have entered the hospital. Due to the characteristics of the bedside, POCT instruments are mainly used in clinical departments after entering the hospital. Although the laboratory is also used, the laboratory is used. It is far less expensive than the clinical department.

In addition to the advantages we mentioned above, economic factors are also a major cause. After all, if the POCT instrument is placed in the clinical department, this part of the income is taken into account in the overall income of the clinical department, and the income of the clinical department increases. It is based on the reduction of income in the laboratory, so in many hospitals there has been a phenomenon in which the laboratory and the clinical department compete for POCT instruments.

Although POCT has been widely used in clinical practice, its current status is not optimistic. Due to the lack of professional technicians in clinical departments, many POCT instruments basically do not do indoor quality control, let alone participate in inter-room quality assessment, but A 'streaking state', the reliability of the test results is worrying. More importantly, the clinical use of POCT instruments is strictly a violation of law, because the Ministry of Health issued the "medical institutions in 2006." The following provisions are included in the Clinical Laboratory Management Measures:

Article 9 Clinical laboratories of medical institutions shall be centrally set up, unified management, and resource sharing.

Article 10 Medical institutions shall ensure that clinical laboratories have the professional and technical personnel, places, facilities, equipment and other conditions that are compatible with their clinical laboratory work.

Article 21 Non-clinical laboratories shall not issue clinical test reports to the clinic, and may not charge corresponding test fees.

The use of POCT instruments in clinical departments is difficult to meet the above provisions (or it is difficult to meet the above provisions at the same time). Strictly speaking, it is illegal and illegal, and it is in a gray area. Therefore, although the laboratory and clinical departments compete in POCT. The middle is in the downwind, but there is policy support. Although it is beaten but not others, it is reasonable! However, this situation is gradually changing. The Municipal Health and Family Planning Commission promulgated by the Tianjin Municipal Health and Family Planning Commission on May 25, 2018. The Notice on Strengthening the Management of Clinical Applications for Instant Detection may provide a policy basis for ending this embarrassing situation. The notice includes POCT instruments, real-time detection management, personnel training assessment, indoor quality control and inter-room quality assessment, report format content and information. Six aspects of the construction, etc., the following briefly introduces the main contents of this notice. For detailed notice, please refer to the Tianjin Health Planning Commission website notice:

The notice stipulates that the medical institutions at the second level and above shall set up an immediate inspection management committee composed of the heads of medical departments, nursing, inspection, prevention, supply, information, equipment, etc., responsible for the immediate inspection and management of the hospital. The immediate inspection management committee is responsible for The person is the main person in charge of the medical institution, the medical department is responsible for the daily management work, and the inspection department is responsible for the immediate inspection of the quality management work and the clinical operation training assessment of the medical staff'. At the same time, it stipulates several main duties of the immediate inspection management committee.

It can be seen from the composition of this management committee that the level is still very high, the main person in charge of the hospital is the person in charge, the medical department is responsible for daily management, and the specific quality management and operation training is under the responsibility of the laboratory. In the main duties One is the content that the test colleagues are very familiar with: 'Regularly check the quality inspection equipment on the spot and organize the real-time test items to ensure the same results in the same medical institution. 'We all know that if there are two in the laboratory Instruments of different brands or different methods are generally used for project comparison to prevent inconsistencies in the same patient test results in the same hospital. This article in the notice can ensure the consistency of POCT testing in the whole hospital.

For the training and assessment of personnel, the notice has made specific provisions, which can be said to be more rigorous. The training content is uniformly formulated and provided by the Municipal Inspection Quality Control Center, and the content is very detailed including but not limited to the detection principle of instant detection equipment, application value, Scope and characteristics, instrument, reagent storage conditions, specimen collection, testing procedures, quality control, interpretation of results, safety precautions, etc. Personnel must participate in the training and pass the examination before they can be employed.

The notice requires that the medical structure must establish an indoor quality control and inter-room quality assessment system for immediate testing, and re-emphasize in the quality control that even if the comparison of the testing equipment is performed, the accuracy of the inspection results is guaranteed. In order to ensure the simplicity of the comparison, at the same time It is stipulated that the same test item of the same medical structure cannot, in principle, use two or more types of testing equipment. The same type of testing equipment must be used in the same ward.

In addition to the regular inspection report, the real-time inspection report must be marked with the same number of the 'instant detection (POCT)' type and the detection equipment, and the inspection report should be pasted into the patient's medical record, and the report cannot be detected.

This notice will provide the basis for the policy of the POCT to leave the laboratory and enter the clinical department. In the future application of the POCT, the laboratory will only be responsible for quality control and personnel training. However, on the other hand, this notice is for POCT is at hospital The standardized use is of great significance, and it is also well-known for the clinical application of POCT, which guarantees the quality of POCT detection, and ultimately benefits patients.