title: Process optimization in the emergency department by the use of point-of-care-testing (POCT) in life-threatening conditions: comparative best practice examples from Germany and Malta.
abstract: OBJECTIVE
  Point-of-care testing (POCT) at the Emergency Department (ED) attains better objectives in patient care while aiming to achieve early diagnosis for faster medical decision-making. This study assesses and compares the benefits of POCT in the ED in Germany and Malta, while considering differences in their health systems.
  
  
  METHODS
  This chapter utilizes multiple case study approach using Six Sigma. The German case study assesses the use of POCT in acute coronary syndrome patients, compared to the central lab setting. The Maltese case study is a pilot study of the use of medical ultrasonography as a POCT to detect abdominal free fluid in post-blunt trauma.
  
  
  RESULTS
  This study provides clear examples of the effectiveness of POCT in life-threatening conditions, as compared to the use of traditional central lab or the medical imaging department. Therapeutic quality in the ED and patient outcomes directly depend upon turnaround time, particularly for life-threatening conditions. Faster turnaround time not only saves lives but reduces morbidity, which in the long-term is a critical cost driver for hospitals.
  
  
  CONCLUSIONS
  The application of Six Sigma and the international comparison of POCT as best practice for life-threatening conditions in the ED.
authors.forename: Sandra C
authors.initials: SC
authors.lastname: Buttigieg
authors.forename: Wilfried
authors.initials: W
authors.lastname: von Eiff
authors.forename: Patrick
authors.initials: P
authors.lastname: Farrugia
authors.forename: Maximilian C
authors.initials: MC
authors.lastname: von Eiff
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D019411:Clinical Laboratory Techniques / Q000592:standards; D017598:Efficiency, Organizational; D004636:Emergency Service, Hospital / Q000592:standards*; D005858:Germany; D006801:Humans; D008319:Malta; D019095:Point-of-Care Systems / Q000592:standards*; D017064:Process Assessment, Health Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D014463:Ultrasonography; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers