MediQAl : a tool to QA POC users

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MediQAl a tool to QA POC users

• Rick Jones
• University of Leeds, UK

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MediQAl a tool to QA POC users

• The Point of Care QA problem
• Background to MediQAl
• purpose
• design
• Demonstration
• Future Developments
• Discussion

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How do we achieve quality ?

• QC A procedure conducted to check that an
  analytical function is working
• Outcome
• An analytical test is rejected if the QC result
  is outside limits
• QA A strategy used to ensure that quality
  measures are achieved
• Outcome
• The analytical process is modified and is
  rechecked. This may include changes to any
  contributing factor, e.g.
• - Personnel - (training)
• - Sample collection
• - Strips
• - Meters
• - Reagents

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The Point of Care Conundrum

• Point of Care Instrumentation
• miniaturisation
• increased functionality
• dispersion
• Medical Informatics
• consolidation of information
• electronic medical records

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POC QA the problem(s)

• Scale
• 4000 POC users in my Trust
• Environment
• Dispersed - wards, clinics, surgeries
• Working practice
• Shifts, Transient staff, Wide ability range
• Not easily managed!!

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MediQAl Aims Objectives

• Automated running of QA programme
• Store data of QA and QC
• Enable analysis of the data of
• users - meters -strips - wards - sites
• Allow meaningful data presentation
• To improve the quality of glucose results
  generated by non-specialist staff at the bedside.

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MediQAl Design

• Uses a relational database to
• Maximise functionality
• Minimise data entry
• Provide flexibilty
• Uses MS ACCESS to provide
• Clean user interface
• Full Windows compatability
• Easy development path

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MediQAL Database

• Multiple tables for maximum granularity
• Configuration details
• People - Staff / Users
• Sites - Hospitals / Practices / Wards / Clinics
• Meters / Strips
• QA Schemes / QC Materials
• QA Distributions / QA Results
• QC Results / Maintenance QC records

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MediQAl Functions

• Data entry
• via forms with pull down lists
• Data extraction
• Lists
• Simple lists of the contents of the indexes
• Reports
• Complex mixtures of data from the database with
  graphs, tables and calculated results

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MediQAl Setting up users

• Data on users controls programme features

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MediQAl QA result entry

• Data from individual QA results is entered
  through a simple form

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MediQAl Reports

• Flexible reporting tools are built in.

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MediQAl Setting up reports

• Reports can be customised with intelligent data
  driven comments

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MediQAl User diploma

• Users are provided with a printed diploma
  confirming their training.

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MediQAl End user report

• End user reports provide graphical and textual
  indications of performance.

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MediQAl Usage

• Home site 2 years use
• monthly QA distributions
• 100 wards
• 50 surgeries
• steady improvement in compliance and performance
• Also used in 100 other UK hospitals
• Demo

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MediQAl The future

• ELAB Online - Click
• multi-analyte
• WWW enabled
• Allows
• paperless system
• site independent approach to service provision
• integration with training and other support
  systems
• possibility of scheme to scheme benchmarking

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MediQAl Discussion

• PC system essential for QA scheme to run
• Still labour intensive
• Only one component of complex programme
• End-user reporting needs research
• understanding by non-specialists
• maximise impact on performance
• WWW approach holds many attractions

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MediQAl Acknowledgments

• Frederick Barrau
• Matthew Gailer
• Doug Hirst
• Medisense UK (Abbott Laboratories)