POC Staffing

We are a 100 bed hospital with limited POC testing (glucose, ACT, pH of the eye). The majority of our testing is done in our 15 provider offices. I am the only POCC and I also oversee phlebotomy training and competency assessments.

Thank you Cindy. 

We are a network of 9 hospitals, 6 free standing EDs, and 3 rural clinics. Our POC team consists of 1 Technical Specialist, 2 full time POCCs and 1 part time POCC. The POCCs each cover multiple sites.

We are a multi-site 384 bed health system with separate extended care, walk in clinic, cancer center, and clinic in a town 100 miles away.  There are 24 POC test systems in use, at 56 unit locations, with 1400 operators.  We are currently expanding at a high rate (nursing college, DO school, second free standing walk in clinic, and a hospital in separate town) I am the only POCC and not full time.  I am at a 0.8FTE, where 1.0 FTE equals full time.

175 bed hospital. 10 sites . 125 operators
 Im the only poc
 Plus I am the lab supervisor as well

Multi-Hospital (7) plus clinics (many). My personal hospital is 180-bed, it's the main cardiac/stroke hospital for the (large city) area. My site does not have peds or L&D. Other hospitals in our group do. I am the senior POCC for my site. Our overall department is set up with one POC Manager, 1 QA specialist (I love this person - I'm not a fan of writing procedures or trainings/tests), 1 person who does lots of emailing/checking credentials of all staff who will be testing using mod complex equipment. The 3 of them travel around - I see QA spec 1x/week, credentialing person 3 days/week. We have 7 senior POCC, 2.75 at our largest hospital, one each at 3 other hospitals. The .75 at our large hospital also does one day/week at a smaller hospital in the area. The Sr. POCC at our north end hospital will also cover the smaller stand-alone ER in the north end, and our east side Sr. POCC will also cover the stand-alone ER on the east side. We also have 2 FT Sr. POCC to cover all of the clinics. We have 1 FT 'float' POCC (not considered senior - entry level POC position) and 2 per diem POCC who used to be FT but are easing into retirement. They mostly help with training. My hospital does ALL the onboarding training for all 7 hospitals/ERs, so the per diems are usually at my site (and I'm so glad to have them!). So, our department is 13 people total (I'm not sure how many beds the other hospitals have - I'm still pretty new here. I was the only POCC at my last place (covering 7 outpatient clinics, minimal moderate complexity testing) and then only 0.6FTE, so it's been great to have so many people to help and to have such a nice structure in place. The dept has been around for ~21 years now and has grown significantly (started with 1 or 2 POCCs).
We also have a central helpline number to cover all locations and Sr hospital POCCs/QA/credential/manager are on call for one week rotating if something happens in the middle of the night or weekend (like, I scanned the wrong wrist band, help me get the results into the correct patient chart, etc).

Hi Debbie, 
   I am a Director with Accumen and I do consulting work with labs to determine the ideal POC Staffing ratio based on their individual and unique needs. It is very hard to compare POC programs because they all differ so much on their geography, patient acuity, complexity, and state/federal laws specific to their labs. 
I use a tool that I created for Accumen that accounts for all of these nuances and calculates the FTE need for the current state as well as the optimal staffing after looking at how well they are utilizing POC tests and making any necessary improvements to their test menu, operator lists, and automation.

A good example of why this is necessary could be illustrated this way:

1. A 750 bed hospital, but the only POC testing they have is waived glucometers - This site would potentially need one part time person for POC because the testing so simple, automated, and waived.

2. A 150 bed hospital with Blood Gases, BMP, Troponin, ACT, Creatinine, and Lactate in ICU, NICU, ED, PACU, Radiology, and Cath Lab, plus INR in Coag Clinic, plus Amnisure, UA and Preg in OB and ED, AND waived glucometers everywhere - This site might need more than one person to manage all of the non-waiveed credentials and competency assessments but would benefit from a full automation setup even if that means spending some money on interfaces for all tests plus all online training and comps. They may also be over-training. Meaning, if they have a POC test that is only performed a few times per month in a department, but they have several hundred testing operators that they are maintaining competency on, then that is not good test utilization.

When I help my clients I look at the number of waived and non-waived methods, total number of trained testing operators by device type, number of locations within each facility where that testing takes place, and number of facilities performing that test. I also evaluate their revenue stream to look at cost per test scenarios since we know that POC can actually save the labs a lot of money when utilized properly, and help the POC department know their value to their lab so they know if they can afford additional FTE's and/or better automation. 

Hope that helps!
Silka Clark, MT
Accumen, Inc - Director, Lab Excellence