NEAR-PATIENT DIAGNOSTICS
New models of care are being discussed and implemented, providing better access to patient diagnostics in more accessible settings
Innovations in point-of-care diagnostics are accelerating diagnosis and improving patient outcomes.
In the years to come, and somewhat on the back of COVID and other endemic/ pandemic challenges, we will see a range of models introduced to reduce the delays across the healthcare system.
Community diagnostics The Diagnostics: Recovery and Renewal paper1
called for improved access to diagnostics in community settings, highlighting some recommendations but leaving it open to interpretation. Population demographics are certainly one factor affecting the selection of tests made available at the point of care or need. The needs of patients in an inner- city borough would differ greatly to a rural facility.
Another factor is the investment in the infrastructure, and who foots the bill. Smaller populations will likely share facilities with other nearby communities – economies of scale if you will. Complex cases will need to bypass these services and be referred or attend acute care settings for emergency or urgent treatment.
Urgent care centres Urgent care centres could become the game changer as long as patients adopt them as their preferred location for receiving care. Many new centres
are planned, some of which will be on hospital sites or attached to existing emergency departments. Historically, urgent care centres have been situated away from the acute care setting, but more recently the thinking has changed, with urgent care centres located adjacent to emergency care facilities. The reason for this appears to be the behaviour of patients and where they continue to access care. The majority of patients continue to present at emergency departments to receive care, for conditions not classified as emergencies (ie non-life threatening).
The notion that patients can be triaged rapidly by the emergency department and diverted to an adjacent urgent care centre is a new one, but it makes complete sense until the behaviours of patients can be influenced to use community based urgent care. Diverting these patients could make a phenomenal impact on the pathways expected to be managed in emergency care, improving flow and ensuring patients receive optimised care in either setting.
Same-day emergency care improvements There appears to be a move toward creating same-day emergency care
One approach that might improve the patient and clinician experience is to offer diagnostics more widely in the community with appropriate quality and governance
48
(SDEC) units to manage patients who need emergency care to stabilise their condition. Again, these are designed to relieve congestion within the emergency care system, get patients the care they need quicker and in the right place, while delivering the best care possible and meeting operational targets. These units need effective integration with multiple specialties in acute care such as cardiology, gastroenterology, women’s services and mental healthcare, as well as a resilient workforce with exceptional multidisciplinary skills.
Community wellness centres Let us take a step back and into the community. Prevention is key to long-term improvements in population health status. The NHS Long Term Plan2
describes
improving the health of the general public by providing additional care choices in the optimal setting. A large number of community wellness centres are planned, similar to the community diagnostic centres, but incorporating a wider range of services and facilities aimed at tackling the sources of ill health. Educating the public in how to achieve and maintain good health is an important step to forming lifetime habits. As a direct result of improved access to advice, support, diagnostics, monitoring and clinical expertise, it is expected that populations with poor access to care, or who experience healthcare inequality, will see quantifiable improvements in all aspects of their health. Community wellness centres are likely to be more successful than previous models if patients are made to feel like part of that community, and a facility that welcomes and supports them will ensure they return for assessment when things do not feel right. At present, especially since the SARS-CoV-2 pandemic, patients have suffered in silence, believing they could not access support or that they would be troubling the healthcare system unnecessarily.
When patients do need a hospital stay,
either through emergency admission or for elective care, there needs to be an
SEPTEMBER 2022
WWW.PATHOLOGYINPRACTICE.COM
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
