Hospital in your home accreditation
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Our hospital system has had a hospital in your program for several years now. In the past they have contracted with a paramedic company to go to the patient's home and do POC testing. Now our program wants to bring it in house, and they are hiring paramedics and RN staff to do the testing. They want to do CG8+ and creatinine on the i-STAT and PT/INR from the Coaguchek. My question is do any of you have programs similar to this and does your program fall under the lab's CLIA or do they have an individual CLIA license for the program. Also, would the lab's certificate of accreditation be sufficient to cover testing being performed in patient's homes offsite of the main lab. We are CAP inspected and would like to have them on our CLIA certificate and treat them like another department in the hospital. The other question we have is how you monitor temperatures on cartridges being transported in private vehicles to make sure they don't get too hot or too cold. The bulk storage will be monitored at our main hospital campus. If anyone is willing to discuss their program's practice with us offline it would be most appreciated.
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We also have another program through our Virtual Acute Care Center called Mobile Health that will dispatch EMT's and Paramedics to patient homes for assessment. They are on their own Mobile CLIA license not under ours. They can do ISTAT CG4, ISTAT Chem 8, Nova Glucose, Coaguchek, Urine dipstick, QuickVue Covid and Flu Antigen, and Occult Blood in Stool. They have bags that they transport in that they take a daily temp and humidity as they leave some in the transport bag. They do leave their vehicles locked and running to maintain temperatures/humidity.
I had the same concerns with temperature control, especially with the mod complex platforms. We were able to purchase wireless temp/humidity monitors that will travel with each POC cooler bag and upload the data to the iPads the RNs will have with them at all times. I can have reports generated and automatically emailed to me at specified time frames.
We were able to collaborate with our Air Med Flight team since they also use this technology. I just validated the thermometers today and will be putting them in use by Monday.
While we were testing the devices out, I definitely noticed some times at which I could tell the RN left the bag of POC stuff in the car and the temps got as high as 102F so there definitely is a need to continuously monitor.
We are also still looking for very well insulated or temperature regulated cooler bags to implement if anyone has any suggestions. The few cooler studies we did so far failed miserably.
Thank you!