Stand alone ED's

Hi Deborah, we have 2 stand-alone ED's in what we call Med Centers.  It is a building with an ED, full lab, doctors' offices, imaging, rehab and out patient pharmacy.  Our newer one has a VERY nice membership gym/pools and PT.  No overnight stay, if needing admit they go to one of our other hospitals in town.  We have iSTAT for blood gas, the lab has 2 chemistry analyzers so no need for iSTAT as back up, no blood bank only emergency release units.  Offices do not send their lab work to the lab due to billing. Lab only gets work from the ED.  Each ED is 12-14 beds.  We opened our first one about 10 years ago

Deborah,

We currently have 5 Free Standing ER's  (FSEDs) and growing in our system, open 24/7.  

Training requirements for these individuals (lab staff or POC staff) is the same as for the system hospitals.
 

The lab and POC will need to involved with the build from beginning to end... constructional build out, lab floor plan layout to even ensuring things like enough electrical outlets (and correct types: 110v or 220v, special electrical sockets for analyzers) and data ports locations (including POC electrical/data ports in the ED floor space).   Few people outside of the lab understand just how much of these we use, we've had these data ports added to building plans only to have someone remove them from the plans.... and then be forced to have them installed additional after the main construction was completed prior to opening day of the facility.   Plan for some extra room too, there will undoubtedly be additional test requests that will require lab space as well, if at all possible.

Technician vs Technologist in the lab, this is going to be entirely dependant on the activity test menu in the FSED.  Some tests require Technologist sign-off... like in Blood Bank.

Jacksonville, Fl

Hi Deborah, we have 4 sites now that are freestanding ED/UC. Patients enter and are categorized as needing ER care or urgent care and are billed accordingly. POCT was involved from the very beginning in planning the lab area builds, as well as test and device selection. From the first one in 2019 to the latest one that opened last fall, we have learned a great deal! The sites do a lot of POC testing, with 6000-10000 point of care tests per month at each site. They also send out limited tests to a nearby hospital for STAT purposes with a 2-hour TAT, and all other tests are sent to the reference lab. They are staffed by lab assistants and basic EMTs. Our POCT staff does the training and competency for the sites, with the lab leads at the sites assisting with training. I would check with your state regulations to see what level of staffing would be required, since it's different in some states. These sites are so successful that 2 of the local hospitals have copied the model and have STAT labs doing POC testing. I'm happy to answer any other questions you might have about how we set these up.

We have 2 FSEDs. We have a limited service lab in both, so the only POC at each location is Glucometers and pH testing. Anything not done in the lab gets sent to Main.