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La Rivista Italiana della Medicina di Laboratorio 2019 Marzo;15(1):40-5

DOI: 10.23736/S1825-859X.19.00005-7


lingua: Inglese

Enhanced clinical, social and cost-effective high complexity home care of pediatric patients through Mobile Laboratory of Analysis: a 5-year experience report

Paolo G. MONTALDO 1, Gino TRIPODI 1, Sandro DALLORSO 2, Paolo PERUTELLI 1, Raffaella COZZANI 1, Karim BEL IMAM 3, Domenico GAGGERO 1, Emilio PASQUARELLA 1, Valter VENTRELLA 1, Salvatore MANGRAVITI 1, Fabio FACCO 1

1 Laboratorio Centrale Analisi, Istituto G. Gaslini, Genova, Italia; 2 Servizio Assistenza Domiciliare, Istituto G. Gaslini, Genova, Italia; 3 Università degli Studi di Sassari, Sassari, Italia

BACKGROUND: The Mobile Laboratory (MoLab) is an original project realized to enhance the effectiveness of the home care for children affected from cancer by performing blood analyses directly at the patient’s home. Before MoLab, tests were carried from the patient’s home to the hospital lab by a nurse; only once results were available the team could return back to the patients for care adjustment. This could affect results reliability and delay appropriate clinical care.
METHODS: On board of a van equipped with point-of-care testing instruments a wide panel of hematology and clinical chemistry tests is performed by skilled technicians. Delivery of samples to the MoLab takes place at the patient’s home. A supervisor remotely controls all analytical phases in real time and redirects validated results to the care team on duty. All procedures undergo a stringent sequence of quality controls.
RESULTS: Data covering five years activity are reported. Pre and postanalytic turnaround time are virtually reduced to zero. A complete analytic panel required less than 20 min. Quality control programs showed good reliability and stability of instrumental performances over time. The number of operative days, enlisted patients and tests requested markedly increased and the cost of analyses reduced accordingly.
CONCLUSIONS: The project’s successfulness in terms of operational workload, analytical reliability, satisfaction of operators and users and, finally, costs analysis was evaluated. By MoLab, performing tests previously avoided because of prolonged TAT became possible. Immediate availability of results facilitates diagnosis confirmation, therapeutic adjustments and planning of follow up procedures up to hours in advance. All these beneficial issues were highly cost effective. The MoLab Project has proven an effective support to enhance the home care for children affected from cancer up to semi-intensive level.

KEY WORDS: Home care services; Point-of-care testing; Home care services, hospital-based

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