Development and Introduction of Point-of-Care Testing in Mobile Critical Care Units for Improved Patient Safety in Rural Areas

Patient safety is one of the main objectives in our health system for the continuous improvement of quality of care and the promotion of clinical excellence. Therefore, quality and safety go hand in hand. This is one of our goals. The Ronda Hospital covers a population of more than 120,000 inhabitants in 2 different provinces, being split into 6 basic health areas with their corresponding health centers plus 3 associated medical centers, making 31 points of care that have to be staffed. The rural area of Serrania de Ronda, owing to being mountainous, is geographically complicated. It is widely dispersed and communication made difficult by secondary roads, which are even worse during winter. The mean traveling time to Ronda Hospital, which is the only hospital in the region, is around 60 minutes. The population profile of the rural area is characteristic of an ageing population. An analysis of patient safety made using nominal groups showed that the geographical dispersion and difficulties in getting to the hospital were detected as priority problems and were those that had most influence on patient safety. We examined the possibility of providing these critical care devices that have the ability to perform analytical measurements at the patient bedside. Ten dry chemical analyzers (i-STAT; Abbott) have been installed in the ambulances who serve the reference population. The professionals positively valued having another diagnostic tool available and having had a response to their demands for improved patient safety.