Development of a Robust Point of Care Testing Program in Newfoundland and Labrador Using Lean Method of Rapid Process Improvement Workshop (RPIW).

Abstract

The implementation of a provincial Point-of-Care Testing (POCT) program across Newfoundland and Labrador (NL), Canada, is designed to standardize verification processes and ensure consistent analytical performance of POCT analysers across diverse healthcare settings. The program is developed using a "Test and Treat" model to support both remote rural communities and urban populations. Many provincial locations operate as standalone POCT sites hence vendors are required to provide site-specific support services. Selection of analytically robust and cost-effective POCT devices is prioritized to support sustainability and quality patient care. Extensive project planning include Lean Six Sigma methodologies, including Rapid Process Improvement Workshop (RPIW), to standardize workflows and improve operational efficiency. Carefully selected Six Sigma team members participate in collaborative brainstorming sessions to develop streamlined verification and installation strategies across 23 provincial POCT sites. Each analyzer is assigned a Provincial Equipment Unit Identification Number (PEUIN) to enhance traceability and inventory management. Primary verification is conducted centrally at St. Clare's Mercy Hospital, St. John's, while secondary verification is completed at individual installation sites to ensure site-specific performance validation. Harmonized installation of identical analysers support a standardized and quality-driven approach to provincial POCT expansion. Structured utilization management processes are not yet fully established within NL Health Services. Development of utilization monitoring tools to evaluate financial implications and cost-effectiveness is ongoing. Quality improvement initiatives are continuously monitored using key performance indicators. Additionally, the implementation of the EPIC hospital information system in April 2026 provides opportunities for further standardization and integration of POCT processes across the province.