HbA1c POC testing in QAAMS has remained analytically sound, matched the quality achieved by Australasian laboratories and met profession-derived analytical goals for 15years.
In Australia, Aboriginal and Torres Strait Islander people have approximately three-fold higher rates of diabetes than non-Indigenous Australians. Point-of-care testing, where pathology tests are conducted close to the patient, with results available during the patient consultation, can potentially deliver several benefits for both the Indigenous client and the health professional team involved in their care. Currently, point-of-care testing for diabetes management is being conducted in over 180 Aboriginal and Torres Strait Islander Medical Services as part of a national program called Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS). The cultural safety of the Program was reviewed by sourcing the views of the QAAMS Indigenous Leaders Team in a focus group setting and by surveying the point-of-care testing operators enrolled in QAAMS, via an electronic questionnaire. The current study confirms that QAAMS remains a culturally safe program that fills a permanent and positive niche within the Indigenous health sector. The study demonstrates that QAAMS provides a convenient and accessible 'one-stop' pathology service for Indigenous clients with diabetes and empowers Aboriginal Health Workers to have a direct role in the care of their diabetes clients.
Hons)ÞT he roles and responsibilities of point-of-care (POC) coordinators are numerous and ever expanding. The ordering and dispatch of reagents and consumables, confirming lot numbers and expiry dates, managing stock wastage, maintenance of quality testing result sheets, management and provision of feedback on quality testing data, verification of patient results, managing device errors, device maintenance and repair, and managing compliance and regulatory issues (to mention just a few tasks) place substantial demands on the POC coordinator's time. With the support of industry, the ability to automate many of these manually intensive tasks should be a goal to which all managers of POC networks strive.In practice, the nature and extent of the challenges faced by POC coordinators often depend on the clinical, cultural, and geographic setting in which the POC testing network operates. The 2 largest POC testing models that our unit coordinates are the QAAMS (Quality Assurance for Aboriginal and Torres Strait Islander Medical Services) Program and the Northern Territory POC Testing Program. The QAAMS Program is a national POC testing model for diabetes management operating in more than 160 indigenous medical services across mainly rural and remote Australia. 1Y3 The Northern Territory Program provides POC testing for acute and chronic diseases in 41 remote indigenous health centers in the territory. 4 Because of the extreme geographic isolation of many of these health services and given that the POC device operators who conduct patient testing in these programs may be one of several different health professional groups, the POC coordinators and supporting scientific staff responsible for these programs face unique challenges with the management of operator training and competency assessment in particular. This aspect of delivering these models therefore forms the basis of this editorial.Organization of POC training sessions for health professional staff from remote communities can be very difficult. Because of the competing time demands on staff in remote health services, not all staff are able to attend on-site training sessions delivered by the POC coordinator; conversely, the cost of flying remote staff to a central location (capital city) for training is prohibitive, and health center managers are reluctant to allow staff the additional time away from the service. Staff turnover rates in remote health centers are also high, 5 and it is often difficult to maintain continuity of patient and quality POC testing during periods when services are understaffed or when there are no trained operators available at remote services. Hard copies of manual training resources such as primary training manuals and posters summarizing quick guides on how to perform patient and quality testing are often misplaced when staff turn over, leaving the next POC operator without key reference material. The ability of the POC coordinator to deliver immediate on-site training sessions when new staff replacements arrive is compromised by the...
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