Implementation of Procalcitonin Testing at Your Hospital
Implementation of Procalcitonin Testing at Your Hospital
Strategies for successfully adopting hospital-wide testing changes
It can be challenging to enact change across a complex healthcare environment. But implementing procalcitonin (PCT) testing in the emergency room (ER), intensive care unit (ICU), and beyond has real, lasting impact on patient management and can help curb the effects of antibiotic overuse and resistance.
Like any shift in process or procedure, implementation requires a well-thought-out plan and clearly defined strategy that includes:
- Individually tailored education
- Reminder systems
- Clinical decision support systems
- Feedback on performance
- Participation of healthcare providers and laboratory professionals
Getting the most out of PCT testing through best practices
Establishing PCT best practices can help healthcare leaders and clinicians:
Conduct appropriate PCT testing and apply correct interpretation, while putting results into the clinical context.
Avoid unnecessary testing.
Achieve desired clinical and health economic outcomes.
The support you need for a successful PCT implementation
Similar to antibiotic stewardship programs, there is no one-size-fits-all approach to making changes to testing. But that doesn’t mean you have to go it alone, creating testing protocols from scratch.
Download the Implementation Guide to learn helpful information to start a successful PCT program in your hospital, including how to:
- Create a multidisciplinary team.
- Clearly define the desired impact of PCT testing.
- Determine clinical applications.
- Create order sets and protocols.
- Establish specific goals and timelines for each phase of implementation.
- Use an implementation checklist to track your progress.
Central to the guide is the Plan-Do-Study-Act (PDSA) cycle, a framework for learning and action that can help your hospital get a PCT program up and running as quickly as possible.
Model for improvement: Plan-Do-Study-Act (PDSA) cycles1
- What are we trying to accomplish?
- How will we know that a change is an improvement?
- What change can we make that will result in improvement? Plan Do Study Act
The importance of getting everyone on board
You can have the most fool-proof plan and sophisticated strategy, but both will fail to deliver if they are not backed up by stakeholders who understand the true value of new testing protocols—including how to interpret results —and the ultimate goal of adoption. To make it work, also regional needs defined by specific patient mix, and healthcare environment, e.g. in Asia-Pacific, should be considered, as reflected by the expert consensus algorithms.2,3
That’s why it is vital to provide tailored education to all clinicians involved with procalcitonin testing.4 In fact, it is the key to successful implementation.5 The alternative path? Passive dissemination of the evidence and educational interventions, which are insufficient and do not offer sustainable solutions for laboratory test implementation.4,6 In addition, a lack of systemic education may lead to sub-optimal results.7
Education Matters
For an educational roll-out to be a successful part of your implementation strategy, you’ll need support. Our team is ready to help your healthcare system effect real change with the right knowledge from key opinion leaders, research studies, clinical evidence, and more. Let’s get to it.
- Dr. Michael Broyles, Director of Medical Affairs, Thermo Fisher Scientific.
Webinar: PCT in Current Practice:
Linking Clinical and Financial Outcomes
- Science of Improvement: Testing Changes: IHI [Internet]. Institute for Healthcare Improvement. 2020 [cited 2020Dec15]. Available here.
- Lee CC, Kwa ALH, Apisarnthanarak A, Feng JY, Gluck EH, et al. Procalcitonin (PCT)-guided antibiotic stewardship in Asia-Pacific countries: Adaptation based on an expert consensus meeting. 2020 Nov 26;58(12):1983-91.
- Schuetz P, Beishuizen A, Broyles M, Ferrer R, Gavazzi G, Gluck EH, et al. Procalcitonin (PCT)-guided antibiotic stewardship: an international experts consensus on optimized clinical use. Clin Chem Lab Med. 2019 Aug 27;57(9):1308-18.
- Horvath AR. From evidence to best practice in laboratory medicine. Clin Biochem Rev. 2013 Aug;34(2):47.
- Mazmanian PE, Davis DA, Galbraith R. Continuing medical education effect on clinical outcomes: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines. Chest. 2009 Mar 1;135(3):49S-55S.
- Cole JL. Provider perceptions on procalcitonin testing: a survey to tailor facility implementation. Infection. 2017 Dec 1;45(6):925-6.
- Trienski TL, File Jr TM. Implementation of a procalcitonin assay requires appropriate stewardship to result in improved antimicrobial use. Infect Dis Clin Pract. 2015 Jan 1;23(1):1-2.
