Attributes required in Point of Care roles

Point of care testing and rapid diagnostics are enjoying increased recognition as an essential element across healthcare systems. With maturing networks and improved focus on patient access, devices and tests are increasingly being adopted in acute care settings and community-based services.

The last few years has seen a boom where technology has caught up with requirements at the point of need. This article poses the following questions.

• Has technology and the need of the patient developed at a faster rate than the development of point of care as a clinical specialty?
• How is the workforce expanding to meet the need?
• What is required of point of care service providers to ensure successful application of the wide range of solutions in the marketplace?

Formal training and qualifications

To date, members of point of care teams have followed internal training programmes mainly developed independently by individual medical laboratories. For posts requiring HCPC registration there is little point of care coverage in the IBMS registration and specialist portfolios. It is covered to a degree, but more is required to distinguish point of care as a specialism within biomedical and clinical sciences.

This has led to a lack of standardisation and potential restrictions or confusion around career opportunities. In recent years, specific qualifications have become available most notably the IBMS CEP and two qualifications through the American Association for Clinical Chemistry (AACC). However, there remains a void in terms of national job profiles within the NHS linked to agenda for change. Even national medical laboratory benchmarking tools omit point of care so how are service providers supposed to build teams with appropriate roles, bid for investment or modernise their service?

A review of job roles is urgently required, along with the qualifications required by those posts and clear routes of progression for staff entering or already within the profession. The attributes required in point of care roles may differ significantly from scientific or support roles in the medical laboratory. Those enjoying the laboratory environment may not feel the same when working across a hospital or community environment.

A search for publications covering the development of point of care talent drew a blank. Surely it is time to address the lack of clarity around the point of care professions. One publication in 2019 sought to characterise the role of POC co-ordinators, their responsibilities and interestingly, their job satisfaction¹

This leads us to ask, what are the essential attributes required in roles across point of care? How should these be incorporated into job descriptions and person specifications? How should employers approach the recruitment and selection process to ensure the right talent is acquired?²

Technology is advancing at a rate that cannot be supported in terms of development of point of care talent. Developing the diagnostic capability will only lead to successful real-world application if it is supported by an experienced and knowledgeable workforce.

Essential attributes and skills- Striving for Excellence

It goes without saying that individuals working in the field of point of care and rapid diagnostics need to be technically gifted. With technology and methodology evolving quickly, those who will remain successful in delivering these solutions must be interested and driven in staying up to date with equipment and device advances, with an underlying understanding of the science and methodologies employed. From selection to implementation to upkeep, point of care roles are set to become more and more technical, even if devices become easier for operators to use.

Point of care solutions are provided in several settings, some adjacent to the patient location, and others by the bedside. Operatives and service providers must be professional at all times. They are the face of the service, and the role will require interactions with many healthcare professionals and service users with direct patient contact. Civility and inclusion are a must with individuals needing to consider the viewpoint of others, understand individual boundaries, and the impact their actions have on team dynamics.

Another extremely important trait is that of persuasiveness. I’ve experienced a range of opinions around the suitability of point of care solutions in the healthcare space. It can sometimes be difficult to be heard amongst the detractors, some of whom are holding on to historic opinions about the performance and accuracy of tests and devices. Individuals may find it difficult to change those opinions, but POC Coordinators and clinical leads will need to be prepared to argue the effectiveness of modern equipment, especially when performance has been verified by POC teams and reliability has been demonstrated. Knowing how current solutions have been deployed, accessing case studies and published data will add weight to your argument for introducing new technologies.

More and more we are seeing large scale adoption of devices and tests that have been shown to impact on defined patient pathways and management of health conditions. A consequence of this will see adopters and decision makers become increasingly business minded, to successfully argue for the introduction of new services. This will require an understanding of the business planning process in your organisation, funding sources, revenue and capital budgets and writing business cases that show the cost effectiveness of that solution. An understanding of the downstream gains is essential to defining the clinical and cost effectiveness of the proposal.

Leadership

Delivering change requires strong leadership, but also the day to day running of teams who are delivering a complex area of healthcare provision. An individual’s astuteness in these roles would be key to delivering effective outcomes and general positivity.

This is a fast-moving specialty requiring individuals who are both agile and persistent when it comes to planning, delivery of ongoing projects and decision making. A qualification or significant experience in project management comes in very handy although not essential. Success can be equally achieved through surrounding oneself with experienced individuals with a variety of backgrounds and involving all stakeholders at the earliest opportunity.

This is one area where those working across the point of care landscape must have excellent communication skills. Keeping all stakeholders in the loop and implementing their requirements can be a difficult task and not all will be happy with the final decision, but committee decisions need to be taken guided by point of care leads. Input from healthcare groups promotes creativity and learning opportunities, further developing the knowledge and skills of the point of care operatives.

An open-minded individual is required in the modern era with new roles in development to meet the needs of a rapidly changing healthcare system. In terms of POCT and rapid testing, plans are already underway to make diagnostics more accessible to patients including home testing and community hubs. The days of point of care being deployed in secondary care hospitals and some GP surgeries have gone, replaced with innovative deployment of devices and tests. Examples can be observed in mobile settings, the high street, care homes and virtual wards to name a few.  Likelihood of successfully delivering the service in any point of care role will now depend on flexibility and adaptability of post holders.

Staff will find themselves in situations that are not pleasant, from supporting equipment in areas where the very sick are being cared for, to being challenged by service users including clinical staff. Usually this is due to device issues, sometimes caused by the operator themselves rather than the technology. In these situations, the courageous individual will prevail, backed up by knowledge, experience, and sound reasoning.  Being objective, logical and tenacious in these situations will demonstrate strength whilst providing assurance to the end user that issues will be quickly addressed one way or another.

The Future Workforce

The job is ever evolving. Point of care as a specialty of healthcare has the spotlight trained on it. Those entering the profession will need guidance and clear career pathways so that the workforce required to support innovative healthcare delivery is developed now, rather than later. We must look at ourselves and the role we can play in producing the workforce of the future. Identifying talent with the necessary drive to succeed is as important as selecting the individuals with desirable scientific qualifications. We must be conscientious in recruitment, understanding what is essential and what is desirable in terms of attributes.

The profession needs to be attractive to graduates and accessible to those with general education. Clear training and development plans must be in place and adhered to, with sufficient support from coaches and mentors to help workers reach their full potential in delivering a highly effective point of care and rapid testing service across the healthcare landscape.

We all have a part to play in future successes.

References

1. A Profile of Point of Care Coordinators: Roles, Responsibilities and Attitudes. https://academic.oup.com/labmed/article/50/3/e50/5429665
2. https://www.mlo-online.com/continuing-education/article/13009204/choosing-the-right-pointofcare-coordinator