Challenges of Conducting Point-Of-Care Testing Operations During The COVID-19 Pandemic In The Municipal Public Health System Based Ambulatory Care And School Health Clinics In New York City

Introduction/Objective Our New York City Municipal Public Health System based multisite ambulatory clinics and school-based clinics, offer various waived POCT (point of care tests) and provider performed microscopy (PPM). To ensure standardization and quality of POC testing across our health system, our laboratory service conducts system wide centralized implementation, monitoring and oversight of the POCT operations in regard to regulatory compliance, test performance, quality control and training. With the emergence of the COVID-19 infection in the New York City, like all other clinical laboratories, our ambulatory care clinics encountered numerous hurdles and challenges. Here we elaborated the issues that we encountered and how we managed to overcome during the COVID-19 Pandemic. Methods/Case Report We categorized the challenges that affected our managers as well as field level laboratory operations and have devised a plane to deal with COVID-19 related predicaments. Results (if a Case Study enter NA) Among the staffing issues, staff relocation to the acute care hospital laboratories during the peak of the pandemic caused massive delay or cessation of POCT operations in our ambulatory care clinics. Manual result entry, for COVID-19 testing, at the patient portals due to lack of interface with the reference testing labs, staff shortages and frequent absences due to illness and fatigue were primary issues noted at technical level. Furthermore, there were notable delays in the processing of paper works and new staff recruitments. The lack of and significant delays in the critical laboratory supplies was another major management issue. Conclusion Given the vastness and complexity of our multisite ambulatory care network, the COVID -19 pandemic impacted our ambulatory care clinic POCT operation in a very challenging way. However, our timeliness, coordinated interventions, close communications and initiatives handled the obstacles that arose very effectively to the ensure quality of POC testing, patient safety and quality care across our health system.

Benefits Achieved for Patients Through Application of Height-Adjustable Examination Tables

Objectives: Ambulatory care is a rapidly growing segment of overall healthcare delivery and populations seen in ambulatory care settings are aging resulting in many patients with mobility limitations. Mounting a fixed height examination table can present a challenge to a patient with mobility limitations and may be somewhat difficult for the general patient population. This study sought to investigate potential benefits to the patient which might be achieved through introduction of height adjustable examination tables. Methods: A data collection tool was administered to patients at the time of a regularly scheduled clinic visit intended to measure exertion required, level of difficulty and feeling of safety. Results: Both patients requiring assistance and independent patients reported higher exertion, more difficulty and feeling less safe when mounting higher fixed height versus height adjustable examination tables. Conclusions: Height adjustable examination tables provide benefits to patients and should be considered when seeking furnishings for ambulatory care clinics.