Implementation of a Point-of-Care Blood Testing System in a Canadian Emergency Department: A Mixed-Methods Evaluation of Workflow and Clinician Perceptions

Abstract

OBJECTIVE: Point-of-care blood gas and chemistry testing is commonly used in emergency care to provide rapid biochemical information during initial patient assessment. We evaluated the implementation of the Siemens Healthineers ePOC Blood Analysis System in a tertiary-care Canadian emergency department (ED) by assessing clinician-perceived usability, adequacy of training, satisfaction, and perceived effects on workflow and clinical decision-making. METHODS: This quality-improvement and implementation evaluation was reported in accordance with the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines, where applicable. The evaluation consisted of (1) a retrospective analysis of core laboratory turnaround times (TATs) during the early implementation period and (2) a post-implementation survey assessing clinician-reported usability, adequacy of training, satisfaction, and perceived effects on workflow efficiency and clinical decision-making. Results: From March to April 2025, the device was used in 42 adult ED patients; 28/42 (66.7%) cases had core laboratory TAT data available. The mean core laboratory TAT was 18 minutes (range: 0-33) for blood gas syringe samples and nine minutes (range: 0-19) for plasma samples. From August to October 2025, 32 clinicians completed the survey. Most respondents reported using ePOC at least monthly (31/32, 96.9%), and 21/32 (65.6%) rated it as easy or very easy to use. Among 29 respondents to the training item, 16 (55.2%) felt training was adequate, while eight (27.6%) felt it was inadequate. Reported benefits included improved efficiency of blood analysis (24/30, 80.0%), shorter time to critical results (25/31, 80.6%), and faster clinical decision-making (25/30, 83.3%). Overall, 24/32 (75.0%) respondents were satisfied or very satisfied, and 29/32 (90.6%) supported continued ED use. Reported barriers included calibration delays, lack of direct electronic medical record integration, and perceived concerns regarding agreement with laboratory values. CONCLUSION: Clinician responses were generally supportive of ePOC use, but perceptions of inadequate training and workflow challenges suggest that its benefits may depend on a more structured implementation approach.