At Aculabs, an East Brunswick, New Jersey-based company that services long-term and acute-care facilities, laboratory director Rita Khoury, MD, DABCC, FAACC, CPP, spends her days overseeing testing for these entities, with the goal of turning around test results quickly to help reduce hospital readmission among residents. This includes a point-of-care testing (POCT) program started in 2014, which became the first and only laboratory program in the Mid-Atlantic that can help maintain, train and integrate bedside blood analysis.
So when Khoury saw an email from AACC last year announcing its new POCT Professional Certification, she was very excited, and applied immediately. Khoury became one of the first POCT professionals to take the exam last November, and soon added the CPP (certified point-of-care testing professional) initials to her name.
“It speaks to the strengths of this field, and it puts us at the same level as medical board certification for any other specialty,” said Khoury, who also holds certification in clinical chemistry from the American Board of Clinical Chemistry. The CPP credential “tells you that this person has a knowledge in POCT regulations, compliance, quality management, leadership, communication and other aspects of POCT, and it benefits everybody—not only our laboratory staff, but also the doctors, hospitals and facilities we serve.”
In addition, she said, CPP certification gives her clients more confidence that when they receive lab test results, they know “behind every number, someone certified is supervising the process.”
The CPP credential, the first of its kind in the United States, certifies testing personnel who have demonstrated competency in all areas of POCT, including regulation and compliance, quality management, education and training, instrument selection and connectivity and information technology. This credential is for all workers who perform diagnostic tests outside central laboratories, including laboratory managers and nursing managers, and additional health professionals such as respiratory therapists or pharmacists and pharmacy technicians.
The certification was designed to elevate the POCT profession and enhance the recognition of POCT as a subspecialty of laboratory medicine with its own unique challenges, goals and operation, said T. Scott Isbell, PhD, DABCC, president of AACC’s Point-of-Care Professional Certification Board.
POCT, defined as bedside or near-patient testing, is often performed by non-laboratory personnel, necessitating the need for a competent individual or group of individuals to provide quality oversight, said Isbell, medical director of clinical chemistry and POCT at SSM Health St. Louis University Hospital in Missouri. While POCT is one of the most rapidly growing areas of laboratory medicine, he said, this aspect of healthcare tends not to get the support and attention it needs, even sometimes within laboratories.
“You might have just a small number of people managing POCT, and they’ve had to teach themselves a lot,” Isbell said. “One of the things we were trying to do with this certification is put some emphasis on them and the important role that they play in making sure that POCT is done to the highest quality, at the highest level. That was a big driver behind the certification.”
POCT as an industry has grown from just glucose meters 25 years ago “to a veritable plethora of devices on the market today,” said Kerstin Halverson, MS, chair of AACC’s Critical and Point-of-Care Testing Division. POCT coordinators largely have had to teach themselves and learn the technologies on their own, she said.
“We wanted to have POCT be a recognized entity, much like blood bank, clinical chemistry and other fields within laboratory medicine that have certifications,” said Halverson, clinical applications manager in the acute care diagnostics division of Instrumentation Laboratory in Bedford, Massachusetts. POCT “is another department, often in the lab but not often well-recognized. Having that certification really helps set us apart and show it’s a deemable department within laboratories or hospitals that really should be recognized.”
Lilah Evans, MT, CPP, agreed. The POCT supervisor at Thomas Jefferson University Hospital in Philadelphia took the exam in May and found out this summer that she had passed, delighting her supervisor and colleagues.
“POCT is a burgeoning, developing field just blowing up,” said Evans. “It’s developing so quickly that it’s really easy to lose focus and get out of date very fast. You have to stay up on things.”
When she was in school in the 1990s, there was no mention of POCT, said Evans. All of her skills have been learned on the job. “It wasn’t one of the major disciplines of medical laboratory science—it’s a new field,” she added. Preparing for the exam gave her renewed motivation to make sure her knowledge was current and increased her confidence at work. The certification, she said, validated her knowledge and experience.
Those who become certified could reap additional benefits in the long term, Isbell noted. These could include higher compensation, job promotions, or titles that more accurately reflect POCT roles. “We’d like to see POCT programs directed by these professionals, and then eventually hope that employers will say we prefer this certification, or maybe eventually require it,” he said.
The two-hour online exam, offered twice a year, consists of 175 multiple choice questions, said Joyce Arregui, AACC’s senior manager of professional education. Those who sit for the exam can take it at home but are monitored by a proctor via webcam, she noted. Thirty-two individuals have been certified so far.
Before taking the exam, however, applicants must have their credentials reviewed by the AACC Point-of-Care Professional Certification Board, Arregui added. They must provide a college or university transcript showing they have a four-year degree in a biological, physical, or medical laboratory science from an accredited institution (those who have been educated outside the U.S. must provide a credential equivalency report from a credentialing agency). Applicants also need to submit a letter from a supervisor stating they have at least two years of experience in POCT, a current resume or CV, and two letters of recommendation from people who can attest to the applicant’s professional qualifications.
AACC has a number of resources available online to help candidates prepare for the exam, Arregui said. These include a content outline, as well as a point-of-care specialist educational certificate program that features eight online courses in POCT essentials such as regulations,policies and procedures.
There are POCT websites with good information, said Isbell, and the AACC Artery, an online forum, has a group dedicated to POCT topics. In addition, he advised, candidates should look for mentors at their institutions/labs or nearby hospitals, as well as opportunities to attend local or regional POCT meetings hosted by AACC or other organizations.
“POCT is a really exciting part of laboratory medicine,” Isbell said, “and I want people to get more engaged with it. If anything, it’s going to continue to grow. We will see more tests move out of the lab to the bedside.”
Don’t forget to study, emphasized Halverson. “It’s not an easy exam,” she said. “There are some hard questions, so it requires some good lab knowledge to know the answers and get through it.”
She knew of one group of candidates who banded together for a telephone study group and tackled different topics within the study guide to help each other prepare.
The CPP credential is worth it, stressed Evans and Khoury.
“I really love the work and love the field,” Evans said. “It’s a great mix between laboratory science and logistics. I get to be a little bit social with different departments, I get to see a lot of what goes on in a hospital, and I get out of the lab. It was a good validation of my experience.”
“I’m encouraging everyone, even here in our lab, if you are qualified in POCT, you have to take the test,” added Khoury. “You’ve done enough hard work, just get officially recognized for it.”
Applicants looking to take the next exam should apply by spring 2020. For more information, see https://www.aacc.org/education-and-career/aacc-certification/point-of-care-testing-professional-certification.