Dade Behring (Deerfield, Illinois) spells quality as CQI, or its Clinical Quality Initiative, in which it partners with its hospital clients to provide educational services and advice on how hospitals can maximize their use of the Stratus CS Acute Care Diagnostic System, which tests for a variety of cardiac biomarkers.

The goal is to demonstrate to hospitals how to integrate the Stratus, a point-of-care cardiac blood testing system, into the overall offerings of a laboratory. The Stratus system tests for various biomarkers for cardiac distress, including troponin and pro-BNP, as early indicators of more critical cardiac disease.

“The clinical quality team is comprised of nurses, EMTs (emergency medical technicians), as well as med-techs, and the team was [designed] basically to deliver the educational component of the diagnostic testing to clients,“ Amy Cotner, CQI manager, told Medical Device Daily.

The CQI team is made up of about 18 people including nurses, medical technologists and a physician assistant. Those team members operate within specific regions in the U.S., but are linked to clients needs through about 120 field Dade Behring representatives who deal with hospital laboratories on a daily basis, said Jeff Thomas, CQI director.

“We operate on multiple levels,“ Cotner said. “We work very closely with our chemistry reps, as well, which is a different entity within our company. We work with the laboratory, as well as the ED, so once we are approached by a hospital that has a need or desire to improve their turnaround time, we go in and we talk to them, understand their specific goals and objectives as it relates to triaging their chest pain patients.“

However, the CQI team may work with potential clients, as well as existing clients.

To assist them in providing education to clients, Dade Behring's CQI team members rely on “evidence-based guidelines as it relates to those particular patients,“ she said.

“From the Dade-Behring point of view, we take the recommended national guidelines, evidence-based guidelines, and we use that as a platform to deliver our education to these hospitals, whether it be the lab, whether it be the ED, or radiology [or] administration, our goal is to pull all of those disciplines in together,“ Cotner said.

While other companies have since adopted this model of education, Thomas said that the Dade Behring CQI team has been in place since 2001.

“We provide a lot of education all the way up to implementation, and once we implement, we handhold those customers from that point forward,“ Thomas told MDD.

One of the beneficiaries of this high level of service is Centennial Medical Center (Nashville, Tennessee).

Chuck Workman, director of emergency services, said that Centennial has been using the Stratus system since 2004. For now, Centennial only uses the Stratus for troponin testing when an ER patient presents with chest pain.

A patient presenting with chest pain at the hospital is typically met by two to four nurses, who immediately run an EKG, draw blood and enter the patient information in the system simultaneously.

“We have a troponin result in 20 minutes,“ Workman said, noting that the entire results process including the EKG takes a total of about 30 minutes.

While some hospitals' protocol for chest pain patients begins when the needle hits the vein to draw blood, Centennial actually measures its reaction time from the moment the patient enters the door, he said.

While the Stratus has the ability to test for biomarkers such as pro-BNP for heart failure, among others, Centennial has chosen to focus on chest pain at this point, Workman said.

Dade Behring provides annual training to the ED nurses and ED physicians at Centennial, and Cotner told MDD that once CQI establishes a relationship with a client, it never really ends.

“[Dade Behring] is there for the patient, and they're there for the facility, [but] the patient is first,“ Workman said.