全要素智能审核在临检各学科结果报告应用中的功效评估
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摘要
目的使用自主开发的金域实验室信息管理系统中的全要素智能审核平台,通过在生化发光、临床血液、临床免疫、质谱、微生物、基因及病理等临检学科分别设置项目的自动审核预警规则,将大量原本需要由人工审核发布的检验报告单交由计算机代为发布,从而减少人工差错引起的报告单结果错误,降低样本周转时间,节约人力成本,提高工作效率。方法根据生化发光、临床血液、临床免疫、临床微生物、基因及病理等临检学科的技术要求和行业标准,设定多条不同的预警规则对检测结果进行判断,判断通过即可由计算机将结果发布,判断不通过则将结果拦截转为人工审核发布。定期统计每个检测项目的自动审核通过情况,并逐步优化预警规则,比较自动审核功能使用前后的样本周转时间(turn around time, TAT)变化和报告单批准人员数量变化来评估自动审核功效。结果实验室各学科使用自动审核功能后,报告单发布的准确性和时效性均出现了明显的提高,平均TAT缩短0.5 h,合计人员减少4人,报告单缺陷率降低80%。结论我中心开发的全要素自动审核程序可以满足更多学科的结果报告自动审核需求,优于市场上大多数的自动审核中间件。使用自动审核功能不仅可以进一步提高实验室工作效率,缩短TAT,还能够减少人为因素引起的结果审核质量缺陷,维护实验室的分析质量保证。
Objective Use the self-developed all-factor intelligent auditing platform in theKMClient laboratory information system to release a large number of inspection reports, the automaticauditing and early warning rules of items are set up in biochemical luminescence, clinical blood, clinicalimmunology, mass spectrometry, microorganism, gene and pathology and a large number of inspection reportsoriginally required to be issued by manual auditing are submitted to the computer for publication, thus reducethe number of people and the error of the report result caused by manual error, reduce the sample turn aroundtime(TAT), save labor costs and improve work efficiency. Methods According to the technical requirementsand industry standards of biochemical luminescence, clinical blood, clinical immunology, clinicalmicrobiology, gene and pathology, several autoverification rules are set up respectively to judge the results.The results can be released by computer if judgement is passed, otherwise the results will be intercepted andreleased by manual verification statistical regularly on the status of automatic audit approval of each testitem, and gradually optimize the early warning rules, compare the TAT changes before and after the use ofautomatic audit function and the number changes of report approval personnel to evaluate the effectiveness ofautomatic audit. Results After the use of the automatic audit in all disciplines of the laboratory, the accuracyand timeliness of the report have been significantly improved. The average TAT in each department has beenshortened by 0.5 h and the total number of staffs has been reduced by 4, and the defect rate of the reportdefect rate has been reduced by 80%. Conclusion The all-factor intelligent auditing platform developed byour center can meet the needs of many disciplines, and is superior to most of the automatic audit middlewarein the market. The use of automatic audit can not only further improve the efficiency of laboratory work andshorten TAT, but also reduce the quality defects caused by human factors, and maintain the quality assuranceof laboratory analysis.
Objective Use the self-developed all-factor intelligent auditing platform in theKMClient laboratory information system to release a large number of inspection reports, the automaticauditing and early warning rules of items are set up in biochemical luminescence, clinical blood, clinicalimmunology, mass spectrometry, microorganism, gene and pathology and a large number of inspection reportsoriginally required to be issued by manual auditing are submitted to the computer for publication, thus reducethe number of people and the error of the report result caused by manual error, reduce the sample turn aroundtime(TAT), save labor costs and improve work efficiency. Methods According to the technical requirementsand industry standards of biochemical luminescence, clinical blood, clinical immunology, clinicalmicrobiology, gene and pathology, several autoverification rules are set up respectively to judge the results.The results can be released by computer if judgement is passed, otherwise the results will be intercepted andreleased by manual verification statistical regularly on the status of automatic audit approval of each testitem, and gradually optimize the early warning rules, compare the TAT changes before and after the use ofautomatic audit function and the number changes of report approval personnel to evaluate the effectiveness ofautomatic audit. Results After the use of the automatic audit in all disciplines of the laboratory, the accuracyand timeliness of the report have been significantly improved. The average TAT in each department has beenshortened by 0.5 h and the total number of staffs has been reduced by 4, and the defect rate of the reportdefect rate has been reduced by 80%. Conclusion The all-factor intelligent auditing platform developed byour center can meet the needs of many disciplines, and is superior to most of the automatic audit middlewarein the market. The use of automatic audit can not only further improve the efficiency of laboratory work andshorten TAT, but also reduce the quality defects caused by human factors, and maintain the quality assuranceof laboratory analysis.
引文
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7冯强.临床生化检验结果的自动审核[J].国际检验医学杂志,2015,36(4):547-548.
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10雷和月,王红旗,郭远瑜,等.免疫学检验结果自动审核程序的建立及其应用[J].临床检验杂志,2015,33(5):388-390.
2 Oosterhuis WP,Ulenkate HM,Goldschmidt HM.Evaluation of LabRespond,a new automated validatiuon system for clinical laboratory test results[J].Clin Chem,2000,46(11):1811-1817.
3 International Organization for Standardization.ISO 15189:2012,Medical laboratories requirements for quality and competence[S].http://www.iso.org.
4 College of American Pathologists.Laboratory general checklist laboratory computer services[Z].http://www.cap.org.
5 Clinical and Laboratory Standars Institute.AUTO10-A Autoverification of clinical laboratory test results:approved guideline[S].2006.
6夏良裕,程歆琦,刘茜,等.临床实验室生化免疫项目自动审核程序的建立与应用[J].中华医学杂志,2017,97(8):616-621.
7冯强.临床生化检验结果的自动审核[J].国际检验医学杂志,2015,36(4):547-548.
8杨大干,胡长爱,邢美园,等.临床决策支持在检验结果自动审核和解释中的应用评价[J].中国数字医学,2014,9(17):45-47.
9何訸,余霆,罗通行.大量历史数据在生化项目自动审核测试验证中的应用[J].中国数字医学,2017,12(2):68-70.
10雷和月,王红旗,郭远瑜,等.免疫学检验结果自动审核程序的建立及其应用[J].临床检验杂志,2015,33(5):388-390.