急诊检验实验室内周转时间的管理与实践
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摘要
目的通过对2015年急诊检验各类项目的实验室内周转时间(TAT)中位数、检验报告规定时限符合率、报告超时原因等指标的统计分析,掌握急诊检验的实际工作效率现状,分析存在的问题,为持续改进提供客观依据。方法按照不同类别项目的号段不同,从LIS系统导出各类项目的原始数据,利用Mircosoft Excel2003软件统计出各类项目的实际TAT时间,利用函数功能计算TAT中位数;并计算出检验报告规定时限符合率和不符合率(即检验报告超时率),并对每天所记录的报告超时原因汇总统计分析。结果 2015年急诊检验各类项目的 TAT中位数与2014年比较,除化学发光类项目外,其他项目类TAT均有不同程度缩短;各类项目的检验报告时限符合率平均为94.8%,检验报告规定时限不符合率(即检验报告超时率)为5.2%;主要超时原因前4位依次是送检样本数量多(59.6%)、重做复检(12.4%)、涂片复检(12.0%)和仪器故障(10.0%)。结论急诊检验报告时限符合率达到规定的要求,对超时原因统计分析,可查找存在问题并分类采取相应的措施,为持续改进提供客观依据。
Objective To master the actual work efficiency situation of emergency inspection,analyze the existing problems,and provide objective basis for continuous improvement through the statistic analysis of intra-laboratory turn-around time(TAT)median,coincidence rate of inspection report within the specified time limit,report timeout reasons and other indexes of different items of emergency inspection group in 2015.Methods All kinds of original data from the different items of emergency inspection groupswere derived from LIS system,according to the different types of projects in different segments.Microsoft Excel2003 software was used to count the actual TAT time of various items,and function was used to calculate TAT median;The non-conformance rate(inspection report timeout rate)and coincidence rate within the prescribed time limit by inspection report were calculated,and gather the statistical analysis on the timeout reasons of daily recorded report.Results With the exception of electrochemical luminescence class,the TAT of other items decreased in different degrees of emergency inspection group in 2015 when compared with 2014.The average coincidence rate of inspection report of various items within the time limit was 94.8%,non-conformance rate of inspection report of prescribed time limit was 5.2%.The top four inspection timeout reasons of various items were more number of submitted samples(59.6%),redo the reinspection(12.4%),smear reinspection(12.0%)and equipment failure(10.0%)in turn.Conclusion The time limit of the emergency report meets the specified requirements and statistical analysis of the causes of overtime can find out the problems and take appropriate measures to provide an objective basis for continuous improvement.
Objective To master the actual work efficiency situation of emergency inspection,analyze the existing problems,and provide objective basis for continuous improvement through the statistic analysis of intra-laboratory turn-around time(TAT)median,coincidence rate of inspection report within the specified time limit,report timeout reasons and other indexes of different items of emergency inspection group in 2015.Methods All kinds of original data from the different items of emergency inspection groupswere derived from LIS system,according to the different types of projects in different segments.Microsoft Excel2003 software was used to count the actual TAT time of various items,and function was used to calculate TAT median;The non-conformance rate(inspection report timeout rate)and coincidence rate within the prescribed time limit by inspection report were calculated,and gather the statistical analysis on the timeout reasons of daily recorded report.Results With the exception of electrochemical luminescence class,the TAT of other items decreased in different degrees of emergency inspection group in 2015 when compared with 2014.The average coincidence rate of inspection report of various items within the time limit was 94.8%,non-conformance rate of inspection report of prescribed time limit was 5.2%.The top four inspection timeout reasons of various items were more number of submitted samples(59.6%),redo the reinspection(12.4%),smear reinspection(12.0%)and equipment failure(10.0%)in turn.Conclusion The time limit of the emergency report meets the specified requirements and statistical analysis of the causes of overtime can find out the problems and take appropriate measures to provide an objective basis for continuous improvement.
引文
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[8]童妙春,张珏,王依屹,等.医学认可实验室样本周转时间的分析[J].国际检验医学杂志,2014,35(3):375-376.
[9]罗春华,赵武,鲜胜,等.生化免疫分析流水线检测系统应用与评价[J].检验医学,2015,12(12):1243-1245.
[10]袁咏梅,刘和录,徐志康,等.如何缩短生化样本周转时间[J].国际检验医学杂志,2012,33(3):261-263.
[11]张丽娜,谷峰,董振南,等.急诊生化检测样本周转时间分析与改进[J].中国卫生质量管理,2014,21(6):39-41.
[12]黎海生,熊林怡,张鸿伟,等.急诊检验报告周转时间的实时监控及持续改进[J].重庆医学,2016,45(8):1128-1130.
[2]王治国,费阳,康凤凤,等.国家卫生计生委发布临床检验专业15项医疗质量控制指标(2015年版)内容及解读[J].中华检验医学杂志,2015,38(11):777-781.
[3]郭翀,刘子杰,宋贵波,等.对15项临床检验专业质控指标5年统计与分析[J].中华检验医学杂志,2016,39(1):29-33.
[4]王治国,费阳,王薇,等.理解临床检验质量指标,抓质量从实验室内部做起[J].中华检验医学杂志,2016,39(1):4-6.
[5]严碧勇,沈凌炜,王琪.绿色通道对提高急诊样本周转效率的影响[J].实验与检验医学,2016,34(2):191-193.
[6]邓朝晖,宋颖博,姜宏兵,等.急诊科与重症医学科急诊样本周转时间的比较分析[J].重庆医学,2014,35(35):4760-4763.
[7]郦卫星,王治国,康凤凤,等.浙江省15项临床检验质量指标调查结果与分析[J].中华检验医学杂志,2016,39(1):23-28.
[8]童妙春,张珏,王依屹,等.医学认可实验室样本周转时间的分析[J].国际检验医学杂志,2014,35(3):375-376.
[9]罗春华,赵武,鲜胜,等.生化免疫分析流水线检测系统应用与评价[J].检验医学,2015,12(12):1243-1245.
[10]袁咏梅,刘和录,徐志康,等.如何缩短生化样本周转时间[J].国际检验医学杂志,2012,33(3):261-263.
[11]张丽娜,谷峰,董振南,等.急诊生化检测样本周转时间分析与改进[J].中国卫生质量管理,2014,21(6):39-41.
[12]黎海生,熊林怡,张鸿伟,等.急诊检验报告周转时间的实时监控及持续改进[J].重庆医学,2016,45(8):1128-1130.