临床检验急诊血常规标本周转时间分析

Analysis of turnaround of stat routine hematology tests in clinical laboratory

目的调查分析急诊血常规标本周转时间(TAT),为缩短TAT提供方向。方法利用实验室信息系统和医院信息系统收集2017年2月13-26日检验科急诊血常规标本TAT相关数据。使用EXCEL计算标本申请到采集、采集到送达、送达到签收、签收到检验、检验到报告、送达到报告和采集到报告的时间。并且分别以2、1、3h作为采集到送达、送达到报告、采集到报告的规定时间计算不及时率。对不同临床科室标本申请到采集时间,不同采集时间段采集到送达时间,以及不同送达时间段签收到报告TAT进行统计学描述。结果共纳入住院急诊血常规标本6 691份,其中247份标本复片。申请到采集TAT最长(P50:601min,P90:1 244min),送达到报告TAT则最短(未复片P50:36min,P90:81min;复片P50:68min,P90:144min)。送达检验科的标本若无需复片,75%能在1h内报告,但是超过一半的需复片标本无法在1h内报告。器官移植、血液科和肿瘤科室申请到采集时间较长,而产科、感染科和心血管内科则较短。18:00到次日03:59采集的标本采集到送达不及时率较高,而08:00-09:59采集的标本不及时率较低。不管标本是否需要复检,06:00-07:29以及17:00-17:59送达检验科的急诊标本TAT延时的情况都较其他时段更为常见。结论检验科不应只着眼于自己控制范围内的实验室内TAT,还应关注检验前和检验后TAT,并对相关人员进行反馈,以便全面监控检验全过程,进一步提升服务质量。

Objective To shorten turnaround time of stat routine hematology tests in clinical laboratory through analysis of it.Methods TAT related data of stat routine hematology tests from February 13 th to26 th in 2017 were collected by laboratory information system and hospital information system.EXCEL was used to calculate TATs from order to collection,collection to transferred,transferred to reception,reception to inspection and inspection to report.Outlier rates were calculated for TAT from collection to transferred,transferred to report,and collection to report using 2,1,3 has target TAT value,respectively.Descriptive statistics were calculated for TAT from order to collection in different clinical department,TAT from collection to transferred during different collection time frames,and TAT from transferred to report during different transferred time frames with the use of SPSS.Results 6 691 stat routine hematology tests were included in this study,among which 247 needed microscopic examination.TAT from order to collection was longest while TAT from transferred to report was shortest.75% of specimens can be reported within 1 hafter transferred if microscopic examinations were not needed.However more than half of specimens can not complete within 1 hif microscopic examinations were needed.TAT from order to collection were longer in organ transplantation department,hematology department and tumor department while shorter in obstetrics department,infectious disease department and cardiovascular department.The TAT from collection to transferred of specimen collected during 18:00 to 03:59 were longer than other collection time and were shortest during 08:00 to 09:59.Meanwhile The TAT from transferred to report of specimen transferred during 06:00 to 07:29 and 17:00 to 17:59 were longer than other transferred time whether microscopic examinations were needed.Conclusion Clinical laboratories should not only focus on TAT within laboratory,but also pay attention to pre-examination and post-examination TATs and give suggestions to related staff.Only in this way,can we monitor the whole examination process and improve the quality of service further.