运用品管圈方法开展检验报告双审核质量控制的价值

Application of quality control circle in the control quality management of report in clinical laboratory

目的探讨品管圈管理工具在提高检验报告双审核执行率及检验报告质量中的应用效果。方法运用品管圈质量管理常用工具,从品管圈整改前上海儿童医学中心检验科2012年10至12月50 300份检验报告中随机抽样5%,共计2515份;再从同院检验科品管圈整改后2013年1月至2014年6月301 780份检验报告中随机抽样5%,共计15 089份,进行品管圈质量管理前、后的检验报告双审核执行率比较和未执行检验报告双审核原因分析;同时,自制品管圈无形成果评分表,针对品管工具能力、沟通协调、集思广益、团队精神、发掘问题、活动信心等6个维度评分,各项评分均为10分制,由10名圈员各自打分,确认品管圈执行后的无形成果。结果实施品管圈整改前临床检验报告双审核执行率为67.4%(1 695/2 515份),品管圈整改后为90.4%(13 640/15 089份),两者差异有统计学意义(x2=983.16,P<0.01)。无形成果的确认中,6个维度评分平均值均提高,活动成长均正向增长,达到2.9以上,其中质量管理工具应用幅度最大,达4.2,且实施前后差异具有统计学意义(t值分别为-7.28、-6.53、-5.10、-9.66、-9.44、-5.34,P均<0.01)。结论运用品管圈管理工具可有效提高检验报告双审核执行率,增强检验人员解决临床实际问题时的品管工具运用、沟通协调、集思广益、团队精神、发掘问题能力及活动信心。

Objective To explore the effect of quality control circle in increasing the audit execution rate and improving quality of inspection report in clinical laboratory. Methods A quality control circle was set up to use professional tools to solve existing problems of inspection reports at 5 percent sampling of all the inspections. Before the application of a quality control circle method, the studied 2 515 detection reports from Qctober 2012 to December 2012; after that, the studied 15 089 detection reports from January 2013 to June 2014 in the clinical laboratory respectively, The exectution rate and cause analysis of the non-execution of double audit were compared. To confirm the effect of the intangible results such as application of quality control circle tool, communication coordination, brainstorm, teamwork spirit, question discovery and confidence, self efficacy scale was scored by 10 quality control circle members to compare the effect of activity score. Results The audit execution rate of inspection reports in clinical laboratory increased from 67.4% （1 695/2 515 reports） to 90.4% （13 640/15 089 reports） with significant difference （χ2=983.16, P〈0.01）. To confirm the effect of intangible results, the average scores of application of quality control circle tool, communication coordination, brainstorm, teamwork spirit, question discovery and confidence obtained by questionnaire survey were totally increased more than 2.9, with the highest increment of 4.2 in application of quality control circle. Before and after the quality improvement, thedifference is significant at the t value of-7.28, -6.53, -5.10, -9.66, -9.44, -5.34, P〈 0.01 level. Conclusion With the application of quality control circle tools, the audit execution rate of inspection reports in clinical laboratory significantly increases and the quality management ability of quality control circle members to resolve actual clinical problems improves.