临床检验前和检验后阶段的管理

Management of the Pre-and Post-analytical Phases of the Clinical Laboratory

临床实验室长期致力于检验质量,已使其产生错误发生率的西格玛水平为4～5,其超过大多数其他医疗领域。然而,对检验前及检验后阶段错误率的更深的理解及他们对患者潜在的伤害已导致加强对实验室的要求,要求实验室对其直接控制之外的活动承担更大的责任。认可机构有对检验外阶段有效管理的相关要求。有各种免费在线资源可用来帮助管理检验外阶段,国际临床化学及检验医学联合会实验室差错和患者安全工作组最近发表的质量指标和提出性能水平提供了特别有用的基准数据。通过建立在现有的质量管理经验、定量的科学背景及对信息技术的精通,临床实验室适合在实验室范围外在减少差错和提高患者安全方面发挥更大的作用。

Clinical laboratory＇s focus on analytical quality has resulted in an error rate of 4～5,which surpasses most other areas in healthcare. However,greater appreciation of the prevalence of errors in the pre-and post-analytical phases and their potential for patient harm has led to increasing requirements for laboratories to take greater responsibility for activities outside their immediate control. Accreditation bodies now require clear and effective management for extra-analytical phase. There are a variety of free on-line resources available to aid in managing the extra-analytical phase, and the recent publication of quality indicators and proposed performance levels by the International Federation of Clinical Chemistry and Laboratory Medicine working group on laboratory errors and patient safety provides particularly useful benchmarking data. By building on its existing quality management expertise,quantitative scientific background and familiarity with information technology,the clinical laboratory is well suited to play a greater role in reducing errors and improving patient safety outside the confines of the laboratory.