医学检验危急值报告评估与持续改进

Assessment and continual improvement of critical value reports of medical examinations

目的通过对本院医学检验科危急值报告开展分析,并探讨其持续改进方向。方法选择本院近2年实验室信息管理系统(LIMS)中的6 481例危急值报告,依次在其科室分布、检测项目、发生时间与处理效果等方面进行评估,总结危急值报告评估的临床作用,并阐述其持续改进内容。结果本研究危急值报告最常见于ICU科、血液科与肝肾内科,最常见检验项目为血钾、血小板计数与白细胞计数,每周一、周四以及每日9:00—13:00危急值报告发生率最高,各科室处理效果基本相当,而ICU与肿瘤内科处理率最高。结论危急值报告高发科室、项目以及发生时间存在一定规律性,需定期进行数据分析,给予针对性持续改进措施,以完善临床工作质量。

Objective To explore the continual improvement of critical value reports of medical examinations. Methods A total of 6 481 cases of critical value reports were selected in LIMS system, and the department distribution, test items, time of occurrence and processing effects were assessed. The clinical role of the critical value reports was sum- marized and the continuous improvement measures were elaborated. Results In this study, the most common departments of critical value reports were ICU, hematology department, and liver and kidney internal medicine. K＋, PLT and WBC were the most common test items. The high incidence time was on Monday, Thursday and 9：00-13：00 in daily. The department processing effects were roughly equal, while the process rates of ICU and oncology treatment were higher than those of the other departments. Conclusion There is certain regularity in the departments, projects, and occurrence time of critical value reports, and therefore, the sustained implementation analysis of the data is needed to continuous improvement.