临床急诊生化检验标本周转时间的改进

Improvement of the turnaround times of STAT biochemistry test in clinical laboratory

目的 针对性改进临床检验周转时间,提升检验科服务质量.方法 利用LIS和HIS系统收集2016年8月1日至9月30日武汉同济医院检验科急诊生化标本TAT相关数据.采用EXCEL和SPSS进行数据统计和分析,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,采集到签收,签收到报告和采集到报告TAT中位数和第90百分位数,并且分别以2、2和4 h作为急诊标本采集到签收,签收到报告和采集到报告规定时间,计算不及时率.同时对不同临床科室标本申请到采集时间,不同采集时间段标本采集到签收时间,以及不同签收时间段标本签收到报告TAT进行统计学描述.结果 共纳入32 235份急诊生化标本,标本申请到报告期间用时最长的阶段为标本申请到采集（P50： 681 min,P90：1 261 min）,其次为采集到签收（P50：94 min,P90：169 min）,最短为标本签收到报告（P50：68 min,P90：111 min）时间.妇科肿瘤和器官移植等科室标本申请到采集时间较长,而感染科和心血管等科室则较短.2：00到3：59采集的标本送检时间最长,6：00到7：29签收的标本签收到报告时间较长.不同采集时段急诊标本量与标本采集到签收TAT无显著相关,但是不同签收时段急诊标本量则与签收到报告TAT显著相关.结论 对TAT数据进行分析有助于帮助医院和实验室寻找存在的问题,提供改进方向缩短TAT.

 Objective To shorten the stat test turnaround time （TAT） and improve the quality of service in clinical laboratory.Method Stat test TAT related data of clinical laboratory in Tongji hospital in Wuhan from August 1st to September 30th were collected by laboratory information system and hospital information system.EXCEL and SPSS were used for data analysis.Median and the 90th percentile were calculated for TATs from order to collection, collection to transfer, transfer to reception, reception to inspection and inspection to report.Outlier rates were calculated for TAT from collection to reception, reception to report, and collection to report using 2 h, 2 h, and 4h as target TAT value, respectively.Meanwhile descriptive statistics were calculated for TAT from order to collection in different clinical department, TAT from collection to reception during different collection time frames, and TAT from reception to report during different reception time frames.Results 32 235 stat biochemistry test data were included in this survey.Among three periods cut by collection and reception time, TAT from order to collection were the longest （P50： 681 min,P90：1261 min）, followed by TAT from collection to reception（P50：94 min,P90：169 min） and TAT from reception to report（P50：68 min,P90：111 min）.TATs from order to collection were longer in gynecological tumor department and organ transplantation department while shorter in infection department and cardiac vascular department.The TATs from collection to reception of specimen collected during 2：00 to 3：59 were longer than other collection time.While the TATs from reception to report of specimen received during 6：00 to 7：29 were longer than other reception time.There was no significant correlation between the amount of emergency specimens collected and TAT from collection to reception in different collection time period.However, the amount of emergency specimens collected was significantly correlated with the TAT from reception to report in different reception time period.Conclusions Analysis of TAT data can be used to identify existing problems and provide improved directions to shorten TAT in clinical laboratories.