6σ管理在电解质检测性能持续改进中的应用

The Application of Six Sigma Management in Continuous Improvement of Electrolyte Detection Performance

目的运用六西格玛(6σ)管理理论评价电解质分析项目中阶段的检测性能、发现问题、指导实验室质量的持续改进,并对改进效果加以验证。方法(1)将两个水平室内质控在控数据的累积变异系数(CV)合成,并将合成后的CV作为不精密度的估计值,将2017年度卫生部临床检验中心电解质正确度验证计划中两个批号偏倚的绝对值的平均值作为检测的偏倚估计值,以卫生行业标准WS/T403-2012中电解质项目的允许总误差作为质量规范,计算电解质项目的西格玛(σ)值,未达到6σ水平的检测项目,计算质量目标指数(QGI)值,查找导致性能不佳的主要原因,并进行质量改进;(2)2018年卫生部临床检验中心电解质正确度验证计划结果反馈后,用同样的方法计算各项目的σ度量值,并比较改进前后σ度量值的差异,验证质量改进的效果。结果经过将近1年的持续改进,各项目的改进效果明显,σ水平大幅提升,具体如下:钾由3.07提高到6.07,钠由2.15提高到4.27,钙由1.70提高到3.03,镁由3.13提高到3.62。结论6σ管理理论可以量化电解质项目的检测性能,并能帮助实验室发现自身问题,在实验室质量持续改进中具有重要应用价值。

Objective To apply six sigma(6 σ)management theory to evaluate the detection performance of the phase of the analysis of the electrolyte items,to identify the problems,so to guide the continuous improvement of the quality of the laboratory and to verify the effect of the improvement. Methods (1)The two levels of indoor quality control were synthesized in the cumulative coefficient of variation(CV)of the controlled data,and the synthesized CV was used as an inaccurate estimation value,and the average value of the absolute value of the two batch number bias in the electrolyte correctness verification program of the Ministry of health in 2017 year was taken as the bias estimation value,and the total allowable error of the electrolytes in the health professional standard WS / T 403-2012 was taken as the quality specification to calculate the sigma(σ)value of the electrolyte items and items not reaching the level of 6 Sigma,so to calculate the quality goal index(QGI)value,and to find the main cause of the poor performance and to improve the quality.(2)The verification plan was developed for the electrolyte correctness of the Ministry of health in 2018.After obtaining the feedbacks,the Sigma(σ)values of each item were calculated by the same method,and the difference of the sigma values before and after the improvement were compared to verify the effect of quality improvement. Results After nearly a year of continuous improvement,the improvement effect of each item was obvious,the level of the sigma was greatly improved.Specifically,potassium increased from 3.07 to 6.07 ,sodium increased from 2.15 to 4.27,calcium increased from 1.70 to 3.03,and magnesium was increased from 3.13 to 3.62. Conclusion The six sigma management theory can quantify the detection performance of the electrolyte items and help the laboratory to find out its own problems.It has an important application value in the continuous improvement of the quality of the laboratory.