採用量化指標改善急診檢驗服務質量

Improve urgent test turn-around time using measurement indicator

目的調查設立急診檢驗TAT監控指標,對提高急診檢驗效率的作用。方法利用實驗室資訊系統收集2010年2月至4月間急診科送檢血鉀的TAT,對資料中的不符合項,按時間段(每小時為一時間段)統計每天不同時間段的TAT不符合項數目分佈及分析產生原因,從而不斷優化工作流程,並按月份(2~8月)進行統計並比較設立TAT監控指標(5月開始)前後每月的TAT平均值和不符合率的變化。結果2~4月資料中的不符合項按每天的時段(每小時)進行統計,6:00~7:00、9:00~12:00以及14:00三個時段的TAT不符合項數量較多;按月份對比,2~4月急診血鉀的TAT平均值較大,TAT不符合率較高,5~8月的TAT平均值及TAT不符合率有明顯的降低。結論對檢驗TAT不符合項數量影響最大的因素是工作流程的交接點和樣本量,設立檢驗TAT監控指標,持續優化工作流程對提高急診檢驗效率是一個相當有效的方法。

Objective To observe the efficiency improvement of emergency department(ED)test by setting the goal of turnaround time(TAT).Methods Collect the TAT data of emergency department in biochemistry including Potassium from February to April in 2010 through laboratory information system(LIS).According to the time bucket(a time bucket per hour)to distribute the outlier of TAT and analyze the reason of the outlier events,thus optimizing the workflow constantly.Then sort out the data according to month(February-August)and comparatively analyze the difference in the TAT average value and outlier rate the TAT indicator(begin in May)Before and after in practice.Results The data(from February to April)According to the time bucket(a time bucket per hour)shows the outlier events in 6:00~7:00,9:00~12:00 and 14:00 three periods with a quantity more;To month contrast,ED Potassium TAT average value longer and outlier rate relatively high February–April,ED Potassium TAT average value and outlier rate have obvious reducing in May-August.Conclusion The interface point of the workflow and sample volume are most important factor to influence TAT and outlier rate,set up and monitor TAT indicator,it is a quite effective method to optimize the workflow and in improving service of the emergency department test continuously.