门诊区域人工及智能静脉采血的安全性评价及成本效益分析

Safety evaluation and cost-benefit analysis of the manual and intelligent venous blood sampling in outpatient department

目的:对比分析门诊区域人工及智能静脉采血的安全性及成本效益。方法:以A院区人工静脉采血为对照,B院区实施智能静脉采血,收集样本院区2022年1月—12月财务和商务智能集成平台数据,通过现场调查法及项目成本法,测算并分析人工与智能静脉采血项目的作业时间、血标本质量、成本收益与服务效能的差别。结果:与人工静脉采血相比,智能静脉采血的登记作业时间[(10.83±4.54)秒vs(31.68±14.36)秒]、整理作业时间[(3.78±1.28)秒vs(12.60±10.12)秒]及总作业时间[(61.34±17.79)秒vs(90.54±37.20)秒]更短,项目总成本更高[(26.77±4.93)元/例vs(23.95±4.72)元/例],人力成本更低[(4.76±0.20)元/例vs(5.71±0.35)元/例],差异均有统计学意义(P<0.05)。人工采血的条码、留取及送检问题发生率均高于智能静脉采血,应用智能静脉采血系统的护士岗位服务效能高达112.07%,人工与智能静脉采血成本收益均为负收益。结论:智能静脉采血流程更加优化,作业时间缩短,血标本质量问题发生率更低,护理岗位服务效能更高。但现行静脉采血收费标准低于实际作业成本,建议适当提高静脉采血项目的收费标准,实现技术劳务价值为主的正向激励机制。

Objective:To compare and evaluate the safety and cost-benefit of the manual and intelligent venous blood collection in outpatient area.Methods:The hospital selected had two branches with the outpatient area in Branch A using manual venous blood sampling as the control group and the outpatient area in Branch B using intelligent venous blood sampling as the experimental group.From January to December 2022,both the financial data and data collected from the Business Intelligence(BI)integration platform were calculated and analyzed to test the differences between manual and intelligent venous blood sampling in terms of operation time,safety quality,cost-benefit and service efficiency through onsite investigation,insider interview and project cost method.Results:Compared with manual venous blood sampling,the registration[(10.83±4.54)s vs(31.68±14.36)s],sorting[(3.78±1.28)s vs(12.60±10.12)s]and total time of intelligent venous blood collection[(61.34±17.79)s vs(90.54±37.20)s]were less,the total cost of the project was higher[(26.77±4.93)yuan/case vs(23.95±4.72)yuan/case],the labor cost was lower[(4.76±0.20)yuan/case vs(5.71±0.35)yuan/case],and the differences were statistically significant(P<0.05).The rate of barcode,collection and submission quality problems of manual blood sampling is higher than that of intelligent blood sampling,the service efficiency of nurses applying intelligent venous blood sampling system was as high as 112.07%,and the cost-benefit of both venous blood sampling methods were negative.Conclusion:Intelligent venous blood sampling project is more optimized with shorter operation time,less blood sample quality problems and higher nursing service efficiency.However,the current charging standard is lower than the cost of venous blood sampling.It is thus suggested to appropriately increase the charging standard of venous blood sampling to promote a positive incentive mechanism focusing on realizing the value of technical services.