PDCA循环在缩短急诊检验全程样本周转时间中的应用

Application of PDCA cycle in shortening sample turnover time of emergency inspection

目的:建立并不断完善急诊检验标本的全程样本周转时间(TAT)评价方案,促进急诊标本TAT的内部监测,不断提高实验室的服务质量。方法:采用实验室信息系统(LIS)和医院信息系统回顾性统计分析,2017年4至6月实行PDCA管理前与2018年4至6月应用PDCA管理后急诊检验标本TAT相关数据。使用Excel电子表格计算全血细胞计数、急诊干生化标本、凝血常规项目的检验前TAT、检验中TAT、检验后TAT和总TAT。结果:经过PDCA管理后,全血细胞计数的检验前TAT、检验中TAT、检验后TAT和总TAT均明显低于实施之前,前后差异有统计学意义(P<0.05);急诊生化标本检验前TAT、检验中TAT、检验后TAT和总TAT均明显低于实施之前,差异有统计学意义(P<0.05)。凝血常规项目的检验前TAT、检验中TAT、检验后TAT和总TAT均明显低于实施之前,差异有统计学意义(P<0.05)。结论:通过使用PDCA质量管理工具缩短全程样本周转时间,减少临床医生的等待时间,为急诊患者抢救赢得时间,推动实验室质量管理的持续改进。

Objective:To establish and continuously improve the evaluation scheme of the whole-course sample turnover time(TAT)of emergency test specimens,promote the laboratory to carry out internal control of the whole-course TAT of test specimens,and continuously improve the quality of laboratory services.Method:The laboratory information system(LIS)and hospital information system were used to analyze retrospectively TAT data of emergency test specimens from April to June 2017 before PDCA management and from April to June 2018 after PDCA management.TAT before the test,TAT during the test,TAT after the test and total TAT of whole blood cell count,emergency dry biochemical tests and coagulation routine items were counted by Excel spread sheet.Result:After PDCA management,TAT before test,TAT during test,TAT after test and total TAT before and after test of whole blood cell count were significantly lower than those before implementation,and the difference was statistically significant(P<0.05).After PDCA management,TAT,TAT in the test,TAT after the test and total TAT of emergency dry biochemical test were significantly lower than before,and the difference was statistically significant(P<0.05).The TAT before test,TAT during test,TAT after test and total TAT after test of coagulation routine items were significantly lower than those before implementation.The difference was statistically significant(P<0.05).Conclusion:Use of PDCA quality management tools could shorten the whole sample TAT,reduce the waiting time of clinicians,win time for emergency patient rescue,and promote the continuous improvement of laboratory quality management.