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全国周转时间调查:最佳绩效的专业共识标准以及被认为会损害高效有效临床管理的阈值。

National turnaround time survey: professional consensus standards for optimal performance and thresholds considered to compromise efficient and effective clinical management.

作者信息

McKillop Derek J, Auld Peter

机构信息

1 Department of Clinical Biochemistry, Southern HSC Trust, Craigavon, UK.

2 Department of Clinical Biochemistry, Belfast HSC Trust, Belfast, UK.

出版信息

Ann Clin Biochem. 2017 Jan;54(1):158-164. doi: 10.1177/0004563216651887. Epub 2016 Sep 28.

DOI:10.1177/0004563216651887
PMID:27166313
Abstract

Background Turnaround time can be defined as the time from receipt of a sample by the laboratory to the validation of the result. The Royal College of Pathologists recommends that a number of performance indicators for turnaround time should be agreed with stakeholders. The difficulty is in arriving at a goal which has some evidence base to support it other than what may simply be currently achievable technically. This survey sought to establish a professional consensus on the goals and meaning of targets for laboratory turnaround time. Methods A questionnaire was circulated by the National Audit Committee to 173 lead consultants for biochemistry in the UK. The survey asked each participant to state their current target turnaround time for core investigations in a broad group of clinical settings. Each participant was also asked to provide a professional opinion on what turnaround time would pose an unacceptable risk to patient safety for each departmental category. A super majority (2/3) was selected as the threshold for consensus. Results The overall response rate was 58% ( n = 100) with a range of 49-72% across the individual Association for Clinical Biochemistry and Laboratory Medicine regions. The consensus optimal turnaround time for the emergency department was <1 h with >2 h considered unacceptable. The times for general practice and outpatient department were <24 h and >48 h and for Wards <4 h and >12 h, respectively. Conclusions We consider that the figures provide a useful benchmark of current opinion, but clearly more empirical standards will have to develop alongside other aspects of healthcare delivery.

摘要

背景 周转时间可定义为从实验室收到样本到结果验证的时间。皇家病理学家学院建议应与利益相关者商定一些周转时间的性能指标。困难在于要确定一个有证据支持的目标,而不仅仅是目前技术上能够实现的目标。本次调查旨在就实验室周转时间目标及其意义达成专业共识。方法 国家审计委员会向英国173名生物化学首席顾问发放了调查问卷。该调查要求每位参与者说明他们在广泛的临床环境中进行核心检查的当前目标周转时间。还要求每位参与者就每个部门类别中多长的周转时间会对患者安全构成不可接受的风险发表专业意见。选择绝大多数(2/3)作为达成共识的阈值。结果 总体回复率为58%(n = 100),临床生物化学与检验医学协会各地区的回复率在49%至72%之间。急诊科的共识最佳周转时间为<1小时,>2小时被认为不可接受。全科医疗和门诊部的时间分别为<24小时和>48小时,病房的时间分别为<4小时和>12小时。结论 我们认为这些数字提供了当前意见的有用基准,但显然还需要与医疗服务的其他方面一起制定更具实证性的标准。

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