Al-Talib Mohammed, Leslie Isla
Brighton and Sussex University Hospitals Trust, UK.
BMJ Qual Improv Rep. 2017 Feb 2;6(1). doi: 10.1136/bmjquality.u213103.w5207. eCollection 2017.
Many hospitals deploy Medical Emergency (MET) and Cardiac Arrest teams to improve the management and treatment of patients who become critically ill. In many cases, blood results are key in allowing the clinicians involved in these teams to make definitive management decisions for these patients. Following anecdotal reports that these results were often delayed, we assessed the process of blood tests being reported in emergency calls, identified the key factors causing delays and sought to make improvements. The initial intervention involved implementing a new blood form that specified the nature of the call, the tests required and a contact number for laboratory staff to contact the clinical team with results. We also developed a streamlined process within the laboratory for these samples to be fast-tracked. Successive improvement cycles sought to increase awareness of the project, improve accessibility to the new forms and embed spontaneous practices that contributed to improvement. Results demonstrated an overall reduction in the time taken for blood samples in emergencies to be reported from 130 minutes to 97 minutes. This project demonstrates that using a specific blood request form for emergency calls, and tying this to a specified laboratory process, improves the time taken for these tests to be reported. In addition, the project provides some insight into challenges faced when implementing change in new departments.
许多医院部署了医疗急救（MET）和心脏骤停团队，以改善对危重病患者的管理和治疗。在许多情况下，血液检查结果对于参与这些团队的临床医生为这些患者做出明确的管理决策至关重要。根据一些传闻称这些结果经常延迟，我们评估了紧急呼叫中血液检查报告的流程，确定了导致延迟的关键因素，并寻求改进。最初的干预措施包括实施一种新的血液检查申请表，该表明确了呼叫的性质、所需的检查以及实验室工作人员与临床团队联系告知结果的联系电话。我们还在实验室内部制定了一个简化流程，以便对这些样本进行快速处理。后续的改进周期旨在提高对该项目的认识，改善获取新表格的便利性，并将有助于改进的自发做法融入其中。结果表明，紧急情况下血液样本报告所需的时间总体上从130分钟减少到了97分钟。该项目表明，针对紧急呼叫使用特定的血液检查申请表，并将其与特定的实验室流程相结合，可以缩短这些检查报告所需的时间。此外，该项目还提供了一些关于在新部门实施变革时所面临挑战的见解。
