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中国738家实验室临床生化检验周转时间的全国性调查。

National survey on turnaround time of clinical biochemistry tests in 738 laboratories in China.

作者信息

Zhang Xiaoyan, Fei Yang, Wang Wei, Zhao Haijian, Wang Minqi, Chen Bingquan, Zhou Jie, Wang Zhiguo

机构信息

National Center for Clinical Laboratories/ Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, National Center of Gerontology, Beijing, China.

Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.

出版信息

J Clin Lab Anal. 2018 Feb;32(2). doi: 10.1002/jcla.22251. Epub 2017 May 11.

Abstract

BACKGROUND

This survey was initiated to estimate the current status of turnaround time (TAT) monitoring of clinical biochemistry in China, provide baseline data for establishment of quality specifications and analyze the impact factors of TAT.

METHODS

738 laboratories were included. Questionnaires involved general information and data of related indicators of TAT during 1 week were provided to participating laboratories. Nine quality indicators were covered, which were medians, 90th and outlier rates of pre-examination, examination, and post-examination TAT. The 25th percentile, median, and 75th percentile of TATs were calculated as optimum, desirable, and minimum quality specifications. Percentages and sigma values were used to describe the outlier rates. Mann-Whitney and Kruskal-Wallis tests were used to identify the potential impacts of TAT.

RESULTS

Response rate of this survey was 46.44%. More than 50% of the laboratories indicated they had set up target TATs in three time intervals and monitored TATs generally. The post-examination TAT of most laboratories was 0min, while the pre-examination and examination TAT varied. Sigma values of outlier rates for 45%60% of laboratories were above 4, while 15%20% of labs whose sigma values were below 3. Group comparisons suggested nurse or mechanical pipeline transportation, link laboratory information system with hospital information system, and using computer reporting instead of printing report were related to shorter TATs.

CONCLUSIONS

Despite of the remarkable progresses of TATs in China, there was also room to improve. Laboratories should strengthen the construction of information systems, identify reasons for TAT delay to improve the service quality continuously.

摘要

背景

开展本次调查旨在评估中国临床生物化学检测周转时间(TAT)监测的现状,为制定质量规范提供基线数据,并分析TAT的影响因素。

方法

纳入738家实验室。向参与调查的实验室发放问卷,内容包括一般信息以及1周内TAT相关指标的数据。涵盖9项质量指标,即检验前、检验及检验后TAT的中位数、第90百分位数和异常值率。计算TAT的第25百分位数、中位数和第75百分位数作为最佳、理想和最低质量规范。用百分比和西格玛值描述异常值率。采用Mann-Whitney检验和Kruskal-Wallis检验确定TAT的潜在影响因素。

结果

本次调查的回复率为46.44%。超过50%的实验室表示已在三个时间段设定了目标TAT,并普遍对TAT进行监测。大多数实验室的检验后TAT为0分钟,而检验前和检验TAT各不相同。45%60%实验室的异常值率西格玛值高于4,15%20%实验室的西格玛值低于3。组间比较表明,护士或机械流水线转运、实验室信息系统与医院信息系统连接以及使用计算机报告而非打印报告与较短的TAT相关。

结论

尽管中国在TAT方面取得了显著进展,但仍有改进空间。实验室应加强信息系统建设,找出TAT延迟的原因,不断提高服务质量。

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