Fernández-Grande Esther, Valera-Rodriguez Carolina, Sáenz-Mateos Luis, Sastre-Gómez Amparo, García-Chico Pilar, Palomino-Muñoz Teodoro J
Servicio de Análisis Clínicos, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Servicio de Medicina Preventiva, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
Biochem Med (Zagreb). 2017 Jun 15;27(2):342-349. doi: 10.11613/BM.2017.037.
For a quicker delivery of laboratory test results to the hospital emergency department (ED), we implemented an autoverification system based on the reference change value (RCV). The aim of this study was to assess how the RCV based autoverification reflected on turnaround time (TAT) and on physician satisfaction.
The laboratory information system (LIS) was programmed to autoverify the results as long as they were within the range settled by RCV, so that the autoverified results were reported to the physician as soon as the tests were carried out, without any further intervention. We analyzed the same three-month periods' TAT and verification time (VFT) from the years prior to and following the implementation of RCV autoverification. The change in physicians' satisfaction levels was assessed using the hospital's Annual Physician Satisfaction Survey (APSS). Over sixty percent of physicians completed the questionnaire, and the amount of daily ED test requests (nearly three hundred) did not vary throughout the duration of this study.
Mann-Whitney U test showed that the VFT was significantly reduced in all the test but troponin I. There were substantial reductions in TAT medians (haemogram, 75%; fibrinogen, 41%; prothrombin time, 40%; sodium, 27%). The percentage of physicians satisfied with the haematological and biochemical tests´ TAT increased from 84% to 93% and from 86% to 91% respectively.
Our results reveal that VFT and TAT were severely reduced in most emergency tests, greatly improving physicians' satisfaction with TAT.
为了更快地将实验室检测结果送达医院急诊科（ED），我们实施了基于参考变化值（RCV）的自动验证系统。本研究的目的是评估基于RCV的自动验证对周转时间（TAT）和医生满意度的影响。
实验室信息系统（LIS）被编程为只要检测结果在RCV设定的范围内就自动验证，这样自动验证后的结果在检测完成后立即报告给医生，无需任何进一步干预。我们分析了实施RCV自动验证前后几年相同的三个月期间的TAT和验证时间（VFT）。使用医院的年度医生满意度调查（APSS）评估医生满意度水平的变化。超过60%的医生完成了问卷，并且在本研究期间，急诊科每日检测请求数量（近300项）没有变化。
曼-惠特尼U检验显示，除肌钙蛋白I外，所有检测的VFT均显著降低。TAT中位数大幅下降（血常规，75%；纤维蛋白原，41%；凝血酶原时间，40%；钠，27%）。对血液学和生化检测TAT满意的医生比例分别从84%增至93%和从86%增至91%。
我们的结果显示，大多数急诊检测的VFT和TAT均大幅降低，极大地提高了医生对TAT的满意度。
