Hilborne L H, Oye R K, McArdle J E, Repinski J A, Rodgerson D O
Department of Pathology, University of California Medical Center, Los Angeles 90024-1732.
Am J Clin Pathol. 1989 Mar;91(3):331-5. doi: 10.1093/ajcp/91.3.331.
Quality assurance has been an essential part of clinical laboratory operations for more than two decades. Analytic precision and accuracy goals have been established, and laboratory performance is monitored periodically. For a laboratory test to be useful, it must be available in a timely manner. Expedience of result reporting has not, however, been routinely included among measures of laboratory quality. The authors evaluated stat and routine turnaround times for 42,414 requests on 24 clinical analytes over a 14-day period with the use of a personal computer. Median turnaround time is 1.70 times faster for stat than for routine tests. When examined by shift, average turnaround time is considerably faster for tests ordered stat than for tests ordered routinely during the day and evening shifts, when the work load is the greatest. The authors are now examining turnaround time as an indicator of quality laboratory performance and efficiency. Computer systems in many clinical laboratories already have the sophistication necessary to perform turnaround time analysis. The authors recommend that clinical laboratories begin to include timeliness of stat and routine result reporting as part of their quality assurance programs. Laboratories may also wish to investigate the usefulness of stat requests during slower shifts because these requests may interrupt the normal flow of specimens without expediting result reporting.
二十多年来，质量保证一直是临床实验室运作的重要组成部分。已经确立了分析精密度和准确度目标，并定期监测实验室性能。要使一项实验室检测有用，其结果必须及时可得。然而，结果报告的及时性并未被常规纳入实验室质量衡量指标之中。作者使用个人电脑，在14天内对24种临床分析物的42414份检测申请的急诊和常规周转时间进行了评估。急诊检测的中位周转时间比常规检测快1.70倍。按班次检查时，在工作量最大的日班和夜班期间，急诊检测的平均周转时间比常规检测快得多。作者目前正在将周转时间作为高质量实验室性能和效率的一项指标进行研究。许多临床实验室的计算机系统已经具备进行周转时间分析所需的精密程度。作者建议临床实验室开始将急诊和常规结果报告的及时性纳入其质量保证计划的一部分。实验室或许还希望研究在工作较清闲的班次进行急诊检测申请的效用，因为这些申请可能会打断标本的正常流程，却无法加快结果报告。
