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缩短门诊实验室周转时间的策略。

Strategies to shorten turnaround time in outpatient laboratory.

机构信息

Departments of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.

出版信息

J Clin Lab Anal. 2022 Oct;36(10):e24665. doi: 10.1002/jcla.24665. Epub 2022 Aug 29.

DOI:10.1002/jcla.24665
PMID:36036784
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9550964/
Abstract

BACKGROUND

Turnaround time (TAT) is one of the most important indicators of laboratory quality. For the outpatient routine chemistry tests whose results are checked by clinicians on the same day, we set a quality goal that >90% of these samples should be reported within 60 min. As more than 20% of the samples failed to achieve this goal in 2020, we introduced an additional autoanalyzer and a real-time monitoring system to improve this rate.

METHODS

As the TAT of the pre-analytical phase is the greatest contributor to TAT, we divided it into sampling, sample transport, and sample preparation times. An additional autoanalyzer was introduced, and its effect on TAT improvement was evaluated with the TAT data of June and July 2020. A real-time monitoring system was introduced to sort delayed samples, and its effect was assessed with the TAT data of June and July 2021. TAT data from December 2019 to January 2020 were set as baseline controls.

RESULTS

The preparation time comprised the largest proportion of TAT. Although there was a slight decrease in overall TAT after the introduction of the above two strategies, the target TAT achievement rate increased significantly from 78.5% to 88.7% (p < 0.001).

CONCLUSIONS

We checked the cause of TAT prolongation and introduced new strategies to improve it. The addition of an autoanalyzer per se was not so effective but was better when combined with the real-time monitoring system. Such strategies would increase the quality of the laboratory services.

摘要

背景

周转时间(TAT)是实验室质量的最重要指标之一。对于当天由临床医生审核结果的门诊常规化学检验,我们设定了一个质量目标,即>90%的样本应在 60 分钟内报告。由于 2020 年超过 20%的样本未能达到这一目标,我们引入了额外的自动分析仪和实时监测系统来提高这一比例。

方法

由于分析前阶段的 TAT 是 TAT 的最大贡献者,我们将其分为采样、样本运输和样本准备时间。引入了额外的自动分析仪,并使用 2020 年 6 月和 7 月的 TAT 数据评估其对 TAT 改善的效果。引入了实时监测系统来对延迟样本进行分类,并使用 2021 年 6 月和 7 月的 TAT 数据评估其效果。将 2019 年 12 月至 2020 年 1 月的数据作为基线对照。

结果

准备时间占 TAT 的最大比例。尽管在引入上述两种策略后整体 TAT 略有下降,但目标 TAT 达成率从 78.5%显著提高到 88.7%(p<0.001)。

结论

我们检查了 TAT 延长的原因,并引入了新的策略来改善它。自动分析仪本身的添加效果并不明显,但与实时监测系统结合使用效果更好。这些策略将提高实验室服务的质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6434/9550964/ff23b6e79e49/JCLA-36-e24665-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6434/9550964/fb8ef5a1f1ba/JCLA-36-e24665-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6434/9550964/ff23b6e79e49/JCLA-36-e24665-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6434/9550964/fb8ef5a1f1ba/JCLA-36-e24665-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6434/9550964/ff23b6e79e49/JCLA-36-e24665-g003.jpg

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