Xie Chunbao, Zhang Jianbo, Luo Jiangrong, Jian Meiling, Zhao Taiqiang, Wang Jiaqiang, Jiang Linxi, Dai Chao, Wei Yao, Jiang Li, Shi Yi
University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Department of Laboratory Medicine, Chengdu, China.
University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Department of Operation Management, Chengdu, China.
J Med Biochem. 2022 Jul 29;41(3):347-354. doi: 10.5937/jomb0-34958.
To optimize the critical value of test items using FOCUS-PDCA (find, organize, clarify, understand, select, plan, do, check and act), and to set the personalized critical value of the test for different departments.
We searched for literature reporting on the critical value and FOCUS-PDCA published over recent 5 years in order to understand the significance and status quo of critical value and FOCUS-PDCA. We also collected and analyzed the critical value data of hospital tests performed in Sichuan province hospitals in 2019, which were later compared to data from 2020 to determine the FOCUSPDCA cycle.
The proportion of critical values in the whole hospital decreased from 3.5% before optimization to 2.5% to 3% after optimization. The critical values of ICU, hematology, nephrology, urology, and neonatal departments after optimization significantly decreased compared with those before optimization, while the critical values of cardiac surgery, emergency ICU, cardiology, and neurosurgery ICU showed no significant difference before and after optimization. Contrary, the critical values of the infection department after optimization significantly increased before optimization.
FOCUS-PDCA can effectively optimize the critical value of test items, which is beneficial for rational utilization of medical resources.
采用FOCUS-PDCA(发现、组织、澄清、理解、选择、计划、执行、检查和行动)优化检验项目的危急值,并为不同科室设定个性化的检验危急值。
检索近5年发表的关于危急值和FOCUS-PDCA的文献,以了解危急值和FOCUS-PDCA的意义及现状。收集并分析四川省医院2019年进行的医院检验危急值数据,随后与2020年的数据进行比较以确定FOCUS-PDCA循环。
全院危急值比例从优化前的3.5%降至优化后的2.5%至3%。优化后,重症医学科、血液科、肾内科、泌尿外科和新生儿科的危急值与优化前相比显著降低,而心脏外科、急诊重症医学科、心内科和神经外科重症监护室的危急值优化前后无显著差异。相反,感染科优化后的危急值较优化前显著升高。
FOCUS-PDCA可有效优化检验项目的危急值,有利于医疗资源的合理利用。