Zhong Xiao, Xiao Li-Hua, Liu Yan, Mo Lan-Fang, Yang Shan-Wen, He Lan-Fang, Wu Qin-Fei, Luo Xiao-Feng, Lin Mei
Infection Management Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, China
Logistics Department, Shenzhen Guangming District People's Hospital, Shenzhen, Guangdong, China.
BMJ Open Qual. 2025 May 15;14(2):e003257. doi: 10.1136/bmjoq-2024-003257.
This study aimed to optimise the aetiological examination process in hospitalised patients to enhance pathogen detection quality and efficiency. The hypothesis was that process management strategies would improve specimen submission rates, quality, timeliness and antimicrobial use adjustment.
A multicentre quasi-experimental pre-post comparison design was used, with baseline and postoptimisation phases.
Two hospitals in Guangming District, Shenzhen, China.
34 790 inpatients in the baseline and 34 361 in the postoptimisation phase, across all departments.
Implemented process clarification, standardisation of specimen collection/submission and multidisciplinary collaboration, with comprehensive staff training.
The primary outcome measures were the pathogen submission rate before antimicrobial therapy. The secondary outcome measure was the adjustment rate of antimicrobial use based on test results, specimen qualification rate and specimen submission time. These measures were evaluated before and after process optimisation.
Postoptimisation, key metrics improved significantly: pathogen submission rate (50.82%-71.77%), specimen qualification rate (90.20%-98.71%), submission time (192-104 min) and antimicrobial adjustment rate (74.11%-93.24%; all p<0.001).
Process management effectively enhanced aetiological examination quality and efficiency, with potential for widespread adoption.
Not applicable as this was a quasi-experimental study.
本研究旨在优化住院患者的病因学检查流程，以提高病原体检测质量和效率。假设是流程管理策略将提高标本送检率、质量、及时性以及抗菌药物使用调整。
采用多中心准实验前后比较设计，包括基线期和优化后阶段。
中国深圳光明区的两家医院。
涵盖所有科室，基线期有34790名住院患者，优化后阶段有34361名住院患者。
实施流程澄清、标本采集/送检标准化以及多学科协作，并进行全面的员工培训。
主要结局指标是抗菌治疗前的病原体送检率。次要结局指标是基于检测结果的抗菌药物使用调整率、标本合格率和标本送检时间。在流程优化前后对这些指标进行评估。
优化后，关键指标显著改善：病原体送检率（从50.82%提高到71.77%）、标本合格率（从90.20%提高到98.71%）、送检时间（从192分钟缩短至104分钟）以及抗菌药物调整率（从74.11%提高到93.24%；所有p<0.001）。
流程管理有效提高了病因学检查的质量和效率，具有广泛推广的潜力。
由于本研究为准实验研究，故不适用。
