Rathore Mohini, Yadav Dharamveer, Banerjee Mithu, Tomo Sojit, Sharma Shailja, Sankanagoudar Shrimanjunath, Shukla Kamla Kant, Selvi Maithili Karpaga, Purohit Purvi, Sharma Praveen, Singh Snigdha, Birdi Amandeep, Shekhawat Raghavendra Singh
Biochemistry Department, All India Institute of Medical Sciences (AIIMS) Jodhpur, India.
Forensic and Medicine Toxicology Department, All India Institute of Medical Sciences (AIIMS) Jodhpur, India.
EJIFCC. 2025 Jun 3;36(2):106-123. eCollection 2025 Jun.
One of the most essential components of a clinical laboratory's overall quality management system is quality control (QC) validation. We typically tend to use more reagents and resources than necessary in an attempt to preserve quality. Achieving higher results while using fewer resources is time imperative. We have attempted to address this issue by providing cost-benefit analysis by implementing effective QC procedures using six sigma methodology and their financial benefits.
Six sigma calculation of 23 routine chemistry parameters was performed over a period of one-year using bias% and cv%. New Westgard sigma rules were applied using Biorad Unity 2.0 software. A comparison was made before and after new sigma rules application including false rejection rate, probability of error detection rate, cost of all reruns, repeats, etc. Relative and absolute annual savings were computed and compared.
Compared to the current rule, there was absolute savings of Indian Rupees (INR) 750105.27 when both internal failure and external failure costs were combined after the candidate rule was employed. The reduction in expenses varied with the quantity of samples examined and the quantity of QC operations carried out each day leading to an internal failure costs cut down by 50% (INR 501808.08) and external failure costs by 47% (INR 187102.8).
The study highlighted how quality control techniques in clinical laboratories need to be carefully planned in order to achieve significant cost reductions by lowering internal or external failure costs and effective prevention and appraisal cost planning activities prior.
临床实验室全面质量管理体系中最重要的组成部分之一是质量控制(QC)验证。我们通常倾向于使用比必要更多的试剂和资源来试图保持质量。在使用更少资源的情况下获得更高的结果迫在眉睫。我们试图通过使用六西格玛方法实施有效的QC程序并分析其财务效益来解决这个问题。
使用偏差百分比(bias%)和变异系数(cv%)对23个常规化学参数进行了为期一年的六西格玛计算。使用伯乐Unity 2.0软件应用新的韦斯特加德西格玛规则。在应用新的西格玛规则前后进行了比较,包括假拒收率、误差检测概率、所有重新运行、重复等的成本。计算并比较了相对和绝对年度节省。
与当前规则相比,采用候选规则后,内部故障成本和外部故障成本合并后绝对节省了750105.27印度卢比(INR)。费用的减少因每天检测的样本数量和进行的QC操作数量而异,导致内部故障成本降低了50%(501808.08印度卢比),外部故障成本降低了47%(187102.8印度卢比)。
该研究强调了临床实验室的质量控制技术需要精心规划,以便通过降低内部或外部故障成本以及事先有效的预防和评估成本规划活动来实现显著的成本降低。