Smellie W S, Galloway P J, Johnston J I
Institute of Biochemistry, Glasgow Royal Infirmary.
J Clin Pathol. 1995 Apr;48(4):372-5. doi: 10.1136/jcp.48.4.372.
To institute recommendations from a laboratory turnround time study; to evaluate audit methods; and to quantify improvements achieved.
Changes to result report distribution and specimen delivery were affected by posting results directly from the laboratory followed by the introduction of a twice daily courier service. Improvements were evaluated by repeating the turnround time audit described in an earlier report. Pre-, peri- and post-analytical turnround times were compared before and after changes had been instituted.
Directly posting general practitioner (GP) results increased the percentage of reports which reached their destination within one and two days after they were generated from 13 to 29% and from 68 to 82%, respectively. Pre- and postanalytical times were superimposable before and after posting was started. Corresponding improvements to the satellite hospital service were from 25 to 78% and from 60 to 82%, respectively. The courier service shortened the median total turnround time from 50 to nine hours for GPs and from 69 to 18 hours for the satellite hospital. Fifty three per cent of GP reports and 21% of satellite hospital reports arrived on the same day as the sample was taken: 99% and 94%, respectively, had arrived by the next day. The number of analytically "old" samples which arrived the day after they had been taken, thus invalidating many results, fell from 25 to 3%.
These audits of laboratory turnround time have been used to present a valid case for changes to laboratory transport and to quantify the improvements achieved. They produce consistent and repeatable results, which may also be used to monitor future performance, to assess further changes and to establish the cost-effectiveness of resources used.
制定实验室周转时间研究的建议;评估审核方法;并量化所取得的改进。
通过直接从实验室发布结果,随后引入每日两次的快递服务,对结果报告分发和标本运送进行更改。通过重复早期报告中描述的周转时间审核来评估改进情况。在实施更改前后,比较分析前、分析期间和分析后的周转时间。
直接发布全科医生(GP)结果后,在报告生成后1天和2天内送达目的地的报告百分比分别从13%提高到29%,从68%提高到82%。开始发布前后,分析前和分析后的时间可叠加。卫星医院服务也有相应改善,分别从25%提高到78%,从60%提高到82%。快递服务将全科医生的总周转时间中位数从50小时缩短至9小时,卫星医院从69小时缩短至18小时。53%的全科医生报告和21%的卫星医院报告在采样当天送达:次日送达的分别为99%和94%。采样后第二天到达的分析上“陈旧”的样本数量,导致许多结果无效,从25%降至3%。
这些实验室周转时间审核已用于提出对实验室运输进行更改的有效理由,并量化所取得的改进。它们产生一致且可重复的结果,也可用于监测未来绩效、评估进一步的更改以及确定所使用资源的成本效益。