Smellie W S, Johnston J, Galloway P J
Institute of Biochemistry, Glasgow Royal Infirmary.
J Clin Pathol. 1994 Jul;47(7):585-8. doi: 10.1136/jcp.47.7.585.
To establish a mechanism to examine the components of turnaround time in a representative cross-section of laboratory users; and to identify potential areas for improvement.
Information was collected manually from result reports received by eight laboratory users: three wards in the main hospital, four GP practices, and one local psychiatric hospital. This was combined with data from the departmental computer files to create a spreadsheet detailing different time points in the processing of a specimen, from venepuncture to receipt of result report.
At the main hospital, 80% of samples arrived within two hours of venesection and 95% by four hours; 75% of samples were analysed within two hours; 85% of results arrived in the wards within six hours of printing, although 12% took more than 18 hours to arrive; median overall time six hours. At the satellite (psychiatric) hospital, all samples arrived within seven hours of venesection; 45% were analysed within two hours--the rest the following morning; there were highly variable post-analytical times, minimum 18 hours, maximum 122 hours; the median overall time was 69 hours. Twenty five per cent of samples from GPs took more than 20 hours to arrive; 75% were analysed within two hours, the rest took over 18 hours--waiting overnight; the post-analytical times were highly variable, minimum 22 hours, maximum 122 hours; the median overall time was 50 hours.
The method is easily repeatable and demonstrates the need for local improvement in the post-analytical period. Although specific to the individual data handling system for one laboratory, this method may be used as a basis for other laboratories in pathology disciplines to undertake a representative assessment of turnaround times for different groups of laboratory users.
建立一种机制,以检查具有代表性的实验室用户样本周转时间的构成要素;并确定潜在的改进领域。
从八个实验室用户收到的结果报告中手动收集信息:主医院的三个病房、四个全科医生诊所和一家当地精神病医院。将这些信息与部门计算机文件中的数据相结合,创建一个电子表格,详细列出从静脉穿刺到收到结果报告的样本处理过程中的不同时间点。
在主医院,80%的样本在静脉穿刺后两小时内送达,95%在四小时内送达;75%的样本在两小时内完成分析;85%的结果在打印后六小时内送达病房,尽管12%的结果需要超过18小时才能送达;总体中位时间为六小时。在卫星(精神病)医院,所有样本在静脉穿刺后七小时内送达;45%在两小时内完成分析,其余的在第二天上午完成;分析后时间差异很大,最短18小时,最长122小时;总体中位时间为69小时。来自全科医生的样本中有25%需要超过20小时才能送达;75%在两小时内完成分析,其余的需要超过18小时——等待过夜;分析后时间差异很大,最短22小时,最长122小时;总体中位时间为50小时。
该方法易于重复,并表明在分析后阶段需要进行局部改进。尽管该方法特定于一个实验室的单个数据处理系统,但它可作为病理学学科其他实验室对不同实验室用户群体的周转时间进行代表性评估的基础。