运用6σ评价急诊血液项目各检测阶段的性能

目的运用六西格玛（6σ）评价急诊血液项目各检测阶段的性能，以期发现问题、制定解决方案、指导质量改进。方法确定分析前、后阶段及全程的性能评价指标，统计2012年1至12月301 125例急诊标本的合格情况、危急值报告情况、报告差错情况及标本周转时间（TAT）共4项指标，计算盯值；确定分析中阶段的性能评价项目，并收集2012年1至12月各项目的室内质量控制数据及卫生部室间质评数据，计算不精密度（CV％）及百分差值，再根据允许总误差（TEa％），计算盯值和质量目标指数（QGI）。对于分析各阶段未达6σ的指标和项目进行分析，查找原因，指导质量改进。结果急诊分析前、中、后阶段及全程的指标和项目的σ值分别为5．4，5．3、6．1、5．4。结论6σ可以有效地评价急诊血液项目各检测阶段及全程的性能，体现实验室目前所处的性能水平，有助于发现问题并推进急诊检验科的质量持续改进。

Application of six sigma for the performance evaluation of emergency blood parameters at each test phase

Objective To apply six sigma （6σ） for the performance evaluation of emergency blood parameters at each test phase, in order to find out the problems, develop solutions and guide quality improvement. Methods The performance evaluation parameters before phase, after phase and during whole process of performance evaluation were determined, and the results from January to December in 2012 were analyzed. A total of 301 125 emergency specimens＇ qualification, critical value reporting, report error condition and specimen turn around time （TAT） were analyzed statistically. The sigma （σ） value was calculated. The project performance evaluation was performed in the analysis phase, and the internal quality control data and external quality control data from January to December in 2012 were collected. The imprecision （CV%） and percentage difference were calculated. According to the allowable total error （ TEa% ）, σ value and quality goal index （QGI） were calculated. The parameters unreaching 6σ were analyzed to find out the reasons and guide the quality improvement. Results Before, in and after phase and during whole process, the σ values were 5.4, 5.3, 6.1 and 5.4. Conclusions 6σ can effectively evaluate the emergency blood parameters at each test phase, and manifest the laboratory＇s performance level at present and help with finding problems and promoting the continuous improvement of the emergency laboratory quality.