应用PDCA循环法提高急诊检验项目全程TAT达标率

目的应用PDCA循环法缩短急诊项目的全程结果回报时间(TAT)。方法回顾性分析2017年1-12月(PDCA循环法实施前)深圳市罗湖医院集团妇科、产科急诊项目血常规、凝血、离子七项、血人绒毛膜促性腺激素(HCG)+孕酮]的TAT未达标率。2018年应用PDCA管理工具,绘制鱼骨图分析原因、柏拉图真因确定、甘特图制订计划,利用5W1H法制订对策,并进行对策实施。同时,购置仪器、人员培训、规范化工作流程、加强临床沟通协调。对2017年1-12月(实施前)与2018年1-6月(实施后)的急诊报告时间达标率进行比较。结果2018年1—6月,急诊项目血常规、凝血、离子七项、血HCG+孕酮申请至采样时间达标率较2017年1—12月分别上升了4.89%、4.53%、6.94%、3.63%;采样至核收时间达标率分别上升了13.33%、13.57%、37.1%、13.95%;核收至发送时间达标率分别上升了20.85%、5.96%、5.01%、6.31%。应用PDCA前后申请至采样时间、采样至核收时间、核收至发送时间,差异均有统计学意义(χ2=11.325、19.569、5.301,P<0.001)。结论应用PDCA循环法对急诊检验项目TAT达标率进行质量改进、人员培训、标准化交接班制度制订,优化标本送检流程,标本高峰期增加运送人员,保障检测仪器的质量,进一步完善了信息系统,加强了与临床的沟通、协调,可以提高急诊项目全程TAT达标率,有效缩短结果TAT。

Application of PDCA cycle method in improving TAT compliance rate of emergency inspection projects

Objective To achieve the refined management,turn-around time(TAT)of the emergency department of gynecology and obstetrics,and the PDCA cycle method to improve laboratory efficiency and clinical satisfaction.Methods The TAT compliance rate of emergency projects(blood routine,coagulation,ion seven,blood HCG+progesterone)were analyzed retrospectively from January to December in 2017(before carrying out PDCA management tool)in department of obstetrics and gynecology in Shenzhen Luohu Hospital Group.In 2018,the PDCA management tool was used to map the cause of the fishbone diagram analysis,the Plato′s true cause determination,and the Gantt chart plan,and the 5W1H method was used to develop the countermeasures.At the same time,purchase instruments,personnel training,standardized workflow,and strengthen clinical communication and coordination.Observe the changes of the TAT before(from January to December in 2017)and after improvement(from January to July in 2018).Results Compared with those before improvement,blood routine,coagulation,ion seven,blood HCG+progesterone application to sampling time compliance rate increased by 4.89%,4.53%,6.94%and 3.63%respectively.The sampling to the collection time compliance increased by 13.33%,13.57%,37.1%and 13.95%.The rate of acceptance to delivery increased by 20.85%,5.96%,5.01%and 6.31%respectively.The application of PDCA before and after TAT application to sampling time,sampling to the collection time,check-to-send time had statistically significant differences(χ2=11.325,19.569,5.301,P<0.001).Conclusion The PDCA cycle method was used to improve the quality of the TAT compliance rate of the emergency inspection project,personnel training,and standardized handover system.Optimize the sample inspection process,increase the quality of the transport personnel during the peak period of the specimen,further improve the information system,strengthen the communication and coordination with the clinic,and improve the TAT compliance rate of the emergency project,effectively shorten the return time of the results.