影响实验室生化结果回报时间的因素探讨  

Analyzing the interference factors of turnaround time in Clinical Laboratory

作　　者：邓德耀[1] 李增安[1] 黄红兵[2] 周林华[1] 支国华[1] 薛云松[1] 冯倩[1] 黄敏[1] 

机构地区：[1]云南省第二人民医院检验科,云南昆明650021 [2]云南省第二人民医院计算机中心,云南昆明650021

出　　处：《中国实验诊断学》2008年第9期1136-1138,共3页Chinese Journal of Laboratory Diagnosis

基　　金：云南省教育厅科学研究基金资助(06Y072C)

摘　　要：目的分析现有工作流程下实验室常规生化检验结果回报时间(TAT)的阈外值,探讨分析前、分析中、分析后三个阶段导致TAT延迟的因素,为优化工作流程,提高效率提供客观依据。方法选择结果回报时间超过十小时的常规生化检验记录为阈外值,分析从采集样本至检验报告返回临床医生过程中的一些时间点、时间点之间的间隔及分析前、分析中、分析后阶段的时间和总的TAT。结果收集的生化检验记录594例中,总的TAT其中位数为629分钟,第90百分位数为650分钟,分析前、分析中、分析后三个阶段时间段各自的中位数、第90百分位数分别为231分钟、278分钟,89分钟、195分钟及292分钟、384分钟。结论本室当前流程下常规生化TAT的延长,主要与分析后阶段效率不高有关,全面建设医院信息化网络,早日完成医生工作站的全面普及,提高信息化程度,使检测结果及时传输到医生工作站,可以减少分析后阶段的时间。同时,分析前阶段也有缩减的空间,若该阶段各时间点的重心前移,可使分析中阶段提前展开,将缩短整个TAT,满足患者及临床的需求。Objective To analyze the Clinical Laboratory outlier events in routine biochemical test turnaround time（TAT）in present workflow,discuss the different causes which prolong TAT in pre-analytical, analytical and post-analytical phase, and optimize the workflow for improving laboratorial efficiency. Methods Identify the test TAT records with phlebotomy-to-resulting time exceeding 10 hours as outlier events. Study the overall TAT,all the time-point and the time-interval between every two steps in whole process. Results In 594 Collected cases of TAT exceeding 10 hours, the median of total TAT was 629 minutes, and the 90th percentile was 650 minutes, the median and the 90th percentile of three phases（pre-analytical, analytical and post-analytical ） respectively were 231 minutes and 278 minutes,89 minutes and 195 minutes,292 minutes and 384 minutes. Conclusion Because of the low-efficiency report transmission, the major cause of TAT delay was occurred in the post-analytical phase. So enhancing the construction of hospital＇s network information system, setting up the computerized doctor workstation which transmitted information between computers, could enable doctor to obtain the results immediately after laboratory results verification. At the same time, several measures could be implemented in the pre-analytical and analytical phases in order to reduce TAT and meet the clinical needs.

关 键 词：临床实验室 结果回报时间 阈外值 影响因素 信息化 

分 类 号：R446.1[医药卫生—诊断学]