PDCA循环在男科实验室中缩短精液样本周转时间的应用  

Application of PDCA circulation in reduction of the turnaround time of semen samples in the andrology laboratory

作　　者：杨斯桀 李婷[1] 张琛[1] 孟庆昊 吴霞[1] 高选[1] YANG Si-jie;LI Ting;ZHANG Chen;MENG Qing-hao;WU Xia;GAO Xuan(Center of Reproductive Medicine/National Research Center for Assisted Reproductive Tech nology and Reproductive Genetics/Key Laboratory of the Ministry of Education for Reproductive Endocrinology,Shandong University,Jinan,Shandong 250001,China)

机构地区：[1]山东大学生殖医学研究中心/国家辅助生殖与优生工程技术研究中心/生殖内分泌教育部重点实验室(山东大学),山东济南250001

出　　处：《中华男科学杂志》2021年第1期31-38,共8页National Journal of Andrology

摘　　要：目的:通过对2018年男科实验室精液检测项目样本周转时间(TAT)的现状分析,使用PDCA循环改进方法,降低本男科实验室样本周转时间阈外值率,提高临床及患者满意度。方法:回顾性分析2018年1季度至2季度男科实验室精液检测项目TAT不合格率,2018年3季度至4季度应用PDCA管理工具,通过头脑风暴法绘制鱼骨图,针对TAT阈外值率高的原因制定对策表并监督实施,观察精液检测项目TAT在改进前后的变化。结果:2018年3季度至4季度精液检测项目检验前周转时间(T1)阈外值率较1、2季度显著下降(第1季度3.43%,第2季度2.07%,第3季度0.83%,第4季度0.78%,P<0.01),样本周转总时间(T总)阈外值率较1、2季度显著下降(第1季度7.00%,第2季度7.15%,第3季度6.36%,第4季度0.87%,P<0.01)。1~4季度计算机辅助精液常规项目T1中位数从22 min下降至17 min, 90百分位数从54 min下降至40 min,1~4季度精液生化项目T总中位数从387 min下降至315 min,90百分位数从1 415 min下降至1 179 min。结论:应用PDCA管理工具可以显著降低精液样本检测周转时间的阈外值率,提高临床诊疗及患者就诊效率,提升男科实验室质量管理水平。Objective: To reduce the out-of-threshold(OOT) value of the turnaround time(TAT) of semen samples in the andrology laboratory and improve the clinical diagnosis and patients’ satisfaction. Methods: We retrospectively analyzed the defect rate of TAT of semen samples in the andrology laboratory in the first two quarters of 2018. In the second two quarters, we made a table of countermeasures targeting the causes of the defects using plan-do-check-act(PDCA) circulation and the fishbone diagram drawn with the brainstorm method, followed by supervision of the implementation of the measures and observation of the changes in the OOT value of TAT of semen samples. Results: The OOT rate of TAT of semen samples before seminal examination was significantly lower in the third and fourth than in the first and second quarters of 2018(0.83% and 0.78% vs 3.43% and 2.07%, P < 0.01), and so was the total OOT rate of TAT(6.36% and 0.87% vs 7.00% and 7.15%, P < 0.01). The median of TAT of semen samples before computer assisted semen analysis was decreased from 22 min in the first to 17 min in the fourth quarter, and the 90 th percentile from 54 min to 40 min. The median of total TAT in biochemical analysis was reduced from 387 min in the first to 315 min in the fourth quarter, and the 90 th percentile from 1415 min to 1179 min. Conclusion: The application of PDCA circulation can significantly shorten the turnaround time of semen samples and improve the efficiency of diagnosis and treatment and quality control in the andrology laboratory.

关 键 词：样本周转时间 PDCA循环 男科实验室 精液检测 

分 类 号：R446.9[医药卫生—诊断学]