智慧化急诊流水线在提升急诊检验效能与质量中的应用与探讨  

The application and exploration of intelligent emergency assembly line in improving the efficiency and quality of emergency testing

作　　者：田佳乐[1] 权文强[1] 寄晓义[1] 李冬[1] Tian Jiale;Quan Wenqiang;Ji Xiaoyi;Li Dong(Department of Laboratory Medicine,Tongji Hospital,Tongji University,School of Medicine,Shanghai 200065,China)

机构地区：[1]同济大学附属同济医院检验科,上海200065

出　　处：《中华检验医学杂志》2024年第5期514-519,共6页Chinese Journal of Laboratory Medicine

基　　金：上海申康医院发展中心检验专科联盟(SHDC22023303);上海市公共卫生行动三年计划(2022-2024,SHDC2022CRD040)。

摘　　要：目的:探讨智慧化流水线在急诊检验中的应用价值。方法:收集同济大学附属同济医院急诊检验2019年6月24日至28日和2023年7月24日至28日两个时间段的各项指标数据进行回顾性研究。对智慧化流水线应用(启用气动传输装置)前后样本量的变化,和检验前周转时间(TAT)中位数和第90百分位数(P90)分别进行比较;调取并分析启用智慧化流水线自动质控前后同一批号质控品的质控相关数据;分析比较智慧化流水线自动审核规则应用前后实验室内TAT中位数和P90数;统计启用智慧化流水线基于患者样本的实时质量控制(PBRTQC)功能和基于质控品的室内质控方式对失控的检出效能。正态分布资料采用两独立样本t检验,偏态分布计量资料组间比较采用Mann-Whitney U检验进行统计分析。结果:智慧化急诊流水线气动传输装置运行后,急诊标本检验前TAT由27.1(18.0,47.7)min下降到24.3(15.2,34.9)min,差异有统计学意义(Z=-9.173,P<0.001);自动质控实施前后项目钾(K)、钠(NA)、丙氨酸氨基转移酶(ALT)、葡萄糖(Glu)、总蛋白(TP)、尿素的室内质控测试结果均差异无统计学意义(P>0.05),且自动质控CV值与手工质控CV值均在允许范围内;干式生化质控品消耗由750μl/次,减少为600μl/次,使用量减少20%;质控操作时间由30 min/次降低到20 min/次,时间节省33.3%;质控人员数、人员走动距离均明显减少;PBRTQC功能的开发后质控失控检出率由0.82%提升到0.98%。启用智慧化流水线自动审核系统后实验室内TAT启用自动审核功能前的37.1(21.3,49.2)min下降到34.4(16.5,46.3)min,差异有统计学意义(Z=-10.062,P<0.001);检验全程周转时间(ToTAT)和TAT分别由56.7(45.8,102.5)、37.4(21.5,49.6)min下降到53.3(42.1,98.3)、33.2(16.4,47.9)min,且差异均有统计学意义(Z=-7.176和-8.245,均P<0.001);ToTAT和TAT的P90数分别下降18.1%和17.0%,样本超时占比下降了65.5%和92.1%,而危急值通报及时率则由8Objective To explore the application value of intelligent assembly line in emergency examination.Methods A retrospective study was carried out by collecting the data from emergency examination in Tongji Hospital affiliated to Tongji University from June 24 to 28,2019,to July 24 to 28,2023.The changes of sample size before and after intelligent pipeline application(with pneumatic transmission device),and the median and 90th percentile(P90)of pre-test turnaround time(TAT)were compared to collect and analyze the quality control related data of the same batch of quality control products before and after using intelligent assembly line automatic quality control;The median TAT and the 90th percentile in the laboratory were analyzed and compared before and after the application of the intelligent pipeline automatic audit rules Statistical enabling of intelligent pipeline-based real-time quality control(PBRTQC)function for patient samples and quality control-based indoor quality control mode for out-of-control detection efficacy.The normal distribution data were analyzed by two independent samples t-test,and the skew distribution data were analyzed by Mann-whitney U test.Results After the operation of the intelligent assembly line pneumatic transmission device,TAT decreased from 27.1(18.0,47.7)min to 24.3(15.2,34.9)min,with a significant difference(Z=-9.173,P<0.001);There was no significant difference in the indoor quality control results of potassium(K),sodium(NA),Alanine transaminase(Alt),glucose(Glu),total protein(TP)and UREA before and after the implementation of automatic quality control(P>0.05),the consumption of dry biochemical quality control products was reduced from 750μl/time to 600μl/time,and the use amount was reduced by 20%.The operation time of quality control was reduced from 30 min/time to 20 min/time,the time was saved by 33.3%,the number of quality control personnel and the walking distance of personnel were significantly reduced,and the detection rate of out-of-control was increased from 0.82%to 0.9

关 键 词：人工智能 流水线 急诊检验 基于患者样本的实时质量控制 全程周转时间 周转时间 

分 类 号：R446[医药卫生—诊断学]