西格玛管理对生化标本检验质量的影响研究
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摘要
目的探究西格玛管理对生化标本检验质量的影响。方法收集2016年度本院临床生化标本检验项目室内质控数据,分析检验全过程以及前、中、后阶段的质量指标,评价各检验项目的性能并设计质量控制方案。结果 AST、CK、ALP、AMY、UA和K性能达到世界级水平;TG和Na性能达到卓越水平;BUN、Ca和TP三个项目性能低,需更严格的质控规则;改进后,检验前阶段样本不合格平均Sigma值达到4.35;检验后阶段中危急值未及时通知和危急值未通知平均Sigma值分别达到2.95和4.30;检验全过程中急诊生化项目TAT不合格、超敏肌钙蛋白TTAT不合格、空间质评不合格和检验报告更改Sigma值分别为3.75、2.45、3.63和4.83。结论西格玛管理有助于全面有效地评价临床生化标本检验质量,便于发现问题并及时改进。
Objective To investigate effect of Sigma management on quality of biochemical specimens test. Methods We collected the indoor quality control data of the clinical biochemical specimen test project of our hospital in 2016. We then analyzed quality indicators of the whole process, the pre-, middle-, and post-stages of the process. We evaluated the performance of each test item and designed the quality control plan. Results The performance of AST, CK, ALP, AMY, UA and K reached world-class level; the performance of TG and Na reached excellent level; the performance of BUN, Ca and TP was relatively poor, which needed strict quality control rules. After improvement, the average Sigma value of the unqualified samples in the pre-test phase was 4.35; the average Sigma value of the not report critical value during post-stage in time was 2.95; the average Sigma value of the non-report critical value during post-stage was 4.30; the average Sigma value of the unqualified TAT in emergency biochemical test, unqualified T TAT in sensitive troponin, unqualified space evaluation, change of test report among the whole process was 3.75, 2.45, 3.63, and 4.83, respectively. Conclusion The Sigma management can help to comprehensively and effectively evaluate the quality of clinical biochemical specimens test, making it easier to identify problems and improve them in time.
Objective To investigate effect of Sigma management on quality of biochemical specimens test. Methods We collected the indoor quality control data of the clinical biochemical specimen test project of our hospital in 2016. We then analyzed quality indicators of the whole process, the pre-, middle-, and post-stages of the process. We evaluated the performance of each test item and designed the quality control plan. Results The performance of AST, CK, ALP, AMY, UA and K reached world-class level; the performance of TG and Na reached excellent level; the performance of BUN, Ca and TP was relatively poor, which needed strict quality control rules. After improvement, the average Sigma value of the unqualified samples in the pre-test phase was 4.35; the average Sigma value of the not report critical value during post-stage in time was 2.95; the average Sigma value of the non-report critical value during post-stage was 4.30; the average Sigma value of the unqualified TAT in emergency biochemical test, unqualified T TAT in sensitive troponin, unqualified space evaluation, change of test report among the whole process was 3.75, 2.45, 3.63, and 4.83, respectively. Conclusion The Sigma management can help to comprehensively and effectively evaluate the quality of clinical biochemical specimens test, making it easier to identify problems and improve them in time.
引文
1徐艳凤.生化标本检验的质量控制方法研究[J].中国卫生标准管理,2016,11(2):151-152.
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10王伦善,贾建安,金玉亮等.6σ标准在临床生化质量管理中的应用[J].临床输血与检验,2014,16(3):269-272.
11张家祝.6σ标准管理对临床生化检验质量的影响[J].医院管理论坛,2016,33(10):50-52.
12于明辉.6σ标准管理对临床生化检验质量的作用分析[J].中国卫生产业,2017,14(12):43-44.
13 Nayar P,Ojha D,Fetrick A,et al.Applying Lean Six Sigma to improve medication management[J].International Journal of Health Care Quality Assurance,2016,29(1):16.
14李润青,宫丽君,王腾蛟,等.西格玛方法在临床生化检验质量管理中的应用[J].中华检验医学杂志,2017,40(9):727-732.
2孙太起,佟久芬,刘梦雅,等.生化标本临床检验异常的原因及检验前质量控制探讨[J].大家健康(下旬版),2017,11(5):44.
3杨静,赵亚曦.临床医学生化检验质量的影响因素分析[J].当代医学,2016,22(9):47-48.
4 Nanda SK,Ray L.Quantitative application of sigma metricsin medical biochemistry[J].Journal of Clinical Diagnosis Research,2013,7(12):2689-91.
5赵香兰,万淑琴.6-西格玛管理法在提高临床护士血标本采集合格率中的应用[J].护理实践与研究,2014,11(10):102-103.
6娄颖.临床生化检验质量的影响因素及对策[J].中国医疗前沿,2013,13(21):106-106,107.
7孙宝琴.影响生化检验质量因素的分析与探讨[J].河北医学,2014,13(9):1580-1582.
8梁有卓.影响生化检验质量的因素分析及改进措施[J].医学检验与临床,2016,27(7):15-17.
9董利民,王标.控制影响血液生化检验质量的标本误差因素[J].临床医药文献电子杂志,2015,2(13):2689,2692.
10王伦善,贾建安,金玉亮等.6σ标准在临床生化质量管理中的应用[J].临床输血与检验,2014,16(3):269-272.
11张家祝.6σ标准管理对临床生化检验质量的影响[J].医院管理论坛,2016,33(10):50-52.
12于明辉.6σ标准管理对临床生化检验质量的作用分析[J].中国卫生产业,2017,14(12):43-44.
13 Nayar P,Ojha D,Fetrick A,et al.Applying Lean Six Sigma to improve medication management[J].International Journal of Health Care Quality Assurance,2016,29(1):16.
14李润青,宫丽君,王腾蛟,等.西格玛方法在临床生化检验质量管理中的应用[J].中华检验医学杂志,2017,40(9):727-732.