[1]黄常洪,张扬南,李晓丽,等.医疗集团化管理背景下临床检验分析前质量精细化管理[J].现代检验医学杂志,2019,34(06):153-156.[doi:10.3969 / j.issn.1671-7414.2019.06.039]
 HUANG Changhong,ZHANG Yangnan,LI Xiaoli,et al.Refined Management of the Pre-analytical Phases of the Clinical Laboratory in Medical Group[J].Journal of Modern Laboratory Medicine,2019,34(06):153-156.[doi:10.3969 / j.issn.1671-7414.2019.06.039]
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医疗集团化管理背景下临床检验分析前质量精细化管理()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年06期
页码:
153-156
栏目:
质量控制·实验室管理
出版日期:
2019-12-30

文章信息/Info

Title:
Refined Management of the Pre-analytical Phases of the Clinical Laboratory in Medical Group
文章编号:
1671-7414(2019)06-153-04
作者:
黄常洪张扬南李晓丽李 秋廖晓梅代国知林应标
(南华大学医院管理研究所,郴州市第一人民医院,湖南彬州 423000)
Author(s):
HUANG Changˉhong ZHANG Yangˉnan LI Xiaoˉli LI Qiu LIAO Xiaoˉmei DAI Guoˉzhi LIN Yingˉbiao
(Institute of Hospital Management University of Shouth China,Chenzhou First People's Hospital,Hunan Chenzhou 423000,China )
关键词:
医疗集团化 分析前质量 精细化管理
分类号:
R446
DOI:
10.3969 / j.issn.1671-7414.2019.06.039
文献标志码:
A
摘要:
目的 针对检验分析前质量管理存在的问题,以ISO15189 质量管理体系为导向,通过改进管理措施,评估管理 措施对分析前质量提升的效果。方法 以郴州市第一人民医院集团四个医疗区2016 年~2018 年检验样本质量为研究对 象,依据检验样本不合格率指标的变化,评估各种持续改进措施的效果。结果 2016 年改善措施实施前,2 539 292 例 标本中有14 881 例不合格,不合格率为5.86‰。2017 年启动ISO15189 申报工作,联合多学科多部门联动改善措施实施后, 2 818 615 例标本中有5 975 例不合格,不合格率为2.12‰。2018 年再次改进后,3 072 291 例标本中有5 199 例不合格, 不合格率为1.69‰。差异均有统计学意义(P <0.05)。标本总量增长的同时,不合格标本数量呈下降趋势。结论 以 ISO15189 质量管理体系为导向,通过建立和完善分析前质量管理制度,建立多部门合作体系,对样本的采集、运送及 保存实施精细化管理,能显著提升分析前检验质量。
Abstract:
Objective To solve the problems of quality management before inspection and analysis, and the ISO 15189 quality management system was taken as the guide to evaluate the effect of management measures on quality improvement before analysis by improving management measures. Methods The quality of test samples from four medical districts of the Chenzhou First People’s Hospital group from 2016 to 2018 was taken as the research object to evaluated the effectiveness of various continuous improvement measures according to the change of unqualified rate index of test sample. Results Prior to the implementation of improvement measures in 2016,14 881 out of 2 539 292 specimens were unqualified, the unqualified rate was 5.86‰. ISO15189 declaration in 2017 was started, after implementation of joint multi-disciplinary and multi-sectoral linkage improvement measures, 5 975 out of 2 818 615 specimens were unqualified, the unqualified rate was 2.12‰. After further improvement in 2018, 5 199 out of 3 072 291 specimens were unqualified, the unqualified rate was 1.69‰(P <0.05). While the total number of specimens increased, the number of unqualified specimens showed a downward trend. Conclusion Guided by ISO15189 quality management system, through the establishment and improvement of pre-analysis quality management system, the establishment of a multi-department cooperation system, the implementation of fine management of sample collection, transportation and preservation, can significantly improve the quality of pre-analysis inspection.

参考文献/References:

[1] 张路,王薇,王治国.临床检验前和检验后阶段的 管理[J].中国医院管理,2015,35(8):34-36. ZHANG Lu,WANG Wei, WANG Zhiguo. Management of the pre-andpost-analytical phases of the clinical laboratory[J]. Chinese Hospital Management,2015,35 (8):34-36.
[2] 林梅,张珍,陈亚宝,等.加强临床生化分析前质 控提高检验质量[J].临床和实验医学杂志,2013, 12(4):317-319. LIN Mei ,ZHANG zhen ,CHEN Yabao, et al. Strengthen quality control before clinical biochemical analysis to improve accuracy of lab results[J]. Journal of clinical and Experimental Medicine, 2013,12 (4):317-319.
[3] 王麟,成景松,胡雪竹. 应用统计质量控制(SQC) 和诺曼图相结合方法对临床血液学常规检验项目风 险管理[J].现代检验医学杂志,2019,34(3):148- 155. WANG Lin , CHENG Jingsong, HU Xuezhu. Applying statistical quality control(SQC)and norman diagram tothe risk management of clinical hematology routine test items[J].J Mod Lab Med, 2019,34(3):148- 155.
[4] 于涛,王云双,王磊. 儿童血培养分析前影响因素 的探讨 [J].国际检验医学杂志,2017,38(15): 2130-2131. YU Tao,WANG Yunshuang,WANG Lei.Discussion of influencing factors before blood culture analysis in children[J].International Journal of Laboratory Medicine, 2017,38(15):2130-2131.
[5] 尚红,王毓三,申子瑜. 全国临床检验操作规程[S].4 版. 北京:人民卫生出版社,2015. SHANG Hong, WHANG Yusan, SHEN Ziyu. National code of practice for clinical examination[S].4th Ed.Beijing:People’s Medical Publushing House, 2015.
[6] PLEBANI M. Harmonization in laboratory medicine:re quests,samples,measurments and reporta[J]. Critrev rev Clin Lab Sci,2016,53(3):184-196.
[7] 马黎明,陈敬银. 临床实验室质量管理缺陷分析及改进 建议 [J].现代检验医学杂志,2008,23(5):120-122. MA Liming,CHEN Jingying.Study on quality management defects in clinical laboratory and suggestions for improvement[J].J Mod Lab Med,2008,23(5):120-122.
[8] 苏增留.做好临床实验室质量管理: 细节很重要[J]. 中 华临床实验室管理电子杂志,2014,2(4):208- 211. SU Zengliu.Managing the quality of clinical laboratories: some details cannot be ignored[J].Chin J Clin Lab Mgt (Electronic Edition), 2014,2(4):208-211.
[9] 中华人民共和国国家卫生和计划生育委员会.临床 检验专业医疗质量控制指标[S]. 北京:中国标准出 版社, 2015 National Health and Family Planning Commission of PRC.The medical quality indication in clinical laboratory [S]. Beijing: China standard Press,2015.
[10] 张云,黄新强,高兴,等.2017 年解放军总医院第 六医学中心急诊检验质量指标调查与分析.[J].现 代检验医学杂志,2019,34(3):158- 160,64. ZHANG Yun, HUANG Xinqiang, GAO Xing,et al. Investigation and analysis of quality index of emergency examination in Chinese PLA general hospital Sixth Medical Center in 2017[J]. J Mod Lab Med, 2019,34(3):158-160,64.
[11] 文杰, 李静, 马琳琳, 等. 多部门合作在检验标本分 析前质量持续改进中的应用[J]. 护理学报,2017,24 (6):17-19. WEN Jie,LI Jing,MA Linlin et al. Application of multisectoral cooperation in pre-analytical quality control of specimen[J]. Journal of Nursing (China), 2017,24(6):17 -19.

备注/Memo

备注/Memo:
基金项目:南华大学医院管理研究所课题(2016GL09)。 作者简介:黄常洪(1974-),男,主任技师, 主要从事生化检验和实验室质量管理,E-mail:490301@qq.com 收稿日期:2018-10-10 
更新日期/Last Update: 2019-12-25