肿瘤标志物项目检测标本周转时间分析及优化

摘要

Objective To analyze the factors affecting the turnaround time (TAT) in tumor marker detection,and to observe the effect of continuous improvement measures such as optimizing the detection process on shortening TAT.Methods TAT related data of the pre-optimized tumor markers were collected by the Laboratory Information Management System (LIS).The reasons and key nodes for the extension of TAT were analyzed.A series of measures were taken,such as strengthening the training of all working staff,increasing detection frequency,and optimizing the test process.Before and after optimizing the process of tumor marker detection,the TAT times were compared.Results The average qualified rate of TAT was 32.5％ before optimizing the process;after the training of the staff and standardization of the progress,the TAT rate increased significantly to 66.1％ (P ＜ 0.05) in November,2017.The TAT rate increased to 73.4％ when adding one more position to run the test at noon in December,2017.By extending the working time on Sunday and processing tests on time,the TAT rate was significantly increased (28.6％ vs.61.3％,P ＜ 0.01).After optimizing the overnight specimen processing,the proportion of overnight specimens decreased significantly(12.8％ vs.6.2％,P ＜ 0.05).After a series of continuous improvement measures and workflow optimization,the TAT rate of tumor marker detection increased significantly (32.5 ％ vs.77.9 ％,P ＜ 0.05).Conclusion Optimizing process can effectively shorten the TAT of tumor marker detection,and meet the clinical diagnosis and treatment needs.%目的 分析肿瘤标志物项目检测标本周转时间(TAT)的影响因素,观察优化检测流程等持续改进措施对缩短TAT的效果.方法 利用实验室信息管理系统(LIS)收集优化前肿瘤标志物项目检测标本TAT的相关数据,统计分析导致TAT延长的原因和关键节点.随后采取强化相关人员全员岗位培训、增加检测频次以及优化标本送检流程等一系列持续改进措施,并比较优化前后肿瘤标志物项目检测标本TAT合格率的变化.结果 流程优化前肿瘤标志物项目检测标本TAT的平均合格率仅为32.5％;经全员岗位培训和规范流程后,2017年11月TAT合格率得到了大幅提升(66.1％,P＜0.005);2017年12月增加中午直落检测岗后,TAT合格率增加到了73.4％;增加周日检测岗及时处理当天标本,使周日送检标本的TAT合格率大幅度提升(28.6％比61.3％,P＜0.001);优化隔夜标本处理流程后,隔夜标本的比例大幅下降(12.8％比6.2％,P＜0.05).经过上述一系列持续改进措施和工作流程优化,肿瘤标志物项目检测标本的TAT合格率得到明显提升(32.5％比77.9％,P＜0.005).结论 优化流程可有效缩短肿瘤标志物项目检测标本的TAT,更好地满足临床诊疗需要.