摘要
目的利用6σ质量标准对急诊实验室8台仪器的检测性能进行综合评价并督促实验室持续质量改进。方法选择8台仪器的46个检测项目为实验指标,以2017年上半年为质量改进前,下半年为质量改进后,收集8台仪器改进前的室间质量评价回报的偏倚和相应月份的室内质量控制的变异系数,以CLIA’88允许总误差为质量目标,按公式计算出σ值,从而综合评价8台仪器的检测性能。通过计算质量目标指数(QGI)值,找出问题所在,并从"人、机、料、环、法"方面下手,进行质量改进。之后收集改进后的室间质量评价回报的偏倚及相应月份的室内质量控制的变异系数,再次算出σ值,从而验证改进效果。结果 46个检测项目,质量改进前达到6σ以上的有27项,占58.7%;5σ以上的有30项,占65.2%;4σ以上的有35项,占76.1%;3σ以上的有41项,占89.1%;2~3σ的有5项,占10.9%。通过计算QGI值得知,需要改进精密度的有8项,需要改进准确度的有8项,需要改进精密度和准确度的有3项。改进后,除了NT-proBNP卫生部无第二次室间质评外,余45项,能够达到6σ以上的有34项,占75.6%;5σ以上的有38项,占84.4%;4σ以上的有40项,占88.9%;3σ以上的有44项,占97.8%;2~3σ的有1项,占2.2%。各阶段的σ值数量明显提高,质量改进已初见成效。结论用6σ质量标准对仪器性能的综合评价能够促进实验室持续质量改进,能够为临床提供一份精准的检验报告,进而减少危急值的复检率,缩短报告的周转时间,大大提升了临床和患者的满意度。
Objective To evaluate and improve overall quality detection of 8 instruments in emergency laboratory using 6σ quality standard.Methods In 2017,collected both internal quality control（IQC）and external quality assessment（EQA）data of 46 assay items from 8 instruments in their laboratory,and then calculated theirσ values and total allowed errors according to CLIA＇88 standards.By comparison of their quality goal index（QGI）between first and second half year of 2017,successfully elevated assayquality using strategy（man,machine,material,method,measurment and enviroment）.ResultsFor all 46 assay items（except NT-proBNP without second EQA data）,made better improvement of detection of 34（75.6%of 6σ qualified）,38（84.4% of 5σ qualified）,40（88.9% of 4σ qualified）,44（97.8% of 3σ qualified）and 1（2.2% of 2~3σ qualified）items,respectively whereas there were 27（58.7% of 6σ qualified）,30（65.2% of 5σ qualified）,35（76.1% of 4σ qualified）,41（89.1% of 3σ qualified）and 5（10.9% of 2~3σ qualified）items before improvement.Conclusion Using 6σ quality standard,could make more progress in the laboratory for many respects：fast and accurate clinical reports,reducing reinspection rate,and increasing patient＇s satisfactory,etc.
作者
史光华
刘连义
张庆
刘艳丽
安冉
刘鹏宇
姜慧英
SHI Guang-hua;LIU Lian-yi;ZHANG Qing;LIU Yan-li;AN Ran;LIU Peng-yu;JIANG Hui-ying(Department of Clinical Laboratory, General Hospital of Beijing Coal Group, Beijing 102300, China)
出处
《现代检验医学杂志》
CAS
2018年第2期146-150,共5页
Journal of Modern Laboratory Medicine
关键词
6σ质量标准
性能
质量改进
6σ quality standard
performance
quality improvement
