RESUMO
Objective To investigate the effect of lean management on emergency biochemistry test turnaround time(TAT) in clinical laboratories.Methods Based on the approaches of standardized operations,5S on-site management,the efficiency evaluation of batch processing and one piece flow,and visual management,the median time of each workflow,the qualified rate of emergency biochemistry test TAT,the unqualified rate in a relatively concentrated period of TAT timeout and the unqualified rate of collected samples were compared before and after optimization.Results The median times (interquartile ranges) of each workflow including sample receipt and storage,result audit and sample storage-result report before and after lean management were 30 (35) min,7 (13) min,17 (8) min and 16(19) min,5(9) min,16(7) min,respectively,and there were significant differences in the former two(all P ＜0.01) but not the third (P ＞ 0.05).The median times (interquartile ranges) of TAT before and after lean management were 63 (51) min and 46 (33) min,respectively(P ＜ 0.05).The qualified rate of TAT increased from 86.00％ to 95.37％ after lean management(P ＜ 0.01).The unqualified rates in a relatively concentrated period of TAT timeout and collected samples decreased from 3.42％ to 1.00％ (P ＜0.01) and from 0.24％ to 0.17％ (P ＜ 0.01),respectively.Conclusion Lean management may improve process efficiency,reduce errors,and shorten emergency biochemistry test TAT in clinical laboratories.
RESUMO
Objective To investigate the intra-laboratory turnaround time(ILTAT) of the emergency biochemistry tests and to analyze the factors influencing ILTAT in order to adopt the corresponding improvement measures for perfecting the service quality and ensuring the patient medical safety.Methods ILTAT of the emergency biochemical specimens in our hospital from June to November 2015 was performed the retrospective statistics for comparing the determination timely rate between ILTAT≤60 min and ILTAT2 ≤120 min.ILTAT at different time periods in laboratory was emphatically analyzed.Results The determination timely rate of ILTAT ≤120min(ILTAT 1) was 98.8%(8638/8743),and which of ILTAT ≤60min(ILTAT 2) was 83.7%(7317/8743).The determination timely rate of ILTAT1 had no statistical difference among different time periods (χ2=3.36,P>0.05).The determination timely rate of ILTAT2 had statistical difference among different time periods(χ2=134.5,P<0.01).The determination timely rate of T 2(10:01-12:00) was highest (88.1%),which of T1 (8:01-10:00) was lowest(76.8%),which of T3(12:01-14:00) and T7 (6:01-8:00) was lower (79.4% and 80.2% respectively).Conclusion At present,ILTAT in our laboratory meets the requirements of the current regulations.Analyzing the ILTAT influencing factors in the emergency biochemistry,optimizing the workflow,improving the equipments and staffing allocation and improving the degree of information processing can further shorten the emergency biochemical ILTAT,and better meet the clinical and patient′s needs.