Six SIGMA evaluation of 17 biochemistry parameters using bias calculated from internal quality control and external quality assurance data.

Background: Six Sigma is a popular quality management system that enables continuous monitoring and improvement of analytical performance in the clinical laboratory. We aimed to calculate sigma metrics and quality goal index (QGI) for 17 biochemical analytes and compare the use of bias from internal quality control (IQC) and external quality assurance (EQA) data in the calculation of sigma metrics. Methods: This retrospective study was conducted in Marmara University Pendik E&R Hospital Biochemistry Laboratory. Sigma metrics calculation was performed as (TEa-bias)/CV). CV was calculated from IQC data from June 2018 - February 2019. EQA bias was calculated as the mean of % deviation from the peer group means in the last seven surveys, and IQC bias was calculated as (laboratory control result mean-manufacturer control mean)/ manufacturer control mean) x100. In parameters where sigma metrics were <5; QGI=bias/1.5 CV) score of <0.8 indicated imprecision, >1.2 pointed inaccuracy, and 0.8-1.2 showed both imprecision and inaccuracy. Results: Creatine kinase (both levels), iron and magnesium (pathologic levels) showed an ideal performance with ≥6 sigma level for both bias determinations. Eight of the 17 parameters had different sigma levels when we compared sigma values calculated from EQA and IQC derived bias% while the rest were grouped at the same levels. Conclusions: Sigma metrics is a good quality tool to assess a laboratory's analytical performance and facilitate the comparison of the assay performances in the same manner across multiple systems. However, we might need to design a tight internal quality control protocol for analytes showing poor assay performance.

To Shorten the Time of Admixture of Temporary Medical Order in PIVAS Using Six Sigma Method / 中国药房

OBJECTIVE:To shorten the time of admixture of temporary medical order in PIVAS,and to guarantee the timely treatment of patients. METHODS:Through the definition,measurement,analysis,improvement and control ie. five steps of six sigma method,the consumed time of each link of temporary medical order admixture in PIVAS was analyzed in our hospital during Mar. 9th-22nd in 2015 (before improvement);key points were found out,and relevant measures were formulated and improved;the consumed time of each link of temporary medical order admixture in PIVAS was collected again during Jul. 27th-Aug. 9th in 2015 in order to evaluate improvement effects. RESULTS:It was quality key point that total length of temporary medical order ad-mixture which included injection sequence,label checking,preparation,package rechecking,drug distribution and so on,was con-trolled within 120 min;through formulating and implementing various measures as improving information system,adjusting prepa-ration sequence and shunting staff posts flexibly,the total time of first 3 batches of temporary order admixture were 120,98 and 77 min after improvement,shortening by about 30,50 and 55 min respectively,compared with before improvement (P<0.05). CONCLUSIONS:The six sigma method has shortened the time of temporary order medical admixture in our hospital. The formulat-ed measures are effective and feasible.