Application of Sigma Metric and TOPSIS Method to Comprehensively Analyze 15 Quality Indicators in Clinical Laboratory...

This study aimed to apply sigma metric and TOPSIS method to comprehensively analyze quality indicators from 2019 through 2024 and explore factors improving laboratory errors in the Department of Clinical Laboratory at the Renmin Hospital of Wuhan University.

Fifteen quality indicators (QIs) covering the total testing process were collected through the laboratory information system and manual statistics. After calculating the rates, they were converted into sigma values according to specific formula, and the turnaround time was expressed in minutes. The TOPSIS method was applied to comprehensively analyze the clinical laboratory medical quality in different years, specialties, and specimen types. Through sigma metric, the trend and quality difference of each indicator were analyzed year by year. TOPSIS method was used to rank the quality of different years, specialties, and specimen types and to identify quality problems and effective improvement measures.

Due to Corona Virus Disease 2019 (COVID-19), the number of specimens in 2022 was the highest, while that in 2020 was the lowest, with blood specimens being the main type. The critical values notification and timely critical values notification were both 100% every year. The sigma values of all QIs were below six, among which the average sigma value of "incorrect sample type" was the highest, at 5.73. The average sigma value of "test covered by interlaboratory comparison" was the lowest, at 1.01. Comprehensive analysis revealed that the performance of QIs in 2024 ranked first. From 2019 through 2023, the rank of pre- and post-phase QIs was: 1) biochemistry, 2) immunity, 3) hematology, and 4) microbiology. In 2024, performance of immunity was the best. The sigma value of blood specimens was the highest among all sample types, and the average was above five.

Although the quality performance of QIs fluctuated year by year, it showed a trend of continuous improvement. The detailed analysis of quality indicators in different years, specialties, and sample types still was unsatisfactory. There, clinical laboratories should take targeted improvement measures according to the problems reflected in the QIs.