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ペンシルベニア州の医師事務所の研究室におけるエラー発生率の縦断的な研究
M J Bloch1, G S Cembrowski, G J Lembesis
1Department of Pathology, Temple University School of Medicine, Philadelphia.
JAMA
|July 8, 1988
まとめ
ペンシルベニア州の医師事務所の研究室は,熟練度テストプログラムで12〜15ヶ月後にパフォーマンスの改善を示さなかった. 検査の誤差を減らすために,規制や研修などの強化された監督が必要である.
科学分野:
- 臨床研究室科学は,臨床研究室科学である.
- 医療の質の向上 医療の質の向上
- 医療診断 医療診断
背景:
- 医者の診療所の実験室 (POL) は,患者のケアにおいて重要な役割を果たしています.
- 能力テスト (PT) は,実験室の品質保証の重要な構成要素です.
- POLにおけるPTプログラムの有効性を評価することは,診断の正確性を確保するために不可欠です.
研究 の 目的:
- ペンシルベニア州の新しい医師事務所の参加者に対して,低量の実験室の熟練度テストプログラムの影響を評価するために.
- 四半期毎のPTへの参加が,時間の経過とともに実験室のパフォーマンスの測定可能な改善につながるかどうかを判断する.
主な方法:
- 特定の分析剤 (血清グルコース,ヘモグロビン,尿分析,喉培養,尿培養,グラムステイン) の四半期エラー率の分析.
- 12〜15ヶ月の期間にわたる実験室のパフォーマンスを追跡する.
- 最初のテスト四半期と,その後のテスト四半期間のエラー率の比較.
主要な成果:
- 最初の2四半期にエラーを犯した研究所の有意な割合は,次の四半期にも同じ分析物でエラーを犯し続けました.
- 12〜15ヶ月間,四半期毎のPTプログラムへの参加は,実験室のパフォーマンスの測定可能な増加をもたらさなかった.
- 高いエラー再発率は,現在のPTプログラムの有効性の限界を示唆しています.
結論:
- 現在の熟練度テストプログラムだけでは,医師の診療所の実験室でのパフォーマンスを改善するには不十分です.
- 検査室の質を向上させ,診断誤差を減らすために,規制監督やターゲットに絞られたトレーニングや相談などの追加的な介入が必要である.
- 将来の戦略は,基本的なPTを超えた包括的な品質管理システムに焦点を当てなければならない.
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