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在宾夕法尼亚州医生办公室实验室中对错误患病率的纵向研究
M J Bloch1, G S Cembrowski, G J Lembesis
1Department of Pathology, Temple University School of Medicine, Philadelphia.
JAMA
|July 8, 1988
概括
宾夕法尼亚州的医生办公室实验室在12-15个月的熟练测试计划后没有表现改善. 需要加强监管,如监管或培训,以减少实验室测试中的错误.
科学领域:
- 临床实验室科学 临床实验室科学
- 改善医疗保健质量 改善医疗保健质量
- 医学诊断 医学诊断 医学诊断
背景情况:
- 医生办公室实验室 (POLs) 在患者护理中发挥着至关重要的作用.
- 能力测试 (PT) 是实验室质量保证的一个关键组成部分.
- 评估PT程序在POL中的有效性对于确保诊断准确性至关重要.
研究的目的:
- 为了评估一个低体积的实验室能力测试计划对宾夕法尼亚州新医生办公室参与者的影响.
- 为了确定是否参与季度PT会随着时间的推移导致实验室性能有可测量的改善.
主要方法:
- 对特定分析品 (血清葡萄糖,血红蛋白,尿液分析,喉培养,尿液培养,格拉姆染色) 的季度错误率的分析.
- 在12至15个月的时间内跟踪实验室性能.
- 在初始和随后的测试季度之间的错误率的比较.
主要成果:
- 实验室在前两个季度犯错误的很大一部分实验室在随后的两个季度继续在相同的分析物中犯错误.
- 在12-15个月的季度PT计划中参与并没有导致实验室性能有可测量的提高.
- 高错误复发率表明目前的PT程序的有效性受到限制.
结论:
- 目前的技能测试计划本身不足以提高医生办公室实验室的性能.
- 需要采取额外的干预措施,如监管监督或有针对性的培训和咨询,以提高实验室质量并减少诊断错误.
- 未来的战略应专注于超越基本PT的综合质量管理系统.
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