臨床實驗室血凝測試報告自動化驗證的評估

目前，許多醫院仍採用人工驗證來審視結果，藉此發出報告。由於人工驗證是一個耗時且繁瑣的過程，因此，許多實驗室對其檢驗資訊系統（laboratory information system, LIS）利用電腦所設置的規則開發臨床實驗室檢驗結果的自動查核（auto-verification）。本研究在LIS系統中，根據Clinical and Laboratory Standards Institute（CLSI）的AUTO10-A文件制定血液凝固分析的自動驗證規則。內容包含了儀器標誌、品管規則、危機值、差異值、首次檢驗、自動驗證範圍、人工標記以及前次數值非數字規則。為了評估自動驗證規則，吾等收集2016年1月至3月的報告數據，結果顯示在使用自動驗證後，PT（prothrombin time）、APTT（activated partial thromboplastin time）與fibrinogen分析的平均報告時間分別降低3.0分鐘（23.8分鐘至20.8分鐘）、4.1分鐘（24.3分鐘至20.2分鐘）與3.8分鐘（25.5分鐘至21.7分鐘），而且經由自動驗證發出報告的比例分別為67.9%、65.5%與55.2%。總之，透過自動驗證後，可縮短報告時間和減少線上醫檢師的工作量，以及提供更佳的醫療服務品質。

關鍵字

自動驗證；報告時效；檢驗資訊系統；血凝檢查

並列摘要

Many hospital laboratories still verify test results manually. As manual verification is time-consuming and tedious, a number of computer-based laboratory information systems (LIS) have been developed. In this study, we evaluated our LIS in auto-verification of coagulation test results from January to March 2016. Based on the AUTO10-A protocol of the Clinical and Laboratory Standards Institute (CLSI), the following parameters were implemented in the auto-verification system: instrument flag, quality control, critical value, delta check, first visit, auto-verification range, mark flag, and pre value error. Results showed that the turnaround time (TAT) of prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen assays was reduced by 3.0 min (23.8 min to 20.8 min), 4.1 min (24.3 min to 20.2 min), and 3.8 min (25.5 min to 21.7 min), respectively. In addition, 67.9% of PT, 65.5% of APTT, and 55.2% of fibrinogen results passed auto-verification and were reported automatically. In conclusion, the implementation of the auto-verification LIS system resulted in decreased TAT and staff workload. This would lead to cost saving and higher quality of medical services.

並列關鍵字

Auto-verification ； turn around time (TAT) ； laboratory information system (LIS) ； coagulation time test

國際替代計量

臨床實驗室血凝測試報告自動化驗證的評估

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