Preanalytical quality improvement: from dream to reality
Preanalytical quality improvement: from dream to reality
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DOI：
10.1515/cclm.2011.600
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发表时间：
2011-07-01
影响因子：
6.8
通讯作者：
Simundic, Ana-Maria
中科院分区：
文献类型：
--
作者：
Lippi, Giuseppe;Chance, Jeffrey J.;Simundic, Ana-Maria
实验室诊断（即整个测试过程）通常通过虚拟循环进行，最初被乔治·伦德伯格称为“脑到脑循环”。在这个复杂的循环过程中，可能会出现错误。根据可靠数据，分析前错误仍占实验室诊断中发生的所有问题的近60%-70%，其中大多数可归因于标本收集、处理、制备或储存过程中的操作不当。尽管在采取不适当的反应之前，这些情况中的大多数会被“拦截”，但在近五分之一的情况下，它们可能导致不适当的调查和不合理的成本增加，同时产生不适当的临床决定并造成一些不幸的情况。已经采取了几个步骤来提高对整个测试过程中这个经常被忽视的方面的认识并建立治理。标准化和监测分析前变量是最重要的，与效率最高和组织良好的实验室有关，从而减少业务成本和增加收入。因此，本文旨在为读者提供有关分析前阶段全面质量管理的重要更新，以在整个测试过程的这一阶段进一步改善患者安全。
Laboratory diagnostics (i.e., the total testing process) develops conventionally through a virtual loop, originally referred to as "the brain to brain cycle'' by George Lundberg. Throughout this complex cycle, there is an inherent possibility that a mistake might occur. According to reliable data, preanalytical errors still account for nearly 60%-70% of all problems occurring in laboratory diagnostics, most of them attributable to mishandling procedures during collection, handling, preparing or storing the specimens. Although most of these would be "intercepted" before inappropriate reactions are taken, in nearly one fifth of the cases they can produce inappropriate investigations and unjustifiable increase in costs, while generating inappropriate clinical decisions and causing some unfortunate circumstances. Several steps have already been undertaken to increase awareness and establish a governance of this frequently overlooked aspect of the total testing process. Standardization and monitoring preanalytical variables is of foremost importance and is associated with the most efficient and well-organized laboratories, resulting in reduced operational costs and increased revenues. As such, this article is aimed at providing readers with significant updates on the total quality management of the preanalytical phase to endeavour further improvement for patient safety throughout this phase of the total testing process.