[Keywords] Clinical laboratory; management; training
At present, China's second-level hospitals above the Department of Laboratory can be divided into blood, biochemistry, immunity, microbiology, body fluids and other relatively independent of the professional laboratory, with the modernization of science and technology in the field of medicine in the wide range of applications, the laboratory equipment have been improved to a large extent to improve the test project. Part of the test items have been fully automated or semi-automated, initially formed a more complete technical system, and can collaborate with each other. Accompanied by the national "clinical laboratory management of medical institutions," the implementation of the author on the new situation of the construction and management of the hospital laboratory to talk about the management of the director of the department.
1. Management of technical personnel
The hospital laboratory test quality level of excellence depends on the level of medical ethics and technical level of its staff, the requirements of the test personnel must have love "injury" concept, with a rich and solid theoretical foundation, skilled and superb operational skills and the ability to actively adapt to the update of knowledge.
1.
1.1 Medical ethics and medical style construction Good medical ethics is an important part of the construction of hospital culture, establish good professional ethics is every medical staff must have a code of conduct, "all for the patients" purpose can not only stay in the mouth, to be implemented in action, as far as possible to meet the needs of patients [1]. Department of management to establish a morning shift system, one of the contents is to carry out medical ethics education.
1.2 Business and technical training Although the level of theoretical education of the test personnel before joining the department has been improved to a certain extent, but the knowledge acquired still has not kept pace with the rapid development of medical testing technology. As the use of technical personnel must be further training, one should be based on the quality of personnel to carry out pre-service rotational learning, familiar with the department's business and job responsibilities, exams on the job; two should be purposeful and well-planned to take academic exchanges, further training in the field, project training, visits to study, etc., to develop a number of business and technical backbone of a stable and professional mindset. At the same time, the department relies on manufacturers to carry out new business training, encourage them to learn and master new technologies and new methods.
2. test quality management
Because the improvement of the quality of instruments and equipment to improve the test results can be better to avoid the interference of human factors, judgment more objective, scientific, feedback to the clinical information and results more and more quickly, so a considerable part of the technical staff that as long as there are people, instruments, reagents can be issued to the clinical test report. This understanding of the lack of quality of clinical laboratory work enough attention, coupled with the urgent requirements of the clinical test report "speed up", ignoring the issuance of the report on the basic measures necessary for quality assurance such as instrument calibration, maintenance, repair, indoor quality control, standard operating procedures, records and other quality management of clinical laboratories. The core of the quality management of the laboratory is quality control, quality control is not only indoor quality control (IRC) and inter-room quality assessment (EQA), but also personnel, quality system, facilities and environment, testing methods, records, samples and other management content. Medical Education Network
2.1 Establishment of a professional team Establish a quality management team headed by the departmental leader, with the leader (person in charge) of each professional laboratory as a member. Develop such as procedure documents, operation manuals, quality control records, error registration and other quality management system and supervise the implementation of regular inspection, analysis of the group indoor and outdoor quality assessment, timely correction of staff technical operation of non-standard behavior; regular collection of clinical departments on the department's comments and suggestions, and put forward solutions.
2.2 Specialized experimental groups to implement the system of responsibility of the group leader, the group leader of the fixed professional The head of each group to implement the competition, take a secret ballot to elect the section party branch committee to produce after the study. The establishment of the operator, professional team leader or technician in charge, the section chief "three-level" test report review system, the laboratory results should be analyzed, such as quality control within the scope of the report can be issued, otherwise, we should look for the reasons, if necessary, to review the test. The implementation of special test reports by the section chief gatekeeper, other test reports issued after checking the team leader.
2.3 Development of specimen collection and delivery system In order to ensure the effectiveness and reliability of the work of the Laboratory Department, the establishment of a written standard for specimen rejection, and have a record of the refusal of the specimen, as well as in the application form to indicate the reasons for the refusal. The reagent kits used are purchased based on the principles of quality first, reasonable price and considerate service, and should be compared and analyzed before selection. Instruments in the use of standards before calibration, normal with indoor quality control substances according to the operating standard program documentation requirements for testing operations.
2.4 Seriously do a good job IRC, and strive to do a good job EQA IRC is the basis of laboratory test quality assurance, and EQA is the continuation and supplementation of IRC, play a role in mutual correction of the accuracy of the test results, quality control of the laboratory to play a supervisory role, promote the role of EQA should be done to achieve the professional experimental team to evaluate 1 times a month, EQA to do the section after each result of the return to evaluate 1 time, to summarize the experience. Summarize the experience.
3. Instrumentation management
The combination of computers and a variety of automated instruments, so that the automation of the test work has been greatly improved. Many testing instruments instead of manpower, as long as the machine, the inspector can be operated according to the instructions to move around, and then the computer directly output test results, greatly reducing the workload of the inspector to improve efficiency, so the management of instruments and equipment is another important part of the management of the Department of Laboratory.
3.1 Claims and build a full instrument files must have: registration certificate, certificate of conformity, sales certificate, operating procedures (laboratory regulations), maintenance and use of records (proof of the state of the instrument), calibration and quality control procedures and records (proof of accuracy and precision), measurement of equipment, strong inspection records.
3.2 Evaluation of the main performance parameters of the instrument Including precision, i.e., containing normal and abnormal levels of specimen detection, linear range, comparability, anti-interference test, etc. to ensure that the daily use of equipment is normal.
3.3 Reconstruction of the standard curve The standard curve should be established before the determination of routine specimens of the new instrument, and should be re-established when replacing the reagents of a new batch number or after the maintenance of the instrument and so on.
3.4 Instrument maintenance and maintenance Establishment of instrument maintenance, maintenance, use of the system, a variety of instruments by a person responsible for the daily maintenance, maintenance, calibration, and make a good record, found that the problem reflected in a timely manner and contact repair.
3.5 Comparison of instruments Comparison of instruments is an important method to ensure the consistency of laboratory reports. At least 3 months for 1 time, and have a detailed record, the method is: first choose a technical performance of the laboratory instrument (as far as possible with the matching calibrator calibration of the instrument), the other instruments were compared with the instrument.
4. Section Administration
4.1 Safety Requirements The laboratory must establish and implement a "safety management system" to prevent physical, chemical, biochemical, electrical and biological injuries; strict separation of the laboratory from the office, and the contaminated area from the non-contaminated area.
4.2 Develop and improve the rules and regulations, job responsibilities and rewards and punishment system One of the purposes of administrative management to establish a set of effective management practices, improve the rules and regulations is to improve the quality of the important guarantee. Laboratory to determine the important analysis of the "alarm" range, when the test results suggest the existence of the alarm range, the Laboratory shall repeat the specimen, and immediately return to the clinical, and clinical diagnosis does not meet the situation, shall repeat the determination and timely contact with the clinical. At the same time, a detailed record should be made, including the date, time, the staff responsible for the test, notify the staff and experimental results.
4.3 Strengthen the training of personnel to strengthen the new project to carry out the entry demonstration and on-the-job training of test personnel. On the one hand, training and improve all the inspection staff to grasp the basic knowledge and quality control theory of understanding; on the other hand, the quality of work is made by the behavior of all employees in various positions to ensure that must strengthen the quality of awareness of the entire staff, and always take the quality of education of the entire staff as a basic task, and always pay attention to.
4.4 adhere to the regular and clinical coordination system to really be able to effectively transform the test data into useful clinical information, the need for close cooperation between the clinic and the examiner, in order to establish a quality information feedback system, and regularly consult the views of the relevant issues raised in a timely manner to deal with the problem, the report and correct.
5. Supervision and assessment management
5.1 Summary at the end of the year, the assessment of excellence and rewards The establishment of a disciplinary management team consisting of the director of the department and the head of the professional team as a member of the department staff to implement the rules and regulations of the situation of supervision, inspection, implementation, found that the problem is recorded in a timely manner in the department of the morning meeting criticized pointed out that and in accordance with the incentives and penalties to be punished or rewarded. Discipline management team quarterly for each person to carry out a comprehensive quantitative assessment, the assessment to test the quality of the main style of discipline, supplemented by sub-scoring and will be accumulated to the end of the year to summarize, merit awards.
5.2 Two-way assessment of the team leader (laboratory director) to implement two-way assessment scoring, one is the whole section staff to the team leader (laboratory director) secret ballot scoring; the second is the section of the party branch committee to the team leader evaluation scoring, the sum of the two brought to the end of the year summary of the work as one of the bases for their evaluation. In short, the director of the department is not only the administrative leadership, but also professional discipline leader, test quality improvement, training of talents, economic benefits to a large extent depends on the director of the management capacity and level [2]. To improve the management of the hospital laboratory, the director of the department needs to continue to learn, update the ideological concepts, develop and improve the department's management system as well as the assessment of rewards and punishments system, with the system to manage and constrain the personnel.
References:
[1] Liu Jilian, Yan Fengye. Talk about the scientific management of laboratory [M]. China Clinical Laboratory, 2002, 9 (3): 6.
［2］ Cong Yulong, Qin Xiaoling. Several major problems and countermeasures in the management of the laboratory [J]. Chinese Journal of Laboratory Medicine, 2003, 11(26): 649?651.