DOI QR코드

DOI QR Code

Calculation of the Quality Additional Rate of Clinical Laboratory Test and Review of Application Criteria

임상병리검사 질 가산율 산출 및 적용기준의 검토

  • Yang, Byoung Seon (Department of Medical Laboratory Science, Jinju Health College) ;
  • Park, Sang Muk (Department of Biomedical Laboratory Science, Donggang University) ;
  • Bae, Hyung Joon (Department of Clinical Laboratory Science, Daejeon Institute of Science and Technology) ;
  • Kim, Won Shik (Department of Clinical Laboratory Science, Daejeon Health Institute of Technology) ;
  • Park, Hun Hee (Department of Clinical Laboratory Science, Ansan University) ;
  • Lim, Yong (Department of Clinical Laboratory Science, Dong-eui University) ;
  • Kim, Yoon Sik (Department of Biomedical Laboratory Science, Donggang University) ;
  • Choi, Se Mook (Department of Medical Laboratory Science, Jinju Health College) ;
  • Bae, Do Hee (Department of Laboratory Medicine, Gyeongsang National University Hospital) ;
  • Park, Ji Ae (Department of Medical Laboratory Science, Jinju Health College)
  • 양병선 (진주보건대학교 임상병리과) ;
  • 박상묵 (동강대학교 임상병리과) ;
  • 배형준 (대전과학기술대학교 임상병리과) ;
  • 김원식 (대전보건대학교 임상병리과) ;
  • 박훈희 (안산대학교 임상병리과) ;
  • 임용 (동의대학교 임상병리학과) ;
  • 김윤식 (동강대학교 임상병리과) ;
  • 최세묵 (진주보건대학교 임상병리과) ;
  • 배도희 (경상대학교병원 진단검사의학과) ;
  • 박지애 (진주보건대학교 임상병리과)
  • Received : 2020.06.23
  • Accepted : 2020.08.28
  • Published : 2020.09.30

Abstract

This study reviewed the quality addition rate, calculation, and application criteria needed to identify the possibility of additional medical technologists in the field for new certification and professional manpower to provide a superior laboratory. The six institutions that participated in the study were the size of large hospitals with more than 1,000 beds, with an average of five full-time laboratory physicians (also called clinical pathologists) and an average of 53 medical technologists, with 10.6 per laboratory physician. An analysis of the time required for each activity category of medical technologists revealed decreasing behavior during the analysis. In contrast, the ratio of the comprehensive pre-analysis activities was high due to the strengthening of laboratory operations and quality control. During the analysis, the proportion of biochemistry tests was high, and post-analysis of most of the results was performed. Hence, improving the quality of sample testing requires significant time, and appropriate personnel are required. In conclusion, the recruitment of medical technologists is also a key component to improving the sample quality, and corresponding personnel regulations are necessary.

본 연구는 질 가산율 산출 및 적용기준을 검토하여 우수검사실 신임인증 및 전문인력영역에 있어 임상병리사를 추가 가능성을 알아보았다. 연구에 참여한 6개 기관은 1,000병상 이상의 대형병원 규모이며, 상근 진단검사의학과 전문의 평균 5명, 임상병리사는 평균 53명으로 전문의 1명당 10.6명으로 나타났다. 임상병리사의 행위분류별 소요시간에 대한 분석결과, 분석 중 행위는 낮아지고 있는 반면 검사실 운영, 정도관리 등의 강화로 포괄적 분석 전 행위의 비율이 높게 나타났다. 분석 중 행위는 생화학 검사수행 등의 비중이 높았고, 분석 후 행위는 결과분석 등이 대부분을 차지하였다. 이와 같이 검체검사 질 향상을 위해 많은 시간이 소요되며, 그에 맞는 인력이 요구된다. 결론적으로 검체검사 질 향상을 위해 임상병리사의 채용 역시 중요하며, 그에 따른 인원 규정이 필요하다 할 수 있다.

Keywords

References

  1. Hsiao WC, Braun P, Becker ER, Thomas SR. The resource based relative value scale. Toward the development of an alternative physician payment system. JAMA. 1987;258:799-802. https://doi.org/10.1001/jama.1987.03400060075033
  2. Health Insurance Review and Assessment Service. Detailed matters concerning the criteria and methods for the application of medical care benefits-Partial revision [Internet]. Wonju: Health Insurance Review and Assessment Service; 2017 [cited 2020 July 20]. Available from: http://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020002000100&brdScnBltNo=4&brdBltNo=6411
  3. Hsaio WC, Braun P, Dunn D, Becker ER. Resource based relative value. JAMA. 1988;260:2347-2353. https://doi.org/10.1001/jama.260.16.2347
  4. Kim HJ, Sohn MS, Cho WH, Park EC, Cheon BY, Lee SH, et al. An overview of Korean resource based relative value scale. Korean Journal of Health Policy and Administration. 1995;5:202-212.
  5. Cha YJ, Kim DW, Kim JW, Min WK, Park Q, Park MJ, et al. Practice characteristics and relative value of laboratory physician's work. Korean J Lab Med. 2005;25:477-488.
  6. Jeon BR, Yoon CH, Jang MA, Cho SR, Kim SL, Lee YK. Korean clinical laboratory accreditation program quality standards for laboratory management: Identifying a compliance gap with World Health Organization quality system essentials. Lab Med Online. 2020;10:152-159. https://doi.org/10.3343/lmo.2020.10.2.152
  7. Shin BM, Chae SL, Min WK, Lee WG, Lim YA, Lee DH, et al. The implementation and effects of a clinical laboratory accreditation program in Korea from 1999 to 2006. Korean J Lab Med. 2009;29:163-170. https://doi.org/10.3343/kjlm.2009.29.2.163
  8. International Organization for Standardization. Quality management systems-Requirements. ISO 9001:2015. Geneva, Switzerland: International Organization for Standardization; 2015.
  9. International Organization for Standardization. Medical laboratories-Requirements for quality and competence. ISO 15189: 2012. Geneva, Switzerland: International Organization for Standardization;2012.
  10. College of American Pathologists. CAP Accreditation Checklists-2018 edition [Internet]. Washington, DC: College of American Pathologists; 2018 [cited 2020 May 20]. Available from: https://documents.cap.org/documents/2019-edition-cap-accreditationchecklists.pdf
  11. Clinical and Laboratory Standards Institute. Quality management system: A model for laboratory services; Approved guidelinefourth edition. CLSI guideline QMS01-A4. Wayne, Pennsylvania: Clinical and Laboratory Standards Institute; 2011.
  12. World Health Organization. Laboratory quality management system: handbook, version 1.1 [Internet]. New York: World Health Organization; 2011 [cited 2020 May 20]. Available from: https://www.who.int/publications-detail/laboratory-quality-management-system
  13. World Health Organization. Laboratory quality management system training toolkit [Internet]. New York: World Health Organization;2009 [cited 2020 May 20]. Available from: https://www.who.int/ihr/training/laboratory_quality/en/
  14. World Health Organization. Laboratory Quality Stepwise Implementation tool [Internet]. New York: World Health Organization;2009 [cited 2020 May 20]. Available from: https://www.who.int/ihr/lyon/hls_lqsi/en/
  15. Korea Laboratory Accreditation Scheme. Korea Laboratory Accreditation Scheme Korean Agency for Technology and Standards, MOTIE, Korea 2014 [Internet]. Eumseong: Korea Labotory Accreditation Scheme; 2014 [cited 2020 May 20]. Available from: https://www.knab.go.kr/inf/bbs/lawrecsroom/ LawRecsRoomDetail.do
  16. AbdelWareth LO, Pallinalakam F, Ibrahim F, Anderson P, Liaqat M, Palmer B, et al. Fast track to accreditation: An implementation review of college of American pathologists and international organization for standardization 15189 accreditation. Arch Pathol Lab Med. 2018;142:1047-1053. https://doi.org/10.5858/arpa.2016-0567-RA
  17. Garcia E, Kundu I, Ali A, Soles R. The American Society for Clinical Pathology's 2016-2017 vacancy survey of medical laboratories in the United States. Am J Clin Pathol. 2018;149:387-400. https://doi.org/10.1093/AJCP/AQY005
  18. Yang BS, Lim Y, Kim YS, Oh YS, Bae DH, Choi SM. Calculation of human resources for medical technologist in diagnostic testing. Korean J Clin Lab Sci. 2020;52:158-163. https://doi.org/10.15324/kjcls.2020.52.2.158