국내 30개 기관의 Turnaround Time (TAT) 설정 상황과 TAT 관리 및 향상을 위한 고찰
Turnaround Time (TAT) Setting Status of 30 Domestic Clinical Laboratories and Consideration for Improvement and Management of TAT
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배경: 검사소요시간(turnaround time, TAT)은 주요한 질 관리 지표 중 하나이다. TAT는 검사 과정에서 시작점의 설정에 따라 다르게 정의될 수 있다. 각 검사실에서는 통제 가능한 요인을 고려하여 검사실 별로 다양한 기준으로 TAT를 설정하고 있다. 우리는 국내 30개 임상검사실을 대상으로 TAT관리 현황을 조사하여 효과적인 TAT 관리 방안을 알아보고자 하였다. 방법: 진단검사의학과 전문의가 상근하는 국내 30개의 임상검사실을 대상으로 웹 페이지를 활용하여 2018년 9월 1일에서 11일까지 설문조사를 실시하였다. TAT 현황을 파악하기 위하여, 관리 시점, 설정 기준, 관리 목표를 문항으로 구성하였다. 각 검사실에서 TAT가 지연되는 경우 가장 문제가 되는 단계, 임상에 대한 조치 그리고 단축의 장애 요인에 대한 문항을 포함하였다. 결과: 30개의 검사실에서 설문에 응답하였다(응답률 100%, 30/30). 응답한 검사실 모두에서 모든 검사에 TAT를 설정하여 관리하고 있다고 응답하였다. TAT 관리 시작점은 원심분리 전 접수 단계(33%)라는 응답이 가장 많았다. 설정된 TAT는 일반 검사 항목에서 120분 이상(37%), 진료 전 검사 항목에서 90분 이내(27%) 그리고 응급 검사 항목에서 60분 이내(77%)라고 응답한 비율이 가장 높았다. TAT가 가장 많이 지연되는 단계는 분석 전 단계(67%)라고 응답하였고, TAT 단축의 가장 큰 장애가 되는 요인은 일반 검사 대비 과도한 응급 및 진료 전 검사의 비율(50%)이라고 응답하였다. 결론: 응답한 검사실들은 다양한 기준으로 TAT를 설정하고 TAT 향상을 위한 관리를 수행하고 있었다. 본 연구결과는 효율적인 TAT 관리를 위한 기초자료로 활용될 수 있을 것으로 생각된다.
Abstract
Background: Turnaround time (TAT) is a major quality control indicator and can be defined differently depending on the starting point in the examination process. To determine effective TAT management plan, we investigated the status of TAT management in clinical laboratories in Korea. Methods: A questionnaire was developed using Google web pages and a questionnaire survey was conducted at 30 clinical laboratories in laboratory medicine from September 1 to 11 in 2018. Questions were developed regarding management time, starting point standards, management goals, most problematic stages of delayed TAT, clinical measures, and shortening barriers for investigation. Results: All clinical laboratories requested to undertake the survey completed the questionnaire (response rate 100%, 30/30) and answered that they were setting and managing TAT for all tests. Many laboratories (33%) set the TAT starting point as the reception stage, prior to commencing centrifugation. Of the surveyed laboratories, 37% achieved a TAT of 120 min or more for general tests, 27% met the TAT of 90 min for pre-clinic tests, and 77% met the TAT of 60 min for completion of stat tests. Most laboratories (67%) reported that the most delayed stage was pre-analysis, and 50% reported that the greatest obstacle to shortening TAT was the ratio of stat and pre-clinic tests to general tests. Conclusions: The laboratories participating in this survey set a TAT based on various criteria and were performing management for TAT improvement. The results of this study can be used as basic data to guide efficient TAT management.
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