摘要目的 分析病理报告延迟的相关因素,为病理科服务质量改进提供参考途径.方法 从浙江省东阳市人民医院1999-2006年8年的病理报告中,以月为单位整群随机抽取24个月共21 038份病理报告,按活检标本、手术标本和冷冻切片标本分别统计报告的及时性,分析延迟报告发生的原因.结果 及时报告19 579份,及时报告率93.06%,延迟报告1459份,延迟报告率6.94%,其中活检报告延迟率6.02%(665/11 052),手术标本报告延迟率7.26%(643/8858),冷冻报告延迟率13.39%(151/1128).延迟报告的原因,以技术原因为主,占1158份(79.37%),其中免疫组织化学或特殊染色、科内讨论或院外会诊、访视患者或与临床沟通比例较高.责任原因占301份(20.63%),其中申请单缺项和缺既往病理资料最多见.发生环节中,以科内因素为主占1048份(71.83%),其中技术原因1017份(97.04%).科外因素411份,其中以责任原因为主,占270份(65.69%,X2=709.59,P<0.05).结论 影响病理报告及时性的因素有技术性和责任性两大类,科内以技术性为主,科外以责任性为主,应当分别运用流程改造、技术进步和加强责任心等措施加以改进.

abstractsObjective To investigate the factors related to delay in pathology reporting and to improve the quality of pathology service. Methods A total of 24 months pathology reports ( total number = 21 038) issued by Department of Pathology, Dongyang People's Hospital (randomly selected during the period from 1999 to 2006) were analyzed. The timeliness of these reports was studied with respect to the types of specimens (biopsy versus surgical versus frozen section). The causes for delay in reporting were statistically analyzed. Results Among all the cases studied, 19 579 reports were timely issued (timeliness rate =93.06% ), whereas 1459 reports were delayed ( delay rate = 6.94% ). Of the 1459 delayed reports, routine biopsy specimens accounted for 6.02% (665/11 052), surgical specimens for 7.26% (643/8858) and frozen section specimens for 13.39% (151/1128). The main causes for delay in reporting were technical ( 1158 cases or 79. 37% ), including requests of immunohistochemical staining, intradepartmental or external consultation, patient contact and discussion with requesting clinicians. Factors related to responsibility, such as inadequate clinical information in the pathology request forms, were identified in 301 cases (20.63% ). The delay in reporting was mainly due to factors occurring within the pathology department (which accounted for 1048 cases or 71.83% ( P<0.05 ) and most were technical ( 1017 cases or 97.04% ). Extradepartmental factors, mainly related to responsibility, were noted in 270 cases(65.69%, X2=709.59, P<0.05 ). Conclusion Factors related to delay in pathology reporting can be categorized into technical and responsibility. The former can be rectified by improvement of laboratory procedures, while the latter needs education of the personnel concerned.