{"title":"Application Effectiveness of a Pre-Analytical Quality Management Pathway Based on the Structure-Process-Outcome Model.","authors":"Liping Cui, Wanling Li, Yueqin Li, Xiaofang Feng, Yue Wang, Pei Gao","doi":"10.2147/JMDH.S486258","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This single-center, before-and-after study applied the structure-process-outcome (SPO) model to pre-analytical quality control to investigate its effect on laboratory testing quality, nursing practices, patient satisfaction, and clinician trust in test results.</p><p><strong>Methods: </strong>A before-and-after design was conducted in a provincial Class A tertiary hospital. The control group (April-September 2022) and observation group (April-September 2023) each included all laboratory specimens and 550 clinical nurses (from the same wards). The SPO-guided pre-analytical quality management pathway involved forming a multidisciplinary team, establishing a grid management system, implementing a non-punitive reporting system, standardizing specimen collection, and developing a quality management information system. Groups were compared on non-compliant test sample rates, nurses' knowledge, beliefs, and behaviors, operational standardization, patient satisfaction, and clinical doctors' trust. Data were analyzed using t-tests (with effect sizes) and <i>χ²</i>-tests; confidence intervals and multiple-comparison corrections were also applied.</p><p><strong>Results: </strong>The observation group showed significantly lower rates of non-compliance in sample type, collection container, volume, contaminated blood cultures, and coagulated samples (all p < 0.01, with 95% confidence intervals). Nurses' knowledge (Cohen's d = 0.44) and behaviors (Cohen's d = 1.56) improved significantly. Operational standardization (92.5 ± 3.2 vs 85.7 ± 4.1), patient satisfaction (93.8% vs 87.2%), and clinical doctors' trust (91.2% vs 84.5%) also increased significantly (p < 0.01).</p><p><strong>Conclusion: </strong>The SPO-based pre-analytical quality management pathway significantly improved non-compliant sample rates, nurses' knowledge and behavior, operational standardization, patient satisfaction, and clinical trust in test results. This approach may serve as a reference for other institutions aiming to enhance pre-analytical quality management.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"18 ","pages":"1571-1579"},"PeriodicalIF":2.7000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927499/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Multidisciplinary Healthcare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JMDH.S486258","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This single-center, before-and-after study applied the structure-process-outcome (SPO) model to pre-analytical quality control to investigate its effect on laboratory testing quality, nursing practices, patient satisfaction, and clinician trust in test results.
Methods: A before-and-after design was conducted in a provincial Class A tertiary hospital. The control group (April-September 2022) and observation group (April-September 2023) each included all laboratory specimens and 550 clinical nurses (from the same wards). The SPO-guided pre-analytical quality management pathway involved forming a multidisciplinary team, establishing a grid management system, implementing a non-punitive reporting system, standardizing specimen collection, and developing a quality management information system. Groups were compared on non-compliant test sample rates, nurses' knowledge, beliefs, and behaviors, operational standardization, patient satisfaction, and clinical doctors' trust. Data were analyzed using t-tests (with effect sizes) and χ²-tests; confidence intervals and multiple-comparison corrections were also applied.
Results: The observation group showed significantly lower rates of non-compliance in sample type, collection container, volume, contaminated blood cultures, and coagulated samples (all p < 0.01, with 95% confidence intervals). Nurses' knowledge (Cohen's d = 0.44) and behaviors (Cohen's d = 1.56) improved significantly. Operational standardization (92.5 ± 3.2 vs 85.7 ± 4.1), patient satisfaction (93.8% vs 87.2%), and clinical doctors' trust (91.2% vs 84.5%) also increased significantly (p < 0.01).
Conclusion: The SPO-based pre-analytical quality management pathway significantly improved non-compliant sample rates, nurses' knowledge and behavior, operational standardization, patient satisfaction, and clinical trust in test results. This approach may serve as a reference for other institutions aiming to enhance pre-analytical quality management.
期刊介绍：
The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.
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