Proposition de tableaux d'indicateurs utiles à la bonne marche d'un service de biochimie hospitalier

Proper management of the laboratory is a common goal for the leader of the department in our hospitals. However, how to bring measurable and comparable elements to prove that the objectives are achieved, or that at least the good tendency is followed in the long run? It is the goal of this article, which presents the experience acquired during almost 30 years of responsibility devoted to the direction of a department. We are based on the code of public health, the statute of the hospital experts, the rules of hospital operation relating to human resources, the materials, the reagents and the financings. We use the following data-processing applications: LMX® (Bayer) for the data-processing management of the laboratory, Clepsydre® (Agfa) for the staff management, Item® (Addsoft) for the management of the working times of PH, Biostoco® (E-software Management) for the management of the reagents, QC on Call® (Biorad) for the management of the quality controls, as well as the standards applications of office automation Word and Excel. Annual summary tables are compiled with the following elements of productions: activity out of B, in a number of analyses, costs which are especially indicators of production and productivity. The indicators of human resources are also calculated: averages of sick leave and working time as well as the days of training for each category of staff. The question of competences is in particular evaluated by the follow-up of the number of conferences and work of publications completed. The price list of the reactive costs by apparatuses and analysis also make it possible to know the most expensive parameters. Synthetic scores are established annually for each sector of analyses to quantify the results of external evaluation of analytical quality and the scores of satisfaction of the doctors and personnel looking after. A monthly follow-up of the statistics of nonconformities of the undesirable events as of the completion dates are set up and allow the setting in necessary corrective actions. All those tools make it possible to approach “total management” and to estimate the quality of the service objectively perceived. The tables proposed are a help for the exercise of the direction of a service of biology, which must answer completely the expectations of the patients, physicians, his personnel and official authorities. From this comprehensive series of indicators, the establishment of national reference frames seems possible to us in order to make progress the role of hospital biology in improving the quality of the delivered care to the patients while optimizing the costs. The accurate knowledge of the indicators should finally allow the organization management teams to equitably allocate the budget necessary to each hospital.