以六標準差提升夜間住診檢體檢驗時效－以某醫學中心爲例

Improvement of Specimen Examination Efficiency for Inpatients at Night by Six Sigma Management-A Case Study of One Medical Center

汪秀玲(Hsiu-Ling Wang)；饒秀芬(Hsiu-Fen Jao)；蕭壬魁(Jen-Kuei Hsiao)；馮文瑞(Wen-Jui Feng)；張建國(Jan-Gowth Chang)；江建華(Chien-Hua Chiang)

六標準差 ； 檢驗醫學 ； 效率 ； 失效 ； six sigma ； laboratory medicine ； efficiency ； failure

品質學報

18卷3期（2011 / 06 / 01）

245 - 258

繁體中文

This study presented a model for improving examination efficiency for inpatients' specimen at night by six sigma principles, adopting the D-M-A-I-C (define, measure, analyze, improve and control) approach. The laboratory medicine department of one medical center as research setting, and the efficiency was monitored and recorded with the laboratory information system (LIS) and the physician's order system (POIS) during 2009 June to August. (1) Define, the total examination flow time over 90 minutes was regarded as a failure. (2) Measure, Pareto Analysis were used to identify three operations resulting in major variation, specimen analysis, transportation and classification accounting for 47.24%, 21.91%, 19.63%, separately. (3) Analyze, corrective interventions to be created such as adjustment of laboratory staff shift, reporting quality of bar code and modified LIS program. (4) Improve, the sigma level for the failure of total process time upgraded from 2.14 σ to 4.07 σ after interventions implemented. (5) Control, the effect of intervention to be verified, and then modified the regulation of specimen delivery. The evidence suggested that our actions can stabilize the efficiency of examination process and then reduce the probability of postponing physicians' diagnosis or treatment.

This study presented a model for improving examination efficiency for inpatients' specimen at night by six sigma principles, adopting the D-M-A-I-C (define, measure, analyze, improve and control) approach. The laboratory medicine department of one medical center as research setting, and the efficiency was monitored and recorded with the laboratory information system (LIS) and the physician's order system (POIS) during 2009 June to August. (1) Define, the total examination flow time over 90 minutes was regarded as a failure. (2) Measure, Pareto Analysis were used to identify three operations resulting in major variation, specimen analysis, transportation and classification accounting for 47.24%, 21.91%, 19.63%, separately. (3) Analyze, corrective interventions to be created such as adjustment of laboratory staff shift, reporting quality of bar code and modified LIS program. (4) Improve, the sigma level for the failure of total process time upgraded from 2.14 σ to 4.07 σ after interventions implemented. (5) Control, the effect of intervention to be verified, and then modified the regulation of specimen delivery. The evidence suggested that our actions can stabilize the efficiency of examination process and then reduce the probability of postponing physicians' diagnosis or treatment.

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