運用精實理念降低值勤助理員工作負荷

Application of Lean Principles to Reduce Workload for Assistant Staff

許湞貽(Jen-Yi Hsu)；蘇靜美(Ching-Mei Su)；陳雅莉(Ya-Li Chen)；邱燕甘(Yen-Gan Chiou)

助理員 ； 工作負荷 ； 人力資源 ； Assistant staff ； Workload ； Human resources

澄清醫護管理雜誌

20卷4期（2024 / 10 / 01）

55 - 65

繁體中文;英文

目的：助理員是醫療體系中不可或缺的角色，常接獲例假日或小夜班值勤助理員反應業務過多且耗時，須同時處理庶務作業及轉送病人，也常有同仁抱怨工作忙碌無暇用餐，導致助理員工作情緒及效率低落，間接影響護理人員臨床作業的連續性，期望透過改善作業流程問題，提升值勤助理員的工作滿意度與醫療品質。方法：經現況調查值勤助理員負責範圍與測量實際工時，發現各區負責人力配置不當、業務量差異大、跨部門作業未整合，導致值勤助理員最耗時步驟總工時高達39.3％，針對人員、制度及跨部門擬定解決方案：運用ECRS手法刪除不必要的步驟、合併及重排負責區域、簡化冰送檢體運送方式，作業流程再造統整人力運用、簡化及刪除跨部門作業、拍攝檢體包裝影片、製作轉送及送檢注意事項單張。結果：值勤助理員最耗時步驟總工時由39.3％降至30.9％，無加班件數，區域人力整合後，值勤助理員工作時數及業務量趨於平均，工作滿意度由55.6％提升至64.3％，改善持續推行迄今維持成效。結論：本專案運用精實理念ECRS手法降低助理員最耗時步驟工時，良好的資源人力配置能讓庶務及傳送作業流程更順暢，簡化工作流程消除工作中不必要的等待，降低工作中的時間浪費，有效整合人力並提升工作效率。

Purposes: The assistant is an indispensable role in the healthcare system. Often tasked with cover-ing weekends and night shifts, assistants frequently report excessive workload and time constraints. They must simultaneously manage administrative tasks and patient transfers, often while colleagues complain of being too busy to take breaks, resulting in low mo-rale and efficiency among assistants. This indirectly impacts the continuity of clinical operations for nursing staff. Improving operational workflows is hoped to enhance job satisfaction among duty assistants and elevate healthcare quality. Methods: Based on current situation assessments and actual work hour measurements of duty as-sistants, it was found that inadequate manpower allocation, significant workload disparities, and lack of integration across departments contribute to the most time-consuming steps totaling 39.3% of total work hours. To address these issues related to personnel, systems, and inter-departmental coordination, the following solutions are proposed: Utilize ECRS methodology to eliminate unnecessary steps, Consolidate and rearrange responsibility areas, Simplify the transport of samples for testing, Re-engineer workflows to optimize manpower utilization, Simplify or eliminate inter-departmental processes, Create instructional videos for sample packaging, Develop guidelines for transfers and sample submissions. Results: The most time-consuming steps for duty assistants have been reduced from 39.3% to 30.9% of total working hours, with no overtime incidents. Following the integration of regional manpower, working hours and workload for duty assistants have trended to-wards average levels. Job satisfaction has increased from 55.6% to 64.3%. These im-provements have been consistently effective since implementation and are being sus-tained. Conclusions: This project utilizes lean thinking and ECRS methodology to reduce the time spent on the most time-consuming steps for assistants. Effective resource allocation ensures smoother administrative and transfer operations, simplifies workflows by eliminating unnecessary waits, reduces time wastage during tasks, integrates manpower efficiently, and enhances overall work efficiency.