運用精實管理縮短住院病人腸胃檢查作業時間

Utilizing Lean Management to Reduce the Operational Time of Gastrointestinal Examinations for Hospitalized Patients

陳右婧(You-Jing Chen)；江蕙娟(Hui-Chuan Chiang)；劉惠瑚(Hui-Hu Liu)；蔡佳容(Chia-Jung Tsai)；何明印(Min-Ing Ho)；劉伊晟(I-Cheng Liu)；賴慧貞(Huey-Jen Lay)

精實管理 ； 腸胃檢查 ； ECRS ； Lean management ； Gastrointestinal examinations ； ECRS

醫學與健康期刊

10卷3期（2021 / 11 / 01）

63 - 79

繁體中文

複雜的作業流程會降低服務對客戶的價值，各醫療院所已陸續應用精實管理思維進行流程改善。本專案係檢視住院病人腸胃檢查作業流程，運用精實思維與流程程序方法找出流程中等待、動作、及搬運三大浪費，透過剔除、合併、重組與簡化（Eliminate, Combine, Rearrange & Simplify，以下簡稱ECRS）手法與跨團隊合作模式，擬定檢查排程系統、規劃排程單內容及動態查詢系統架構、醫令系統之註記欄位與檢查排程與傳送派遣系統連動等對策，讓檢查排程作業時間由2,904秒降為1,099秒（目標達成率184.47%），檢查完成作業時間由2,848秒降為2,554秒（目標達成率588%），醫療資訊系統導入不僅有效縮短前置作業時間，避免人工運送之錯誤，亦大幅降低人力成本，建構以資訊化為基礎的作業環境，提供高品質之照護服務。

Because complicated operational processes lower the value of service to customers, many healthcare providers have adopted what is known as lean manufacturing to improve their operational process. In this study, we focused the effect of lean thinking and process methods for gastrointestinal examinations for hospitalized patients. We examined the utilization of lean thinking and process methods to find out the wastage during the three processes of waiting, action and transportation, the use of ECRS and inter-team coordination methods to simulate check-up scheduling system, content-planning of scheduling forms and setting-up of a status-checking system, and the corroboration between the description section of healthcare information systems and check-up scheduling and dispatching system. Operational time was decreased from 2,904 seconds to 1,099 seconds, 184.47% of target attainment. Check-up completion was also reduced from 2,848 seconds to 2,554 seconds, 588% of target attainment. Our incorporation of lean thinking into our health information system not only effectively reduced preparatory operational time, but it also prevented time-consuming mistakes associated with manual transportation and greatly reduced manpower requirements. These improvements operational environment based in part in digitalization, should allow hospitals to provide better quality care.

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