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)

《品質學報》 18卷3期 (2011/06) Pp. 245-258

摘要

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.

關鍵字

六標準差 ； 檢驗醫學 ； 效率 ； 失效

並列摘要

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.

並列關鍵字

six sigma ； laboratory medicine ； efficiency ； failure

參考文獻

林志良、林穀鴻(2009)。晶圓切割製程的穩健設計─六標準差與田口實驗設計的應用。工程科技與教育學刊。6(2)，213-225。

施威祥、紀姿妃、林正峰、黃美真、王拔群、鄭嘉惠、周家任(2009)。運用六標準差降低生化檢驗品管時間。品質月刊。45(6)，20-26。

高振渾(1994)。醫院應用作業系統─檢驗儀器連線系統。醫療資訊雜誌。3，9-15。

張錦標、許芸瑋、袁援(2001)。檢驗室資訊系統 （LIS）。生物醫學暨檢驗科學雜誌。13(3)，48-54。

()。