- 期刊
運用精實管理提升護理人員準時下班達成率之專案
A Projects of Use Lean Management to Improve the AverageRate of Nursing Staff Off Duty on Time
摘要
護理人員因工作流程繁瑣，容易延遲下班，也讓工作效能及滿意度降低，影響身心健康。調查2016年8-11月4個護理單位，發現準時下班達成率平均只73.6％，工作效能滿意度平均只2.9分（1－5分評量），故成立專案小組，並設定目標值為準時下班達成率由73.6％上升至93.5％。運用精實概念中八大浪費與價值溪流圖實證發現，造成延遲下班原因為：書寫護理過程紀錄耗時、困難注射、聯繫醫師藥物到期及聯繫醫師填寫自費同意書及簽章。經確立問題，擬定解決策略包括：運用精實管理手法：價值流圖、目視化、自働化等創新手法，精簡護理紀錄模式、自動帶入會診紀錄、成立神射手及研發「即時傳呼系統」、運用資訊完成醫師簽章與提示系統，並標準化。經改善後，準時下班達成率由73.6％提升至96.3％、工作效能滿意度由2.9分提升至3.8分。2018年效果維持，達成率更達98.8％。經由跨單位合作以精實管理概念與手法，刪除工作流程中不必要的浪費流程，有效提升護理人員準時下班達成率，創造出精實的價值。
並列摘要
Owing to heavy workload and cumbersome workflow, it is easy for clinical nursing staff to confront delays in work, leading to reduced satisfaction of work effectiveness, thereby affecting physical and mental health. In a survey of four care units from August to November 2016, we found the average rate of nursing staff being off-duty on time was only 73.6%, but the average satisfaction rate of work efficiency was only 2.9 points (via the five-point method). Using the empirical results of the eight wastes and value stream map in Lean Management, the following reasons for the delays in getting off work were found: writing up the record of the nursing process, difficult injections, and contacting the physician for the expiration of drugs and requiring his/her signature for the self-paying consent form. The average rate of nursing staff off-duty on time increased from 73.6% to 96.3% by using the methods in Lean Management as follow: standardization, value stream maps, visualization, signal boards and automation, etc. By streamlining the nursing recording mode and automatically bringing in consultation records, setting up a team for smooth injection flow and developing a real-time contact system, the use of information systems to complete the physical signature and a reminder system was enhanced. Then, we standardized these methods. Finally, the average rate of nursing staff off-duty on time increased from 73.6% to 96.3%, and the average satisfaction rate of work efficiency increased from 2.9 points to 3.8 points. This effect continued from January to August 2018, where the average rate of nursing staff off-duty on time increased to 98.8%. Through cross-unit cooperation with Lean Management and removing unnecessary waste progress in the workflow effectively improved the rate of nursing staff off-duty on time.