RFID應用於洗腎室流程管理之探討

Study of RFID Application in Dialysis Room Process Management

陳慶霖(Ching-Lin Chen)

指導教授 ： 張晴翔

長榮大學/健康科學學院/醫務管理學研究所/碩士(2007年)

https://doi.org/10.6833/CJCU.2007.00071

摘要

近年來，無線射頻辨識（Radio Frequency Identification，RFID）技術應用日益廣泛，舉凡醫療資材辨識與追蹤、連續性照護、病患識別與定位、感應與遠距偵測、感染控制、以及醫院電子病歷的整合；在藥衛材的部分，則可用在藥品比對、稽核、庫存控管自動化（智慧醫藥櫃）、預防偽藥、藥衛材供應鏈管理等。因此，透過RFID 軟硬體提供直接且連續性的資訊及相關衛材之識別、定位、追蹤功能，以達到即時(right time)且隨時(all the time)的資訊傳遞，使醫療資訊系統能發揮更大之功效，進而提昇醫療照護之效率及效能。
本研究期望利用RFID技術，改善洗腎室目前庫存管理模式及作業流程的問題、節省人力與時間成本、精確掌握衛材庫存量和使用量、減少人工腎臟的損失量，進一步利用RFID功能提升病人照護品質，為病人和醫院創造出更大的價值。
在此個案中，每月盤點衛材時，常出現使用量與庫存量帳目不符的錯誤。人工腎臟損失量一年達120支，損失金額65,770元。訂購衛材模式無ㄧ定標準規則，使得庫存過多，也增加庫存管理成本。每月須由輪班護佐專責負責庫房管理，無形之中，浪費了許多人力與時間成本。備料流程花費528小時/年(88,704元)，批價流程花費360小時/年(60,480元)，盤點流程花費36小時/年(6,048元)，採購流程花費48小時/年(8,064元)，月盤點流程花費24小時/年(4,032元)。護理人員在幫病患洗腎時，會發生誤拿人工腎臟型號的情形，且無經過二次核對，讓病患使用型號錯誤的人工腎臟，不只造成病患身體上的不適，也使醫療品質受到影響。
本研究方法利用實地訪談，及個案醫院所提供的95年5月份至96年5月份有關衛材訂購量、使用量和庫存量等次級資料，評估出未導入RFID前病患報到流程、備料計價流程、衛材損失量、週盤點進貨流程、月盤點流程所浪費之成本、時間及問題。本研究準備以被動回收性TAG，並與廠商建立TAG回收機制。以RFID的技術取代目前的紙張式管理，配合後端資料庫管理系統，讓洗腎室的管理模式朝向自動化，並利用個案研究方式強化模式的應用基礎。
藉由RFID的導入，發展出病患報到辨識模式、病患衛材核對模式、護理人員計價模式、護佐庫存管理模式等。藉由資訊結合，解決流程以及衛材庫存管理的問題，提昇醫院洗腎病人照護品質。預估會有以下的預期效益：減少各流程所浪費的時間與成本：病人計價流程(50%)、護佐備料流程(50%)、護佐盤點流程(100%)、護佐採購流程(100%)、月盤點流程(100%)、衛材損失量(65,770元/年)；準確掌握衛材使用量與庫存量，減少庫存管理成本，讓庫存管理朝向無紙化，並且更有效率；提升醫療照護品質：利用PDA與TAG的讀取，可再二次檢查所使用之衛材是否吻合，讓病患在洗腎之餘無後顧之憂，未來亦可應用於其他醫院洗腎室。

關鍵字

洗腎室 ； 流程管理 ； 庫存管理 ； 人工腎臟

並列摘要

Recently, the application of Radio Frequency Identification (RFID) is more and more popular, e.g., identification and tracing of medical materials, continuous attendance, identification and position of disease, response and remote detection, infection control, and the integration of hospital electrics illness cases; in respect of medical materials, it can be applied in medicaments comparison, examination, stock automatic control ( smart medicine cupboard), prevention of fake medicament, and management of medicament supply chains. So, through RFID soft and hard ware, direct and continuous information and relevant identification, position and tracing of medical materials can be supplied to reach right time and all the time transmission of information, so as to make medical information system more efficient, and increase the efficiency and function of medical attendance.
This study expects to improve the present stock management mode of dialysis room and the problems existing in process, save manpower, time and cost, master stock and usage amount of medicine materials, and reduce the loss amount of artificial kidneys by using RFID technology. Further more, using the functions of RFID to raise quality of patients’ attendance, and create larger value for patients and hospitals.
In this case, during inventory check every month, usage amount often isn’t compliance with stock account. The loss of artificial kidney is 120 pieces per year, and loss amount is NTD $65,770. There is no certain standard rule for ordering medicine materials, which causes overstock and increases the cost of stock management. Shifts of nurses have to take the responsibility of managing the warehouse, which invisibly wastes lots of manpower, time and cost. The prepare process costs 528 hours per year ($88,704); the process of setting prices 360 hours per year ($60,480); inventory process 36 hours per year ($6,048); purchase process 48 hours per year ($8,064); month inventory process 24 hours per year ($4,032). When nursing staffs are helping patients with dialysis, the problem of mistakenly taking wrong type of artificial kidneys would happens. It not only causes uncomfortable to patients, but also will affect the medical quality, if let patients use a wrong type artificial kidney without checking for the second time.
The study use on-site interview and various materials of relevant medical materials purchase amount, usage amount, and stock amount from May 2006 to May 2007 offered by the related hospital to estimate the problems before introducing RFID, e.g., the waste of cost, time and manpower during the processes of patients registration, preparing materials and setting prices, lose amount of medical materials, weekly inventory of purchased goods, and etc. The study prepares to make TAG passive recovery and set up recovery system with manufactures. By using RFID technology to replace present paper management, and cooperating back-end database management system to let the management mode of dialysis room develop automatically, and strengthen the application base of the mode by the way of researching individual case.
By introducing RFID, the modes of identification for patients’ registration, checking patients’ medical materials, nursing stall set prices, stock management, and etc., combination with information, solving the problem of process and the stock management of medical materials, the quality of dialysis patients’ attendance will be upgraded. Expecting profits are estimated that reducing waste time and cost in these processes: patients valuation (50%), nursing and preparing material (50%), nursing and stocktaking (100%), nursing and purchase (100%), monthly inventory,(100%), loss amount of medical material ($65,770 per year); Through exactly mastering the usage and stock amount of medical materials to reduce stock management cost, let stock management toward to paperless, and become more efficient; upgrading the quality of medical attendance: by reading PDA and TAG, second examination on the compliance of medical materials used can be made, and let patients free from worries after dialysis. It can also be applied in dialysis rooms of other hospitals.

並列關鍵字

RFID ； dialysis room ； process management ； stock management ； artificial kidney

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