應用精實六標準差改善檢查流程-以T醫院為例

面臨醫療環境不斷變化，民眾愈來愈重視醫療服務品質，醫院所提供的醫療服務往往是病人的最能接觸到的服務感受，且隨著病患人數逐年增加，容易發生病人等待看診擁擠、等待檢查時段延遲之情況，此外，提升醫院檢查流程效率有助於降低醫療成本，為醫院提高獲利，達到醫院永續經營，因此，醫院如何加強於檢查流程管理及提昇醫療品質、服務效率，縮減醫療資源浪費，儼然現今醫療機構及學術關注的焦點之一。本個案檢查室檢查項目內容繁雜，且排程檢查時段規則多且複雜，常導致病人因檢查等候時間過長，造成內、外部顧客焦急。如何從中找出浪費、消除不必要之程序、提升效率促使檢查流程精簡流暢，關係到醫院內部系統價值鏈之團隊合作整合順暢，甚為首要任務。故本研究希冀藉由精實六標準差的工具運用，導入國內外精實生產系統概念，以審視檢查流程系統中產生不必要的浪費，運用精實生產之「暢流」為首要，優化檢查流暢度、有效縮短檢查等候及降低成本，以提升檢查室檢查流程效率，並擬定出改善流程。最後，本研究運用精實六標準差衡量工具，能降低檢查時間，從改善前的240分鐘，降低為改善後167分鐘，大幅降低73分鐘，特別是大幅降低神經傳導檢查與頸動脈超音波檢查，神經傳導檢查由原先40分鐘，降低為20分鐘，頸動脈檢查由原先35分鐘，縮短為20分鐘，因此，對於本研究個案之檢查流程利用精實概念，確實有效減少檢查流程的不必要浪費，明顯降低檢查流程時間，提供後續醫院及學術界參考。

關鍵字

醫院；精實管理；六標準差；精實六標準差；改善流程

並列摘要

Faced with the ever-changing medical environment, people are paying more and more attention to the quality of medical services. The medical services provided by hospitals are often the most accessible service experience of patients, and as the number of patients increases year by year, patients are prone to crowding. Waiting for the delay of the inspection period, in addition, improving the efficiency of the hospital inspection process will help reduce the cost of medical care, increase the profit for the hospital, and form a sustainable operation of the hospital. Therefore, how can the hospital strengthen the inspection process management and improve the medical quality and service efficiency? Reducing the waste of medical resources is one of the focuses of medical institutions and academic attention today. The contents of the inspection room in this case are complicated, and the rules of the scheduling inspection period are numerous and complicated, which often leads to the patient waiting for the inspection time is too long, causing the internal and external customers to be anxious. How to find waste, eliminate unnecessary procedures, improve efficiency and make the inspection process streamlined and smooth, and the team cooperation and integration of the hospital's internal system value chain is smooth and top priority. Therefore, this research hopes to introduce the concept of refined production system at home and abroad by using the tools of six standard deviations to examine the unnecessary waste in the inspection process system, and to use the "smooth flow" of precision production as the primary and optimize inspection. Smoothness, effective reduction of inspection waits and cost reductions to improve the efficiency of the inspection room inspection process and to develop an improvement process. Finally, this study used a six-standard measurement tool to reduce the time of examination, from 240 minutes before improvement to 167 minutes after improvement, a significant reduction of 73 minutes, especially to significantly reduce nerve conduction examination and carotid ultrasound. The nerve conduction test was reduced from the original 40 minutes to 20 minutes, and the carotid examination was shortened from the original 35 minutes to 20 minutes. Therefore, the use of the refined concept for the examination process of this study case effectively reduces the unnecessary waste of the inspection process. Significantly reduce the inspection process time, provide follow-up hospital and academic reference.