流程管理介入對手術室服務效能之影響

The Impacts of Applying Process Management to the Effectiveness of Operating Room

陳春枝(Chuen-Jy Chen) ； 盧美秀(Meei-Shiow Lu) ； 邱文達(Wen-Ta Chiu) ； 謝長堯(Chang-Yao Hsieh)

《醫務管理期刊》 5卷4期 (2004/12) Pp. 460-472

https://doi.org/10.6174/JHM2004.5(4).460

摘要

The purpose of this quasi-experimental study was to explore the impacts of applying process management on the effectiveness of operating rooms. Data about the activities performed in connection with elective surgeries were collected in operating rooms at a medical center in northern Taiwan. The times taken to complete each activity in every step of each process were recorded in structured sheets by nurses. The aim of the process management intervention was to designate scheduling coordinators and establish processing standards. Data were collected for three months both before and after interventions for comparisons to be made. The indicators of effectiveness were: the utilization rates of the operating rooms, the operation schedule cancellation rates, and the delayed time, the frequencies of variations in process. Data were analyzed by using t-test and Chi-square. The results indicated that after interventions (1) The utilization rates of operating room 22 ((the symbol is abbreviated)=-3.30, (the symbol is abbreviated)＜.01 ) and 20 ((the symbol is abbreviated)=-2.01, (the symbol is abbreviated)＜.05) were reduced and showed significant differences. (2) The cancellation rate was reduced by 1.01%, and showed significant differences. ((the symbol is abbreviated)=7.02, (the symbol is abbreviated)＜.01) (3) The delayed time of process variations showed no significant differences, while the variation frequencies were reduced by 6.12%. The study showed process variations were reduced and quality was improved by process management. The results of this study might provide a useful reference for hospitals, surgical departments and operating room managers involved in administration management.

關鍵字

手術室 ； 流程管理 ； 效能

並列摘要

The purpose of this quasi-experimental study was to explore the impacts of applying process management on the effectiveness of operating rooms. Data about the activities performed in connection with elective surgeries were collected in operating rooms at a medical center in northern Taiwan. The times taken to complete each activity in every step of each process were recorded in structured sheets by nurses. The aim of the process management intervention was to designate scheduling coordinators and establish processing standards. Data were collected for three months both before and after interventions for comparisons to be made. The indicators of effectiveness were: the utilization rates of the operating rooms, the operation schedule cancellation rates, and the delayed time, the frequencies of variations in process. Data were analyzed by using t-test and Chi-square. The results indicated that after interventions (1) The utilization rates of operating room 22 ((the symbol is abbreviated)=-3.30, (the symbol is abbreviated)＜.01 ) and 20 ((the symbol is abbreviated)=-2.01, (the symbol is abbreviated)＜.05) were reduced and showed significant differences. (2) The cancellation rate was reduced by 1.01%, and showed significant differences. ((the symbol is abbreviated)=7.02, (the symbol is abbreviated)＜.01) (3) The delayed time of process variations showed no significant differences, while the variation frequencies were reduced by 6.12%. The study showed process variations were reduced and quality was improved by process management. The results of this study might provide a useful reference for hospitals, surgical departments and operating room managers involved in administration management.

並列關鍵字

Operating Room ； Process Management ； Effectiveness

參考文獻

Alon, E.,Schupfer, G.(1999).Operating room management.Anesthesist.48(10),689-697.

Applegeet, C.(1995).Scheduling surgical procedures; delays in surgery; OR reports; visitors in the OR; purchasing departments.AORN Journal.61(1),252-257.

Bross, B.,Gamblin, B. B.,Holtzclaw, S. L.,Johnston, S. E.(1995).Using a computerized scheduling system to pridict procedure lengths.AORN Journal.61(6),1054-1061.

Dexter, F.(1996).Application of information systems to operating room scheduling.Anesthesiology.85(6),1232-1234.

Dexter, F.,Macario, A.,Lubarsky, D.(2001).The impact on revenue of increasing patient volume at surgical suites with relatively high operating room utilization.Anesthesia & Analgesia.92(5),1215-1221.