降低手術器械包盤重製率與其效益分析

Surgical Instrument Packages Re-sterilizing Rate Reduction and Cost Analysis

吳寶媛(Pao-Yuan Wu) ； 莊玉如(Yuh-Jue Chuang) ； 李夢英(Mung-Yeng Li) ； 賀倫惠(Lun-Hui Ho) ； 王琦(Chi Wang) ； 石惠美(Hui-Mei Shih)

《醫務管理期刊》 14卷2期 (2013/06) Pp. 163-181

https://doi.org/10.6174/JHM2013.14(2).163

摘要

目的：器械是外科手術必備的器具也是成功的重要關鍵，然而，手術器械種類繁多，價格昂貴，是手術室一項重大支出。本專案論文希望探討影響手術室器械包盤重製率的因素，提高手術室各科器械包盤動用率，減少器械包盤因未使用而過期，需進行重製、消毒作業，增加人力、成本的支出。方法：以個案醫院一般外科及婦產科為例，依據手術室器械使用記錄，資料以百分比、平均值及最大值進行分析整理，並根據請購與成本效益設計器械包盤數量調整方法，依結果進行器械包盤減量、下架或改變滅菌包裝方式，延長效期以降低重製率及成本，並藉由器械包盤定期檢討計劃以提升手術器械之管理。結果：將個案醫院重製率過高之器械包盤共減量20類1,445包，一年可節省重製費用4,485,280元，下架之器械包盤共19類120包，一年所節省之重製費用為372,480元，而下架包盤轉至供應組當備品，可節省器械請購成本64,362,100元。結論：結果顯示器械包盤重製率與成本效益有顯著的正相關，在降低營運成本及維持相同服務品質前提下，管理者應定期進行手術室內器械包盤檢討作業，降低重製率減少各項成本之支出與耗費。

關鍵字

手術室 ； 器械包盤 ； 重製率 ； 效益分析

並列摘要

Objectives: The operating room is the costliest and most complex department in the hospital as well as being high specialized and responsible for substantial revenue. The purpose of this study was to increase the utilization rate of surgical instrument packages, and to decrease the number of packages that passed their expiration date in order to decrease re-sterilizing of those packages in terms of manpower and cost.Methods: This study explored factors influencing redoing of surgical instrument packages based on the records of the surgical and obstetric and gynecological units of the case hospital. These equipment use records were analyzed in terms of percentages, means, and maximums.Results: Packages with a low utilization rate were then either reduced in number or taken off the shelf; 20 categories with 1,445 packages were reduced in number to save redoing at a cost of NT 4,485,280 per year; 19 categories with 120 packages were taken off the shelf to save redoing at a cost of NT 372,480 per year; some of the off the shelf packages were transferred to the supply unit as spares to avoid a new purchase cost of NT 64,362,100.Conclusions: There was a significant correlation between redo rate and cost. Reducing the quantity of some instrument packages, taking some off the shelves, changing the way some were packaged, extending the expiration date, and regular monitoring were implemented to enhance management. In order to lower operating costs and maintain the same quality of service, managers should review the operation of surgical instrument packaging on a regular basis to decrease the redo rate and reduce costs.

並列關鍵字

o perating room ； surgical instrument package ； redo rate ； cost analysis

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