運用精實管理優化門診就醫服務

Quality Improvement of Outpatient Service by Lean Management

吳麗蘭(Li-Lan Wu) ； 俞克弘(Ker-Huang Yu) ； 蔡鈺婷(Yu-Ting Tsai) ； 林雅真(Ya-Chen Lin) ； 黃美齡(Mei-Ling Huang)

《北市醫學雜誌》 16卷1期 (2019/03) Pp. 75-83

https://doi.org/10.6200/TCMJ.201903_16(1).0009

摘要

不良門診就醫動線直接影響民眾對醫療服務品質之良窳，本專案目的乃運用精實品管手法優化門診就醫動線，提升優質服務。筆者針對2016年度門診內、外部顧客申訴案件高達26件，以就診服務品質佔6件為首，再而環境設施及就醫動線為依序；相對影響同年09月門診為外部顧客整體滿意度調查亦低至80.4%%﹔經至現場實地觀察及員工訪談發現：（一）環境動線：高診療量診間位置相鄰，高齡民眾穿插其間、險象叢生﹔（二）服務品質：護理師於診間用餐及休憩（內部員工滿意度＜50%）﹔再而轉診（檢）、篩檢地點隱密及不便，常因查詢時中斷診療服務；導致申訴案件不斷，影響醫院聲譽。故成立改善專案團隊，運用精實管理，再造就醫流程，並將閒置空間新置：（一）增設住院中心；（二）員工休憩室；（三）初診書寫區，藉由改善策略不僅2017年門診服務滿意度由80.4%提升至91.3%、護理人員滿意度50.0%提升至100%，且就醫服務申訴案件降為0件﹔藉由本次改善策略著實達此專案目的。

關鍵字

精實管理 ； 門診就醫動線 ； 服務滿意度

並列摘要

Poor medical treatment traffic flow of the outpatient clinics directly affects the quality of the medical services. This project aimed to optimize the outpatient medical treatment traffic flow and improve the quality of services by using the lean quality management methods. A total of 26 cases of internal and external customer complaints were reported in 2016 in which 6 were about service quality, followed by environmental facilities and medical treatment traffic flows. The outpatient service satisfaction rate in September of the same year was reduced to 80.4%. After on-site observations and interviews with employees, we found (1) dangerous traffic flow in which the location of the high-patient-volume clinics was concentrated and elderly passing through with dangers; (2) unsatisfied service quality because the nursing staff dined and taking break in the clinics (internal employee satisfaction rate ＜50%) and that the location of referral and screening department was inconvenient and the inquiries always interrupted the treatment process. The continuous complaints affected the morale of employees. An improvement project team was set up. The quality control method was used to recreate the service process, and the idle space was reset. The inpatient center and the employee rest room were set up. With these improvements, the outpatient service satisfaction rate was increased from 80.4% to 91.3% in 2018, while the employee satisfaction rate was increased from 50.0% to 100%. The number of cases of medical service complaint was reduced to 0. The purpose of this project was achieved.

並列關鍵字

lean management ； outpatient medical treatment ； service satisfaction