透過您的圖書館登入
IP:44.200.196.114
  • 學位論文

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

指導教授 : 盧美秀
若您是本文的作者,可授權文章由華藝線上圖書館中協助推廣。

摘要


本研究目的主要在於探討流程管理對於手術室服務效能的影響,為一介入性研究。收集北部某一醫學中心於流程管理介入前後手術室的手術作業活動。研究工具為結構式記錄表,由手術室護理人員記錄預定手術病人在手術流程中之各時間點及異常情況。介入措施為設立排程管理員,對預定手術排程予以追蹤與協調;及建立作業流程標準,以使流程能得到適當的管控。研究工具由7位專家作內容效度檢定;收集3個月的資料為前測,並於介入措施後,再收集3個月的資料為後測,以探討服務效能前後之差異,服務效能指標為:預定手術之病人人次、手術房間使用率、手術排程取消比率、護理人員加班人次與費用及流程中異常次數與延遲時間。所收集的資料以描述性統計、t檢定及卡方檢定進行資料分析。研究結果顯示:流程管理介入後,手術病人人次下降5.55%,其中整形外科及骨科病人人次前後具顯著差異;手術房間使用率介入前後均在87.5%以上,介入後下降0.59%,骨科的使用率下降呈顯著差異(-9.84%);排程取消比率降低1.01%,其中4科前後取消比率呈顯著差異;護理人員加班人次及費用明顯下降,呈顯著差異;流程各步驟花費時間介入前後無顯著差異;流程異常次數介入後降低5.81%,延遲平均時間前後無顯著差異。本研究結果顯示流程管理可以降低流程中的變異,使流程穩定,有效改善作業品質。研究結果可作為醫院、外科系及手術室管理者在行政管理上之參考。

關鍵字

手術室 流程管理 效能。

並列摘要


Abstract Title of Thesis:The Impacts of Applying Process Management to the Effectiveness of Operating Room Institution:Graduate Institute of Nursing, Taipei Medical University Author:Chen, Chuen-Jy Thesis directed by:Lu, Meei-Shiow, Professor & Dean, College of Nursing The purpose of this intervention study was to explore the impacts of applying process management on the effectiveness of operating room. Data of the activities in process for elective surgeries were collected in an operating room at a medical center in northern Taiwan. The time of activities in every step for the process will recorded in a constructed sheets by nurses. The process management intervention were to set up a scheduling coordinator and process standards. Data were collected in 3 months both before and after interventions to examine the differences in between. The indicators of effectiveness were: the patient number of operations, the utilization rate of operating rooms, the cancellation rate of schedule, the frequency and cost of nurses’ working overtime, and the frequency of variations as well as the delayed time in process. Data were analyzed by using t-test and Chi-square. The results indicated (1) The number of operations was reduced by 5.55% after intervention; in which, the plastic and orthopedic surgeries showed significant differences. (2)The utilization rate of operating rooms before and after interventions were above 87.50%; after interventions , the utilization rate was reduced 0.59%, in which, the orthopedic surgery showed significant difference. (3) The cancellation rate was reduced by 1.01% , in which ,four departments showed significant differences. (4) The frequency and the cost of working overtime for nurses was reduced to reach significant differences. (5) The time of every step in process had no significant differences. (6)The frequency of process variations were reduced by 5.81%; the delayed time before and after intervention showed no significant difference. The study showed process variations reduced and quality of process improved by process management . The results of this study would provide a reference for hospitals, surgical departments and operating room managers for administration management.

參考文獻


黃崇惠(2002)•提高手術室利用率專案•台北:台大醫院企劃室。
邱文達(2001)•醫療品質的新發展•新台北護理期刊,3(2),1-6。
盧美秀(2001)•實證醫學、實證護理與實證管理•新台北護理期刊,3(1),1-5。
邱文達(2002)•如何由醫療品質管理因應健保變革之衝擊•於台大醫療事務室主辦•提昇醫療品質專題演講講義•台北:台大醫院。 吳惠足(2001)•縮短手術室每台刀之轉換時間•於中華民國護理學會手術室護理委員會主辦•手術全期病患成果研討會講義•台北:台大醫院。 林衍訓(1999)•應用模擬技術於手術室管理與評估-以某醫學中心為例•未發表的碩士論文,台北:國立台大公衛學院。 季瑋珠、賴佳君(2001)•全民健保預防保健服務使用率之分析•台灣衛誌,20(1),43-51。
杜敏世(1995)•護理研究•台北:華杏。

被引用紀錄


許秀玲(2007)。護理人員對「病人安全」認知之研究~以某區域醫院為例〔碩士論文,元智大學〕。華藝線上圖書館。https://doi.org/10.6838%2fYZU.2007.00265
楊惠琄(2009)。發展手術全期護理資訊系統及評估其使用成效〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831%2fTMU.2009.00059
金榮義(2010)。照護流程標準化以急救流程為例〔碩士論文,中臺科技大學〕。華藝線上圖書館。https://doi.org/10.6822%2fCTUST.2010.00002
沈煌斌(2005)。射頻識別應用系統規劃方法之研究〔博士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2005.10137
陳志華(2005)。以提升病人安全為目的之RFID手術室醫療系統規劃與研究〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2005.01168

延伸閱讀