透過您的圖書館登入
IP:3.238.162.113
  • 學位論文

臨床細菌檢驗導入自動化流程效益之實證研究

An empirical study on the benefit of clinical microbiology laboratory import automation process

指導教授 : 馬震中

摘要


背景與目的:利用精實生產的概念作為引用自動化技術(automation technology)及檢驗資訊系統(laboratory information system, LIS)來改變醫療產業工作模式,目的縮短檢驗報告時間、提升醫療水準、減少成本支出、提升病人和員工的安全以及品質且提升醫院營運模式增加競爭力,本研究目的是探討南部某區域教學醫院微生物科由手工作業轉置自動化分析所產生的效益分析。 材料與方法:本研究以南部某區域教學醫院為個案醫院,資料收集範圍以個案醫院醫學檢驗部微生物組提供分析資料。收案時間分為兩部分:第一部分為傳統作業時間為2012年10月至12月;第二部分為自動化作業時間為2014年3月至5月。本研究從臨床檢驗項目其中的「需氧菌培養」為研究資料,利用檢驗單、就診紀錄 、手工紀錄單,分析導入自動化前後差異。本研究以單一群體前後測為研究方法,且以採病歷回顧法方式收集資料。 結果:本研究收案傳統作業統計資料共有6963件以及自動化作業資料共有7587件。菌名鑑定從原本傳統作業3.13天經導入自動化後縮短至2.20天;藥敏鑑定從原本傳統作業3.77天經導入自動化後縮短至3.02天;整體報告鑑定從原本傳統作業3.57天經導入自動化後縮短至2.96天。準確度方面在傳統作業方式低準確度佔比為4.3%,導入自動化作業方式後低準確度佔比降為0.02%。另外羅吉斯迴歸研究結果顯示,準確度高、菌名鑑定4-5天、藥敏試驗6天以上、整體報告鑑定4-5天對於時間及品質效益具有影響力。 結論與建議: 隨著科技進步及資訊系統發展使自動化流程日益更新,故自動化作業是更穩定及更精準作業型態提供醫院作為發展趨勢。由於本研究為實證研究,從文獻中可以得知導入自動化是具有效益,故本研究以臨床細菌檢驗以自動化作業作為實證研究例子,可呈現時間及品質是具有效益。

關鍵字

臨床細菌檢驗 自動化 效益

並列摘要


Background and objectives: Using the concept of lean production for automation technology and Laboratory Information System (LIS) to change the mode of medical industry; it aimed to shorten the time consumption of inspection reports, improve health standards and reduce costs, enhance the safety and quality of patients and hospital staff, and to enhance the business model and increase competitiveness. The study was designed to analyze effectiveness generated by a southern regional teaching hospital when its Microbiology Division was replaced by automated system analysis from manual labor. Materials and Methods: The Microbiology Division of the southern regional teaching hospital was selected as sample source. Data were collected from two time segments: October 2012 through December for manual labor group; March 2014 through May for automated group. In specific, the "aerobic culture" data from clinical examination, including test report, treatment records and manual record were used as research data, and analyzed to find the difference before and after automation. The study method was before and after test for specific sample; the data were collected from case review. Results: In this study, statistical data received for manual labor group were 6963 and automated group were 7587. Bacteria identification took 3.13 days for manual labor group and 2.20 days for automated group, which was shortened; similarly drug susceptibility identification took 3.77 days for manual labor group and 3.02 days for automated group; overall report took 3.57 days manual labor group and 2.96 days for automated group. In terms of accuracy, the error proportion was 4.3% for manual labor group, while 0.02% for automated group. Further logistic regression results showed high accuracy, time consumption for bacteria identification (such as 4-5 days), drug susceptibility testing (such as for more than 6 days) and overall report (such as 4-5 days) have impact on time and quality effectiveness. Conclusions and Recommendations: With the development of science and technology and information automation and update, it is more stable and accurate for hospital to run automation systems. It’s the developing trend. The study was empirical research (based on the automation of clinical and bacteriological examination), as well as literature research that showed automation is beneficial, it can be concluded that time and quality matter effectiveness.

參考文獻


之醫療費用結構與成本效益分析—與傳統支架之比較。內科雜誌,
經導管動脈化學栓塞治療標準流程之建立及其效益評估。臺灣公共衛
林明鋒、賴姝惠、黃美鑾 (2003)。改變外科手術預防性抗生素使用對經
Technology Results and Microorganism Contamination.
系統的歷史發展。北市醫學雜誌,3(7), 662-672。

延伸閱讀