運用日常管理系統降低手術室第一台劃刀延遲率

目的：手術室第一台劃刀延遲會造成病人及手術室人員的等待，以及後續已排程之手術延遲，甚至取消既定排程，降低手術室服務效能。日常管理系統為提升手術室使用效能非常重要的改善工具。方法：於北部某區域教學醫院（350床）之手術室進行，運用日常管理系統降低第一台劃刀延遲率，制定手術接應作業流程，建立持續品質改善行動計畫以提升對策執行力，如：視覺控制、流程看板、站立會議及進行延遲原因檢討改善，並建立快速回應機制改善第一台劃刀之延遲發生。結果：第一台劃刀延遲率由改善前（2017年10月）32.1%（44/137）降至改善後（2018年4月）7.6%（10/131），劃刀延遲時間由平均29.6分鐘降至21分鐘。住院手術取消率由0.19%降至0%。結論：運用日常管理系統降低第一台劃刀延遲率，可減少病人及手術人員等候時間，增加團隊工作效率。

關鍵字

日常管理系統；第一台手術；延遲率

並列摘要

Objectives: Delays in first scheduled surgeries cause patients and operating staff to wait, and the delay or cancellation of subsequent scheduled surgeries reduces the operating room's efficiency. Methods: The researchers collected data in the operating room of a 350-bed regional teaching hospital in Northern Taiwan. A daily management system was used to reduce the delay rate of the first scheduled surgery, prolong the streamlined surgery standardized operation procedure, establish continuous quality improvement action plans (e.g., visual control, process board, and a daily huddle to review reasons for delays) to enhance execution, and provide a quick response. Results: The delay rate for the first scheduled surgery decreased from 32.1% (44/137) prior to improvement (October 1 to 31, 2017) to 7.6% (10/131) postimprovement (April 1 to 30, 2018). The average delay time decreased from 29.6 minutes to 21 minutes, and the hospital's surgery cancelation rate decreased from 0.19% to 0%. Conclusions: A daily management system lowered the first scheduled surgery delay rate, reduced waiting time for patients and operating room staff, and increased the team's work efficiency.

並列關鍵字

daily management system ； first scheduled surgery ； delay rate

參考文獻

王素秋、施錦珠、洪逸倫、黃惠美、張家慧（2018）‧精實醫療管理於手術室之應用‧領導護理雜誌，19(1)，3-12。https://doi.org/10.29494/LN.201803_19(1).0001

Coffey Jr, C., Cho, E. S., Wei, E., Luu, A., Ho, M., Amaya, R., ... & Sener, S. F. (2018). Lean methods to improve operating room elective first case on time starts in a large, urban, safety net medical center. The American Journal of Surgery, 216(2), 194-201. https://doi.org/10.1016/j.amjsurg.2018.05.002

Darwish, A., Mehta, P., Mahmoud, A., El-Sergany, A., & Culberson, D. (2016). Improving operating room start times in a community teaching hospital. Journal of Hospital Administration, 5(3), 33-39. https://doi.org/10.5430/jha.v5n3p33

Donnelly, L. F., Cherian, S. S., Chua, K. B., Thankachan, S., Millecker, L. A., Koroll, A. G., & Bisset, G. S. (2017). The daily readiness huddle: a process to rapidly identify issues and foster improvement through problem-solving accountability. Pediatric radiology, 47(1), 22-30. https://doi.org/10.1007/s00247-016-3712-x

Fixler, T., & Wright, J. G. (2013). Identi fication and use of operating room efficiency indicators: the problem of definition. Canadian Journal of Surgery, 56(4), 224-226. https://doi.org/10.1503/cjs.020712

國際替代計量

運用日常管理系統降低手術室第一台劃刀延遲率

全文下載

主題瀏覽