降低手術銜接時間延遲率改善方案

A Project of Improving the Surgery Delay Rate Due to Prolonged Waiting Intervals

本專案旨在降低手術銜接時間的延遲率，去除無效時間，以提昇手術室效率。臨床工作中發現，手術銜接時間延遲造成手術團隊閒置的等待病人，為去除無效的等待時間故成立專案，發現手術銜接時間延遲問題為：等待等候區人員分配次台手術、病房術前準備未完整、麻醉術前準備不完整、加護病房執行手術病人術前準備未完整。經由決策矩陣分析後，以修訂分配次台手術流程作業規範、制定品管監控計畫、獎懲制度和宣導銜接流程課程、制定通知接病人規範、修定急診手術術前麻醉同意書填寫通知流程、規劃跨部會議討論、制定通知加護病房轉送病人規範等方法，將手術銜接時間延遲率由25.05%降低至6.66%，顯示藉由跨團隊專業合作，能有效降低手術銜接時間的延遲率，提高手術室效率。

This project focused on reducing the surgery delay rate due to prolonged waiting time during surgical intervals. In a clinical surgical practice, prolonged waiting intervals cause operative teams to be idle as they wait for the next scheduled operative patients. This project was designed to cut down ineffective waiting time to improve the utilization efficiency of operating rooms. The identified problems causing prolonged waiting intervals included operative teams awaiting the personnel in the waiting area to assign subsequent operations, incomplete preoperative and anesthetic preparation, and disorganized preoperative preparation for ICU patients. Based on a decision matrix analysis, the improvement measures included revising regulations on the workflow of scheduled surgeries; developing a quality monitoring plan, a reward and discipline system, and a training course on workflow during surgery waiting intervals; establishing a regulation for surgical patient pick-up; revising the workflow of completing an anesthesia consent form for emergent surgery; organizing an interdepartmental discussion meeting; and establishing regulations for ICU patient referrals for surgery. After the completion of these measures, the surgical delay rate due to prolonged waiting intervals decreased from 25.05% to 6.66%, indicating that the surgery delay rate due to prolonged waiting intervals can be reduced through professional interdepartmental collaboration.