排程管理介入對手術房之使用效率之影響

The Effect of Scheduling Management on the Efficiency of Operating Room

目的：應用個案研究方法，探討某醫學中心手術房排程管理介入對提升手術房之效率的影響，包括手術人次、手術房使用率、手術排程取消率及第一台手術延遲情形。方法：研究樣本為某醫學中心回溯描述性研究；兩組樣本之選擇採立意分派為介入前後；手術房效率指標為手術人次、手術房使用率、手術排程取消率、第一台手術延遲時間及延遲率。資料分析方法包括ANOVA、χ2檢定、複邏輯斯迴歸及t檢定等。介入措施內容包含：排程管理員對第一台手術安排協調、制訂護理人員接病患流程、制訂門診病患報到流程及制訂工友人力調度準則等，使手術排程順暢。結果：1.手術人次在介入後下降8.7%。2.手術房使用率在介入前後平均在89.69%以上，但介入後下降5.0%。3.介入措施後排程取消率降低0.78%。4.介入措施後第一台手術開始的延遲時間顯著降低（10.05分鐘比2.35分鐘）；第一台手術開始之延遲率顯著降低（52.8%比12.3%）。結論：排程管理介入對於手術人次、手術房使用率並無顯著增加，而在手術排程取消率、第一台手術延遲率及延遲時間有顯著降低，顯示手術房排程管理規章的制定與執行，使流程順暢、穩定，能有效改善。

The purpose of this study is to investigate the effect of scheduling management on operating room, including sum of the patients receiving operation, utilization rate of the operation room, cancellation rate of scheduled operation, and delayed first surgery of the day. The case explored is a high performance hospital. The management level places heavy emphasis on the scheduling management. This study utilized the case study and retrospective descriptive design method to collect raw data. Through empirical investigation of the case hospital, the effect of cancellation rate of scheduled operation and delayed first surgery of the day were supported by this statistical examination. In addition to sum of the patients receiving operation and utilization rate of the operation room, the effect of scheduling management were not supported in this case. When looking at the result from case study, it is better to include the change over factors to complete a new model. Anyway, some implications about the research and practices will be disscused in this paper for the operation room managers, leader in department of surgery, and hospital managers to improve efficiency of the operating rooms.