以品管手法降低手術延遲開始發生比率之研究

Research on the Use of Quality Method to Reduce Delay of Scheduled Operation

本研究目的在針對醫院手術室之手術延遲開始問題做深入探討，了解手術延遲開始之現況，建立手術室內工作人員守時規範、去除無效的等候時間，以使手術室之排刀流程更順暢，並控制醫院因加班造成的人力成本支出。本研究安排專人油作業現場利用查檢表隨刀登陸，運用直接時間測定法及工作資料分析法。研究對象為星期一至星期五各手術房第一台手術及下午3pm以前；星期六8am~12N進入手術式進行手術的住院病患，統計分析延遲原因，針對重要少數但影響結果層面較大的重點做改善，建立工作人員在手術室內之管理規範，以降低手術延遲開始發生之比率。

With aims to reduce patient waiting time, establish standardized working guidelines, stream-line the process in scheduling operations and to curb the inflating manpower cost, the objectives of this study were to investigate and to analyze the causes of delay in scheduled operations. Study was conducted in a prospective manner. Observation data were fieldcollected by designated personnel. Scheduled operations during the routine work days (Monday morning through Saturday noon) were enrolled within an observation period from August to November, 2001, Managerial intervention was introduced to establish the standardized working guidelines for operation room personnel. Our study revealed that the rate of delay in scheduled operations was 56.8% (of September 2001) before the introduction of quality method; the main cause of delay was attributed to the late appearance of members from surgical teams for various of reasons. After the introduction of quality method, the rate of delay was reduced to 7.6% (of November 2001). The average time of delay for single operation was reduced from 23 minutes (of September 2001) to 15.7 minutes (of November 2001). The improvement rate was 173.23% and the target achievement rate was 86.62%.