系統動態模擬分析門診領藥燈號之設計評估

Simulation Analysis of Newly-Designed Queue Display Systems for Outpatient Pharmacy

傳統上的醫院門診領藥燈號系統，在領藥人數增多時很容易產生排隊次序上的爭議與困擾。本研究以一套彷如航空站顯示飛機航班起落及登機門的告示系統，期以增進病患排隊領藥的次序，並藉由藥師條碼管制病患領藥的內容鑑識，可有效提昇病患的用藥安全。研究以系統動態學建置門診領藥系統改善方案的評估，以病患埋怨、排隊零亂、藥師負荷及投資成本等四大要項的總負荷成本，評估是否投資新看板系統、業務量增加程度及埋怨單價成本之合理設定等模擬之結果。研究發現，(1)線性迴歸分析出埋怨單價成本及業務量增加程度是影響總負荷成本的重要因素；(2)在埋怨單價成本合理設定條件下，研究的個案醫院應考量新式看板系統取代傳統的燈號方式；(3)領藥後的條碼更新候藥排隊順序，除可降低傳統上次序的零亂現象，也可以於電腦上即時檢測藥品外觀及藥物交互作用，提昇病患服用藥物的安全。

The traditional queue display system for outpatient pharmacy still stirs substantial disputes and debates as patients are lining up for receiving their medicines. We designed an innovative queue display system in this study which incorporates that aircraft departure scheduling display systems informing travelers of the latest information and queuing status. The line-up for outpatient pharmacy could be expected to be ordered in a smooth way and to join with bar-code systems in line with inspecting the patients' drug safety. The simulation was implemented using system dynamics in evaluating the cost-effectiveness of that would-be newly-designed queue display system. The results show that (1) the simulated unit price of a patient complains on both line-up dispute and the volume of outpatients visits are the two main factors influencing total simulated burden costs resulted from a multi-regression; (2) The studied hospital was suggested to adopt the modern queue display system for outpatient pharmacy for increasing volume of OPD patients in replace of the traditional patient-call queue system; (3) Bar-code used in outpatient queuing for pharmacy could not merely decline the line-up in mess for receiving medicines but also help detect the prescription drug safety and reduce the risk of potentially harmful drug interactions within processes of outpatient pharmacy.