縮短門診病人等候沖洗Port-A作業時間

Optimizing Outpatient Port-A Catheter Flushing: Reducing Operation Time and Improving Eff iciency

病人經常抱怨等候執行沖洗人工血管時間長且進入沖洗的動線不順，故引發動機。本專案旨在縮短門診病人等候沖洗人工血管（Port-A）作業時間及改善動線問題。透過流程程序圖及義大利麵線圖，發掘病人等候時間長及動線不順原因為動作、等待及搬運三大浪費。透過搜尋文獻及討論，擬定解決方案包括（一）減少等待及搬運浪費：沖洗Port-A作業導入剔除、合併、重組及簡化（ECRS）手法，將原12項步驟減為7項；（二）減少等待、動作及搬運浪費：採集中工作區，重新規劃沖洗動線與補貨用物位置及設置專屬Port-A補貨車；（三）減少動作浪費：將工作車改開放式櫃，減少開關抽屜次數；結果：病人動線距離由17.4公尺縮短至6公尺，且等候沖洗花費時間由2.6分鐘縮短1.1分鐘，開關抽屜及工作桌動作由8次縮短0次，補貨時間花費由1.5分鐘（距離39.6 M）縮短0.1分鐘（距離0 M），達專案目的。減少時間的浪費，可提升人員工作效率及醫療服務品質。

Patients frequently express concerns about the lengthy wait times and inefficient travel required for flushing Port-A catheters, highlighting areas for improvement. This project aims to address both wait times and travel inefficiencies in outpatient Port-A catheter flushing procedures.
Using process flowcharts and spaghetti diagrams, we identified the main inefficiencies: unnecessary actions, extended wait times, and inefficient transportation. Through comprehensive literature reviews and discussions, we implemented the following measures:
1) Reducing waiting and transportation waste by applying the Eliminate, Combine, Rearrange, and Simplify (ECRS) principles to the Port-A catheter flushing process, decreasing the number of steps from 12 to 7.
2) Minimizing waiting, unnecessary actions, and transportation waste by establishing a centralized work area, redesigning the line of travel for flushing, repositioning supply items, and introducing a dedicated Port-A catheter supply cart.
3) Reducing wasted actions by using work carts with open shelving, eliminating the need to frequently open and close drawers.
As a result, the patient line of travel was shortened from 17.4 meters to 6 meters, and the wait time for flushing was reduced from 2.6 minutes to 1.1 minutes. The number of actions involving drawers and desks dropped from 8 to 0, and the time required for restocking supplies decreased dramatically from 1.5 minutes, covering a distance of 39.6 meters, to just 0.1 minutes with no distance covered, thus fulfilling the project’s objectives. By reducing wasted time, we enhanced both staff productivity and the quality of medical services.