運用創新人因工程以及精實管理提升門診檢驗急做效率

Use innovative human factors engineering and lean management to improve the efficiency of outpatient urgent inspection

研究指出檢驗報告正確性及時效攸關疾病診治成效。本院2018年7～10月檢驗急做流程之流程週期效率為11.9～14.4％，存在許多不必要浪費，且報告錯誤率高達0.018％。利用價值溪流圖及系統圖找出二大主因為：1.門診病人抽血等太久；2.急做報告時間太久。投票選出14項要因，以三現原則與系統圖找到8項真因，導入創新人因工程與精實手法提出設備、流程、人因等三大改善群組並擬定對策為：1.設備改善之併管計畫、更換條碼列印設備、創建多功能採檢室與人工智慧群組；2.流程改善之檢驗無紙化、機台整合及調整位置、急做報告置頂、報告自動驗證、與檢體動態資訊；3.人因改善之引進人因座椅、跨團隊合作打造同仁專屬減壓時光，改善後流程週期效率為57.8％、報告錯誤率由0.018％降為0.002％，成效顯著。

The studies have pointed out that the accuracy and timeliness of laboratory reports are critical to the disease diagnosis and treatment from July to October 2018, the cycle efficiency of the emergency laboratory reports process in our hospital was 11.9~14.4%, there was a lot of unnecessary waste, and the error rate was as high as 0.018%. Use the value stream mapping and the system diagram to find out the two main reasons: 1. The time for outpatients watting for drawing blood is too long and 2. The time of completing the laboratory report is too long. Fourteen factors were selected by voting, and eight true factors were found based on the system diagram. Three improvement groups including equipment, process and human factors were proposed by introducing Innovative ergonomics and lean methods. We develop strategies as follows: 1. Equipment improvement: management plans, replace barcode printing equipment, create multifunctional inspection rooms and AI smart groups. 2. Process improvement: paperless inspection, machine integration and position adjustment, urgent report on the top of the screen, automatic report verification, and dynamic information about the specimen. 3. Ergonomics: introducing ergonomics seats and cross-team cooperation to create an special leisure time for colleagues. After the improvement, the cycle efficiency was 57.8%, and the reporting error rate was reduced from 0.018% to 0.002%, and the result was remarkable.