基於「分艙分流」防疫目標規劃藥庫大量點滴發放作業：流程改造與實施效益

Designing the IV Drip Operation For Staggered Shifts in Epidemic Prevention: Process Transformation and Implementation Benefits

COVID-19疫情期間，醫院藥庫大量點滴發放作業中有來自全院各科室外包人員及運輸工具之聚集，加上外包人員頻繁進出且長時間滯留，恐生防疫破口。本研究運用「分艙分流」防疫概念，預期降低大量點滴發放過程之群聚感染風險，亦望提升發放效率及整體滿意度。以5W1H手法歸納並確認發放作業問題，然後分為四個面向進行改善，分別為：一、發放流程改善：（1）只輸送不停留、（2）規範推車擺放位置及擺放規則、（3）規範推車推達藥庫時間、（4）制訂大量點滴發放及推車排序規則、（5）實施電話通知配套措施；二、重整點滴擺放位置；三、設置警戒區；四、科室大量點滴推車改善作業：（1）運輸工具規範、（2）藥庫推車不外借、（3）運輸工具消毒清潔。改善後，本研究結果分別有一、群聚人數：由15人降為0人；二、滯留時間：由20分鐘降為2分鐘；三、作業時間：由平均每日112.2分鐘降低至每日平均77分鐘；四、整體滿意度：外包人員由66%升為88%、藥庫人員由38%升為88%；五、作業環境內部自我評核由15分提升至33分。對不足處再持續改善，調整規定時限並建立「專屬LINE群組」通知。再改善後成效：一、時限規定：各科100%符合；二、通知方式滿意度由電話通知之59%提升至LINE群組通知之84%。結論，藥庫大量點滴發放流程以「分艙分流」為基礎並結合網路科技，成功縮短外包人員滯留時間、減少人員聚集，創造高滿意度之新型態作業模式。

During COVID-19 epidemic, the operation of IV-drip distribution in the drugstore was included the gathering of outsourced personnel and transportation tools from various departments in the Hospital. In addition, the outsourced personnel have frequently passed in and out and stayed for a long time, which may lead to the break of epidemic prevention. This study has applied the concept of isolation and triage for epidemic prevention, which is expected to reduce the risk of cluster infection, and also to improve distributed efficiency and overall satisfaction. We used the 5W1H method to summarize and to confirm the problems of distribution operation, and then improved with four aspects. 1. Improvement of the distribution process: (1) only delivering without stop, (2) standardizing the rule of cart placement, (3) standardizing the time when the carts reach the drugstore, (4) making the ruled of IV-drip distribution and cart sorting, (5) Implement supporting measures for telephone notification; 2. Reorganizing the placement of IV-drips; 3. Setting up warning areas; 4. Department improvement of IV-drip carts: (1) standardization of transport tools, (2) no lending of drugstore carts, (3) disinfection and cleaning of transport tools. After the improvement, the results of this study are: 1. The number of people in the group: from 15 to 0; 2. The staying time: from 20 minutes to 2 minutes; 3. The operation time: from 112.2 minutes to 77 minutes per day; 4. Overall satisfaction: those of outsourced personnel is increased from 66% to 88%, and those of drugstore personnel is increased from 38% to 88%; 5. Internal self-assessment of operating environment is increased from 15 to 33 points. We keep improving the deficiencies and create the specific LINE group notification. The results after further improvement: 1. Time limit: 100% compliance for each subject; 2. Satisfaction with notification methods is increased from 59% for phone notification to 84% for LINE group notification. In conclusion, the IV-drip distribution process of the drugstore is based on isolation and triage mechanism and combined with communication technology; it has successfully shortened the retention time of outsourced personnel, reduced personnel aggregation, and created a new type of operation mode with high satisfaction.