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題名:運用失效模式與影響分析來改善門診病人採檢的流程
書刊名:醫務管理期刊
作者:林曉華鄭鴻榕林汶珊
作者(外文):Lin, Hsiao-huaCheng, Hung-jungLin, Wen-shan
出版日期:2013
卷期:14:3
頁次:頁228-243
主題關鍵詞:失效模式與影響分析門診病患採檢等候時間Failure mode and effects analysisOutpatient waiting time
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(1) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:1
  • 共同引用共同引用:10
  • 點閱點閱:17
目的:門診病患採檢等候過久是檢驗科最大的報怨區塊,為了改善門診病患對採檢等候時間的抱怨,進行此專案的研究。方法:我們運用失效模式與影響分析(Failure mode and effects analysis,FMEA),對「門診病人等候採檢流程」,再根據JCAHO(Joint Commission on Accreditation of Healthcare Organizations,JCAHO)風險評量表,以風險的發生率(risk occurrence rate,O)、嚴重度(severity,S)、偵測度(detection ability,D)為評估基準,作量化的評估,根據潛藏的前三項高風險因子,擬定執行改善計畫。結果:擬定改善對策:(一)更換一對一的叫號系統。(二)門診抽血櫃台重新整修,新增簽收電腦設備二台。(三)門診抽血櫃台重新設計規劃,增加抽血櫃台的位置及人力,並將試管的擺放規則化。最後以「顧客抱怨等候時間的案件」及「上午顧客抽血平均等候時間」為管制方法,來矯正及改善顧客採檢等候的抱怨事件。結論:經由FMEA風險管理工具,分辨採檢流程上常常造成失效的風險所在,作為改善作業之順序設定,標準化及單純化的改進,並參考管制指標,使失效的風險免於發生,來達到防範於未然的效果。
Objective: The majority of complaints from outpatients to the central laboratory refer to the long wait to have blood samples drawn. This study was designed to reduce that time and avoid patient complaints.Methods: Failure mode and effects analysis (FMEA) was conducted on the workflow pattern of outpatient sampling. Based on Joint Commission on Accreditation of Healthcare Organizations risk management guidelines, risk occurrence rate, severity, and detection ability were evaluated as the quantitative parameters Based on the three most common potential high-risk factors, a plan for improvement was drafted.Results: Actions included: 1. A one by one queuing system; 2. Renovation of the sampling station and addition of a two receipt system. 3. Redesign of the blood sampling area and workflow pattern by adding more blood-drawing stations, reassigning manpower, and rearranging the blood-drawing tubes. The number of patient complaints about waiting time and average blood-drawing and waiting times were used to monitor the results.Conclusion: Through FMEA risk management and identification of areas of lost efficiency during blood sampling, an improved, standardized and simplified workflow plan was drafted to improve results.
期刊論文
1.葉俊賢、吳月鑫(20090300)。應用FMEA於採購作業風險防制之研究。危機管理學刊,6(1),1-10。new window  延伸查詢new window
2.Astion, M. L.、Shojania, K. G.、Hamill, T. R.、Kim, S.、Ng, V. L.(2003)。Classifying laboratory incident reports to identify problems that jeopardize patient safety。American Journal of Clinical Pathology,120(1),18-26。  new window
3.Burgmeier, J.(2002)。Failure mode and effect analysis: an application in reducing risk in blood transfusion。Joint Commission Journal on Quality Improvement,28(6),331-339。  new window
4.Capunzo, M.、Cavallo, P.、Boccia, G.、Brunetti, L.、Pizzuti, S.(2004)。A FMEA clinical laboratory case study: how to make problems and improvements measurable。Clinical Leadership and Management Review,18(1),37-41。  new window
5.Eijk, A. C.、Rook, D.、Dankelman, J.、Smit, B. J.(2013)。Defining Hazards of Supplemental Oxygen Therapy in Neonatology Using the FMEA Tool。The American Journal of maternal child nursing,38(4),221-228。  new window
6.Lu, Y.、Teng, F.、Zhou, J.、Wen, A.、Bi, Y.(2013)。Failure mode and effect analysis in blood transfusion: a proactive tool to reduce risks。Transfusion。  new window
7.Meyrieux, C.、Garcia, R.、Pourel, N.、Mège, A.、Bodez, V.(2012)。FMEA applied to the radiotherapy patient care process。Cancer Radiother,16(7),613-618。  new window
8.Riehle, M. A.、Bergeron, D. B.、Hyrk, K.(2008)。Improving process while changing practice: FMEA and medication administration。Nursing Management,39(2),28-33。  new window
9.Sheridan-Leos, N.、Schulmeister, L.、Hartranft, S.(2006)。Failure mode and effect analysis: a technique to prevent chemotherapy errors。Clinical Jouranl of Oncology Nursing,10(3),393-398。  new window
10.侯勝茂、陳欣欣(20040700)。提昇病人安全的新作為。臺灣醫學,8(4),504-509。  延伸查詢new window
11.莊情惠、莊秀文(20090800)。化學治療給藥之失效模式與效應分析。護理雜誌,56(4),62-70。new window  延伸查詢new window
12.田霓、張慈容、蕭瓊子、施木青、盧章智、劉淳儀、吳錫金、張照勤(20110700)。運用醫療失效模式與效應分析建立臨床檢驗不符合事件評估機制。醫療品質雜誌,5(4),42-50。new window  延伸查詢new window
學位論文
1.曾耀群(2009)。應用醫療照護之失效模式與效應分析於醫療流程之改善(碩士論文)。國立清華大學。  延伸查詢new window
圖書
1.許國敏、莊秀文、莊淑婷(2006)。病人安全管理與風險管理實務引導。臺北:華杏。  延伸查詢new window
2.Healthcare Organizations(2002)。Failure Mode and Effects Analysis in Health care: Proactive Risk Reduction。New York:Joint Commission Resources, Inc. (JRC). IL。  new window
3.Institute of Medicine (US) Committee on Quality of Health Care in America、Kohn, Linda T.、Corrigan, Janet M.、Donaldson, Molla S.(1999)。To err is human: building a safer health system。Washington D.C.:National Academy Press。  new window
 
 
 
 
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