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題名:運用精實方法改善檢驗作業流程之實證研究
書刊名:醫務管理期刊
作者:鄭雅文馬震中 引用關係林尊湄張晴翔 引用關係
作者(外文):Cheng, Ya-wenMa, Chen-chungLin, Tsun-meiChang, Ching-hsiang
出版日期:2014
卷期:15:3
頁次:頁243-257
主題關鍵詞:精實生產系統價值流週轉時間單件流檢驗醫學Lean production systemValue streamTurnaround timeOne piece flowLaboratory medicine
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(3) 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:3
  • 共同引用共同引用:6
  • 點閱點閱:202
目的:為消除醫院檢驗作業流程的浪費,將國外精實生產系統改造醫院的經驗,運用到個案醫院的檢驗作業流程。方法:運用精實生產系統之「確認價值、確認價值溪流、暢流、後拉式及完善」五大原理,導入自動化系統及自動驗證,改善緊急與常規之血液、尿液、生化檢驗三大作業流程。結果:個案醫院檢驗部門在導入精實生產系統的方法後,檢驗空間減少63.4平方公尺,生化檢體的傳送距離減少13.3公尺。血液檢驗流程,緊急與常規檢體的平均週轉時間(Turnaround Time, TAT)在改善後分別下降27%與66.4%;尿液檢驗流程,緊急與常規檢體的平均週轉時間在改善後分別下降31%與58.9%;生化檢驗流程,緊急與常規檢體的平均週轉時間在改善後分別下降11.4%與36.4%。結論:個案醫院導入精實系統可消除浪費,改善血液、尿液、生化檢驗作業流程。另外,運用精實生產系統「暢流」觀念,將常規檢體改由單件流方式進行檢驗,可明顯消除檢驗流程的浪費。本研究藉由導入精實系統,改善檢驗流程的浪費,可減少工作人員的負擔,增進檢驗服務效能,進而提升對病人高品質的醫療服務。
Objective: In order to efficiently eliminate waste in hospital laboratory processes, this case study implemented the Lean System in a hospital laboratory as had been done successfully in many foreign hospitals. Method: Lean methodology was implemented on the basis of five principles: Valuation, Value-Stream, One Piece Flow, Pull System and Perfection. Automation and auto-verification were also introduced to improve the Stat and Routine processes in hematology, urinalysis and chemistry. Results: After the Lean System was introduced, 63.4 m^2 of laboratory space were freed up. In addition, the travel distance of specimens for chemistry tests was reduced to 13.3 meters. The average Turnaround Times for Stat and Routine of hematology procedures dropped 27% and 66.4%, respectively. The average Turnaround Times for Stat and Routine urinalysis procedures dropped 31% and 58.9% respectively; the average Turnaround Times for Stat and Routine chemistry procedures dropped 11.4% and 36.4% respectively. Waste in the routine transportation of specimens decreased by replacing Batch Flow with One Piece Flow. Conclusions: By applying Lean Methodology, the hospital laboratory can efficiently decrease waste and improve the processes in hematology, urinalysis and chemistry. Improving these processes reduced staff workload and promoted efficient service. As a result, hospitals can offer higher quality medical services to their patients.
期刊論文
1.朱宗緯(20100600)。淺談精實服務之應用。品質月刊,46(6),55-57。  延伸查詢new window
2.張清波(20080300)。TPS、精實生產、精實六標準差。品質月刊,44(3),16-22。  延伸查詢new window
3.楊大和、謝瓊嬉(20080900)。電子業向汽車業取經--精實生產在TFT-LCD產業成功的應用。品質月刊,44(9),8-15。  延伸查詢new window
4.鄭榮郎(20051200)。精實六標準差推動之架構。品質月刊,41(12),57-61。  延伸查詢new window
5.劉明德、梅國忠(20101000)。精實生產轉化為精實服務。品質月刊,46(10),28-32。  延伸查詢new window
6.戴貞德、蔡任賓(20091100)。導入精實生產系統之引導策略--以中小型企業為例。商業現代化學刊,5(2),39-54。new window  延伸查詢new window
7.Ben-Tovim, D. I.、Bassham, J. E.、Bolch, D.、Martin, M. A.、Dougherty, M.、Szwarcbord, M.(2007)。Lean thinking across a hospital: Redesigning care at the Flinders Medical Centre。Australian Health Review,31(1),10-15。  new window
8.Hawkins, R. C.(2007)。Laboratory turnaround time。The Clinical Biochemist Reviews,28(4),179。  new window
9.Nelson-Peterson, D. L.、Leppa, C. J.(2007)。Creating an environment for caring using lean principles of the Virginia mason production system。The Journal of Nursing Administration,37(6),287-294。  new window
10.Zaninotto, M.、Plebani, M.(2010)。The "hospital central laboratory": Automation, integration and clinical usefulness。Clinical Chemistry and Laboratory Medicine,48(7),911-917。  new window
11.任恒毅、廖秀姬(20081000)。精實生產價值溪流程改善方法之實證研究--以某汽車空調製造商為例。品質學報,15(5),323-336。new window  延伸查詢new window
圖書
1.Graban, Mark、胡瑋珊(2011)。精實醫療:以精實方法改善醫療品質、病患安全與員工滿意。臺北市:中衛發展中心。  延伸查詢new window
2.Womack, J. P.、Jones, D. T.、鍾漢清(2004)。精實革命。臺北市:城邦文化。  延伸查詢new window
3.Garban, M.(2009)。Lean Hospitals。New York:CRC press。  new window
 
 
 
 
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