研究生: |
楊培茹 Yang, Pei-Ju |
---|---|
論文名稱: |
應用精實六標準差改善急性心肌梗塞病患之血管再灌注時間 An Application of Lean Six Sigma for Improving the Door-to-Balloon Time in Acute Myocardial Infarction: A Case Study |
指導教授: |
蘇朝墩
Su, Chao-Ton |
口試委員: | |
學位類別: |
碩士 Master |
系所名稱: |
工學院 - 工業工程與工程管理學系 Department of Industrial Engineering and Engineering Management |
論文出版年: | 2010 |
畢業學年度: | 98 |
語文別: | 中文 |
論文頁數: | 62 |
中文關鍵詞: | 精實六標準差 、急性心肌梗塞 、血管再灌注時間 、流程改善 |
外文關鍵詞: | Lean Six Sigma, acute myocardial infarction, door-to-balloon time, process improvement |
相關次數: | 點閱:3 下載:0 |
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精實六標準差 (Lean Six Sigma)乃結合精實(Lean)原理與六標準差(Six Sigma)手法,兼具加快流程速度與系統性統計分析的優點,是當前企業之熱門流程管理手法。此外,在不容許任何誤差與缺失,以病人安全為根本的醫療產業,其與六標準差強調顧客滿意與近乎完美的理念,可說是不謀而合;而精實著重消除浪費與改進速度,更是為競爭激烈的醫療產業注入新的思維。但,醫療的不確定性與資訊的不對等,讓醫療品質的議題引起許多紛爭,且醫療流程產生不良品的代價為病患之健康,是難以量化評估及彌補。如何應用精實六標準差進行以病患為中心的流程改善,是一重要的研究方向。
本研究應用精實六標準差改善程序改善急性心肌梗塞就醫流程。依循六標準差的DMAIC步驟,找出關鍵品質特性,藉由價值溪流圖之繪製,找出流程中非加值活動,並運用特性要因圖進行真因分析,以腦力激盪產出改善方案,剔除浪費提升流程週期效益。改善後的D2B流程,其流程時間不僅小於ACC/AHA訂定之標準(90分鐘),更減少了58.4%的流程時間。流程週期效率由32.27%提升至51.81%,平均住院天數縮短3天,節省醫療資源耗用468.6萬/年。本研究顯示精實六標準差除可提升醫院的醫療品質,更可強化其市場競爭力。
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