本研究旨在改善新竹某地區醫院的急診室流程。透過應用80/20原則和要因分析，找出了關鍵醫療行為和影響因素。分析急診室功能位置的相對距離，並藉由流程程序圖找出重要的改善項目。前所未有的Covid-19疫情發生，導致急診室動線需重新規劃與設計。本研究發現，舊有設置方面，病患、醫師和護理人員的動線重疊且接觸點眾多，增加了Covid-19的感染風險。為解決此問題，使用活動關係圖重新設計穿脫防護區域，減少動線重疊。然而，進一步分析流程程序圖，發現就診民眾、勞務人員和警衛人員的行徑路程和篩檢時間較長且交疊。因此結果建議放棄一部分不重要的緊急處理區域，改設穿脫防護裝備區域，提高醫療人員的防護和動線流暢性。同時在急診觀察區域內設置醫療相關人員穿脫防護裝備的前室，避免與疑似或確診個案同處一個開放空間。另外，移動式戶外篩檢亭應與負壓病房病人出入口分離，以避免篩檢民眾與隔離民眾的動線交疊，實現分流分艙的效果。透過這些改善措施，應可提升急診室的運作效率，降低感染風險，減輕疫情帶來的損失。

The present study aims to enhance the emergency department workflow at a hospital in a specific area of Hsinchu. Key medical behaviors and influencing factors were identified by applying the 80/20 principle and conducting a root cause analysis. The relative distances of emergency department functions were analyzed, and significant improvement areas were identified through process flowcharts. The unprecedented occurrence of the Covid-19 pandemic necessitated a redesign and reconfiguration of the emergency department layout. This study found that in the existing setup, there was an overlap in the pathways of patients, physicians, and nursing staff, resulting in numerous contact points and an increased risk of Covid-19 transmission. An activity relationship diagram was used to redesign the donning and doffing areas for protective gear, reducing the overlap of pathways.
However, further analysis of the process flowcharts revealed that the travel distances and overlapping screening times for patients, service personnel, and security personnel were lengthy. As a result, it was recommended to eliminate certain non-essential emergency treatment zones, establish designated areas for donning and doffing protective equipment to enhance the protection, and streamline the pathways for medical staff. Additionally, a pre-room for medical personnel to don and doff protective gear should be placed within the emergency observation area to prevent coexistence in an open space with suspected or confirmed cases.
Furthermore, the mobile outdoor screening booths should be separated from the entrances and exits of negative pressure isolation wards to avoid the overlap of pathways between screening individuals and isolated patients, achieving effective diversion and separation. Through these improvement measures, it is expected that the efficiency of the emergency department's operations will be enhanced, the risk of infection reduced, and the losses caused by the pandemic mitigated.

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