摘要提升門診藥局的運作效率，滿足顧客的需求為各醫院藥劑部營運重要的述求。在門診藥局作業中，等候領藥的時間是病患滿意度的重要指標，也是醫院藥劑部門不斷努力改善的項目。本研究先運用動線分析進行門診藥局調劑作業動線的探討，提出設施規劃之改善方案，以減少調劑流程中不具附加價值的作業活動。再運用系統模擬進行調劑作業指派方式之決策，探討各領藥窗口之處方型態分配及作業流程，建構調劑作業模擬模型，並探討三種門診藥局的調劑作業方案：方案一：為原有作業方式，即採原設施規劃與原調劑作業指派法則方案二：為採新擬定之設施規劃與原調劑作業指派法則方案三：為採新擬定之設施規劃與新擬定之調劑作業指派法則研究發現，設施規劃改善方案縮短藥師調劑作業的移動距離，減少藥師不具附加價值的活動，也可?醫院在10年中節省成本達$1,333,467元。模擬輸出結果呈現方案二將公用藥架移至調劑動線的新設施規劃較方案依原系統的總作業時間縮短減少3分14秒（改善幅度達26%）；但方案三的採新擬定之調劑作業指派方式其調劑作業時間與原系統並無明顯差異。因此以現階段的模擬結果，方案二為最佳決策方案，也就是設施規劃將公用藥架移至調劑線，而作業指派方式維持原處方指派方式。未來可以再探討在新設施規劃下，顯著影響作業時間之變數，並研擬其他的調劑作業指派方式，期望有更佳的改善方案。 ABSTRACTThe pharmacy department in each hospital has been trying hard to improve its operation efficiency and to satisfy the patients’ demand. It is well known that the waiting time at outpatient pharmacy is an important indicator for patients’ satisfaction. Therefore, this study employs two methodologies so as to shorten the waiting time of the outpatient pharmacy in a medical center. We use our first methodology, namely, “Flow Analysis” to investigate the dispensing process to eliminate “non-value adding” activities. Our flow analysis assists us to bring up with a new facility-planning proposal in the outpatient pharmacy. We name the AS-IS scenario and the new proposal as Alternatives I and II, respectively. Also, we propose a new prescription type and order assignment rule to each delivery window for the operations in the new facility-planning proposal, which is called Alternative III in this study. Next, we utilize “System Simulation” as the second methodology to evaluate the performance of the three alternatives. In this study, we develop the simulation models corresponding to the three alternatives using the simulation software “eM-Plant” for the output analysis. Our numerical results show that the new facility-planning proposal in Alternative II gains a considerable annual cost saving of $1,333,467 over Alternative I. Also, it leads to a 26%-reduction (which is around 3 minutes and 14 seconds decrease) in the waiting time. On the other hand, the new dispensing order assignment rule in Alternative III does not show significant improvement over Alternative II. Our analysis concludes that Alternative II is the best one for the operations of the outpatient pharmacy in this study. We will keep working on deriving new dispensing order assignment rules as the extension of this study.
