以系統模擬進行區域醫院藥局作業改善

Tunghai University Institutional Repository > 工學院 > 工業工程與經營資訊學系所 > 碩博士論文 > Item 310901/28412

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Title:	以系統模擬進行區域醫院藥局作業改善
Other Titles:	Operation Improvement by System Simulation in the Pharmacy of a District Hospital
Authors:	郭庭均 KUO, TING-CHUN
Contributors:	黃欽印 HUANG, CHIN-YIN 工業工程與經營資訊學系
Keywords:	系統模擬;候藥時間;藥局作業流程;Simul8 System Simulation;Waiting Time;Pharmacy Operation and Process;Simul8
Date:	2016
Issue Date:	2016-10-20T03:47:20Z (UTC)
Abstract:	在醫療服務過程中，最容易聽到病人抱怨就是等候時間過久的問題。現今醫院普遍都有「五長兩短」(等待掛號時間長、等待看診時間長、等待批價時間長、等待檢驗時間長、等待領藥時間長、等待問診時間短及解釋病情時間短)的現象發生。因此，藥局藥事作業流程管理成為藥局管理者關切的重點。如能更有效運用藥事人力、設備及物力資源，將有助於提升藥事人員工作效率，縮短病人候藥時間、減少病人抱怨。本研究主要目的為使門診藥局整體作業流程更順暢，提高工作效率，使藥師可以做更多對病患的服務項目。藉由系統模擬Simul8過程評估不同藥事作業流程策略對藥局管理之影響。以個案醫院藥局實際紀錄各動作單元完成時間作為數據參數設定，並設計四種策略改善方式，分別為(1)藥總包自動配送至指定調劑藥師工作站(2)自動錠劑分包機藥品低於最低庫存量再行補藥(3)強化調劑櫃位功能-增加櫃位指示燈及電子劑量秤(4)重新規劃藥局空間，重整藥品存放位置。同樣以Simul8評估此四種對策對於藥局藥事作業流程及工作時間之影響。結果得知本研究所提出的四項策略分別能夠使模擬結果為助理員工作時間佔比由85.08%下降至66.46%(降幅21.89%)；助理員補藥工作之時間佔比由14.29%下降至3.53%(降幅75.30%)；調劑藥師工作時間佔比由87.49%下降至76.9% (降幅26.16%)；磨粉調劑藥師工作時間佔比由64.03%下降至48.04%(降幅24.97%)；核藥師工作時間佔比由96.06%下降至75.96%(降幅20.92%)的改善成果。 In the process of medical service, complaint of long waiting time is the most heard problems. ”Five-long & two-short” is the general problem of hospitals (long registration waiting time, long outpatient waiting time, long cashier waiting time, long examination waiting time, long getting prescribed medicine waiting time, short physicians consulting time, short patients' condition explanation time). Therefore, management of pharmaceutical affairs operating procedure in pharmacy becomes the priority issue of managers. Effectively using pharmacists’ manpower, equipment and materials will improve pharmacists’ work efficiency, hence shorten patients’ waiting time for getting the prescribed medicine and reduce patients’ complaints.The main purpose of this study is to better the workflow of outpatient pharmacy, to improve work efficiency, and to enable pharmacists to offer more services to patients. The approach of the study is to evaluate the effects of different pharmaceutical operating procedures on pharmacy management by simulation software Simul8. This research designs four improvement strategies as followed: (1) Automatically distribute all medicines to the dispensing pharmacists’ workbench, (2) Refill medicines in automatic tablet distributor when the inventory is below the designated refilling level, (3) Enhance the functions of dispensing counters by adding indicating lamps and electronic scales, and (4) Replan the space of the pharmacy and rearrange the location of medicines. The above four improvement strategies are simulated by Simul8 as well. The result of this study reveals that these 4 strategies lead to the following improvement results: working time of assistants declined from 85.08% to 66.46% (decreased by 21.89%); resupplying medicines time of assistants declined from 14.29% to 3.53% (decreased by75.30%); working time of dispensing pharmacists declined from 87.49% to 76.9% (decreased by26.16%); working time of powdering dispensing pharmacists declined from 64.03% to 48.04% (decreased by 24.97%); working time of checking pharmacists declined from 96.06% to 75.96% (decreased by 20.92%).
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