門診藥局運用流程再造之概念於縮短候藥時間之研究

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Title:	門診藥局運用流程再造之概念於縮短候藥時間之研究
Other Titles:	The Study for Reduce Hospital Pharmacies Waiting Time for Taking Medicines by Concept of BPR
Authors:	林慧欣 Lin, Hui-Shin
Contributors:	周瑛琪 Chou, Ying-Chyi 東海大學企業管理學系碩士班
Keywords:	門診藥局;流程再造;時間研究;閒置時間;改善 pharmacy;reengineering;Time Study;idle time;improvement
Date:	2006
Issue Date:	2011-04-15T01:31:14Z (UTC)
Abstract:	臺灣已於1995年3月正式實施全民健保，造成大醫院求診人數增加，使得醫院舊有的服務系統趕不上持續遞增的門診人數；醫院裡所附設的門診藥局亦是如此，故造成病患看診完的候藥時間過長與不滿意。流程再造的觀念於1990年由Hammer提出後，即受到世界上許多企業廣泛的應用，且獲得極大的助益；然而，此一觀念在醫療院所的應用並不普及。本研究係以中部某醫學中心作為研究對象，並門診藥局調劑流程為主，據其現有的人力、設備及作業方式為基礎，以“工作研究”中的“時間研究”做為分析工具。並經由文獻探討、訪談、觀察等方式來蒐集門診藥局實務資料加以彙總分析，詳述個案流程再造的實施步驟。研究重點主要在落實流程再造的理念，並以門診藥局的調劑流程做為推動流程再造的實施範例。藥師調劑之作業時間受「儲位-包裝-劑型」所影響；其中以藥品儲位影響最鉅。因此，本研究透過抽樣測時資料，分析出調劑作業常用藥品品項及罕用藥品品項，加以重新分配儲位，以利藥師調劑作業；並提出流程再造相關之4項建議，以改善在調劑流程中所產生之瓶頸，並剔除流程中的閒置時間。經由研究的過程並驗證其執行的步驟及成果，求得各發藥窗口改善前後病患等候時間的差異。研究結果顯示：經流程再造後可減少約10.41%之閒置時間同時提高約8.95%的服務水準。本研究提供門診藥局流程再造之客觀參考依據，同時滿足醫院的經營理念和減少病患等待領藥的時間，以提昇醫療品質與加強競爭力。 In Taiwan, with the official implementation of National Health Insurance on March of 1995, the patient number of major hospitals have increase rapidly which leads to the old process of pharmacy service unable to cope with the increasing number of prescription and result in long waiting time and dissatisfied for taking medicines. Since 1990, the concept of business process reengineering had been proposed by Hammer, it was applied by many worldwide business enterprises and hence it provided a great benefit. However, the concept was not generally adopted by hospitals.The subject of this study is a medical center in the central Taiwan. This study focus on dispensing process and the data of this study is based on the current manpower, facility and work method of the hospital pharmacy. Under the divisionalization of dispersing workstation (window divisionalization), the hospital dispense process has been reengineering using the analysis tool of “time study” within the “work study”. After reading references, interviewing, and observing the results, this study can provide the detail practice steps of hospital process reengineering in the hospital pharmacy. The purpose of this study was making the hospital dispense process more efficient by the concept of business process reengineering in hospital pharmacies.The pharmacist dispensed a prescription is influenced by position , packing, and shape, position especially. The study through analyzing dates from use stopwatch to measure the samples. The outcome showed some pharmaceuticals were used frequently in the dispensing job, and some were infrequent. We based on the pharmaceuticals were used frequency in dispensing job to reposition pharmaceuticals and after reposition can really improve pharmacist to do job batter. And this study recommends four opinions about reengineering in order to solve bottle neck and to eliminate idle times in the dispensing process. Through observation process, the implementation steps and results can be verified. The differences of waiting time before and after the process reengineering is that we can reduce about 10.41% of idle times and also improve the service level for 8.95% after the process reengineering. This study can not only provide the objective reference of the reengineering and decrease in the waiting time at the pharmacy of the patients, but also fulfill the business concept of the hospital. And enhance the quality of medical treatment and capability of competition at last.
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