醫療機構管理研究所;Graduate Institute of Health Care Organization AdministrationKU, SHEI-LINGSHEI-LINGKUWANG, PA-CHUNPA-CHUNWANGCHUNG, KUO-PIAOKUO-PIAOCHUNG古雪鈴王拔群鍾國彪2008-05-022018-06-292008-05-022018-06-292006http://ntur.lib.ntu.edu.tw//handle/246246/64658本研究目的在探討手術病人流程於介入六標準差管理前、後，對手術病人服務效率的影響。研究收集北部某一醫學中心手術病人於進出手術室期間之六個作業活動流程點時間；手術室停留時間共分三組（ 120分鐘以內、121-240分鐘間、及241分鐘以上）。研究工具為結構式記錄表，由手術室護理人員記錄時間及異常因子，前測總共收集1, 692人（2005年3月25日至5月15日），後測共收集1,692人（2005年6 月27日至8月7日）；資料分析以描述性統計、t檢定及卡方檢定進行服務效率前後差異之比較。研究結果顯示介入六標準差管理後，每台手術病人停留手術室時間每組各減少3.43分、4.77分與12.98分(P<0. 05)。手術換檯時間實施後分別減少6.76分、5.30分、7.02分(P<0. 05 )。手術室工作人員超時工作時間實施後每台手術分別減少6.01分、10.07分、20分(P<0.05)。本研究結果支持六標準差可降低手術流程中的變異，使流程穩定並有效改善手術病人停留手術室時間、手術換檯時間以及手術室工作人員超時工作時間。本研究結果可作為同儕醫院、外科部門及手術室管理者在行政管理上之參考。 This study evaluates the difference in service time before and after the implementation of the six sigma initiative in the operation rooms (OR). Nursing staff in OR used the structured data collection forms to record data from six processes check points for surgical patients in a medical center during the enrollment period. Patients were assigned to three groups based on their staying time in OR (<=120, 121-240, >241 minutes). This study enrolled 1,692 patients in the baseline group (from March 25, 2005 to May 15, 2005) and 1,692 patients in the post-test group (from June 27, 2005 to August 7, 2005). The differences in service efficiency were compared using the t-test and the chi-square test. The analyses demonstrate that three surgical groups according to staying time achieved reductions of 3.43, 4.77, and 12.98 minutes in OR (p<0.05). Moreover, turnaround time was reduced by 6.76, 5.3, and 7.02 minutes (p<0.05), respectively, and employee overtime was reduced by 6.01, 10. 07, and 20 minutes, respectively (p<0.05). The study supports that the six sigma technique can effectively reduce patient stay in OR, improve turnaround time of OR, and can significantly reduce staff overtime. This study provides empirical results for use by managers in peer hospitals, surgical departments, and for administrative purposes.application/en-US六標準差手術時間服務效率Six sigmaoperation timeservice efficiencyjournal article