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研究生:吳永順
論文名稱:門診藥局等候時間最佳化之研究------以成大醫院為例
指導教授:蔡長鈞蔡長鈞引用關係
學位類別:碩士
校院名稱:國立成功大學
系所名稱:工業管理學系
學門:商業及管理學門
學類:其他商業及管理學類
論文種類:學術論文
論文出版年:1999
畢業學年度:87
語文別:中文
論文頁數:60
中文關鍵詞:等候網路門診藥局參數分解法
外文關鍵詞:queueing networkdecomposition methods
相關次數:
  • 被引用被引用:24
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:5
全民健保已於民國84年3月正式實施,造成大醫院病患求診人數急遽增加,使得醫院門診藥局舊有的服務模式與空間設備趕不上持續遞增進來的調配單,故造成病人長時間等候藥品。而要病人在遭受病痛煎熬之時,再加上長時間等候領藥是不合乎人情的;此外,也會影響到醫院的醫療服務品質,進而影響病人再次求診的意願。所以讓病人等候時間合理化為現代醫院提升競爭能力所不容忽視的問題。
本研究針對成大醫院門診藥局現有的配藥環境與流程,以及醫院相關病患的資料,做一全盤性的瞭解,再試圖對藥局作業流程加以改善。根據成大醫院資料統計結果得知,藥品項數較少者佔所有調劑單的大多數,故模式將根據其現有的設備和收集的資料,將調劑單依藥品項數多寡分為單號和雙號兩條等候線,取代舊有隨機分配的等候線,以分析此系統在等候時間最小下,該以品項數多寡來分界,並同時考慮在不同日期、不同時段下,各個服務台之最佳藥師數配置,做為醫院管理者的決策指標,以期滿足醫院的經營理念和減少病患的等待領藥時間。本研究經由使用數學規劃法和模擬法兩者同時並行來分析系統,結果顯示本研究所提出的新系統不論在病患等候時間方面或藥局前病患的等候個數均優於現有系統。
第一章 緒論1
第一節 研究動機與背景1
第二節 研究目的1
第三節 研究範圍與限制2
第四節 研究流程3
第二章 文獻探討5
第一節 等候網路5
2-1-1 正確的分析6
2-1-2 近似法7
2-1-3 模擬或其它相關技術10
第二節 系統模擬10
2-2-1 模擬的步驟10
2-2-2 模擬的確認11
第三章 研究方法13
第一節 數學規劃13
3-1-1 符號定義13
3-1-2 假設條件14
3-1-3 數學模式14
第二節 系統模擬19
3-2-1 進行模擬程式之撰寫19
3-2-2 進行模擬的設定19
第四章 實證分析22
第一節 研究背景22
4-1-1 研究對象22
4-1-2 研究資料22
4-1-3 現有系統描述24
4-1-4 新系統描述26
第二節 系統數學模式求解與模擬27
4-2-1 數學規劃法求解27
4-2-2 模擬模式設定31
第三節 資料結果分析32
4-3-1 新舊系統病患等候時間比較32
4-3-2 新舊系統病患等候長度比較33
4-3-3 數學模式之求解34
4-3-4 考慮顛峰時間的系統配置35
4-3-5 參數分解法和模擬結果比較39
第五章 結論與建議43
參考文獻47
附錄 圖表51
一、 英文部分
[1] Baskett, F., K. M. Chandy, R. R. Muntz and F. Palacios,”Open, Closed and Mixed Networks of Queues with Different Classes of Customers,”J. ACM,22,pp.248-260, 1975.
[2] Buzen, J. P.,”Fundamental Operational Laws of Computer System Performance,”Acta Inform.,7,2,pp.167-182, 1976.
[3] Bard, Y.,”Some Extensions to Multicalss Queueing Network Analysis,”Performance of Computer Systems,M. Arato,A. Butrimenko and E. Gelenbe(Eds.),North Holland, Amsterdam, 1979.
[4] Beaman, MA and JA Kotzan,”Factors Affecting Medication-Order Processing Time,”Am J Hosp Pharm,39,pp.1916-1919, 1982.
[5] Bryan, O. F., Jr., and M. C. Natrella,”Testing Large-Scale Simulations,”Byte,10, pp.183-194, 1985.
[6] Buzacott, J. A. and J. G. Shanthikumar,“Approximate Queueing Models of Dynamic Job Shop,” Management Science,31,7,pp.870-887, 1985.
[7] Bard, M. and D. Sipper,”Flexibility in manufacturing systems:definitions and Petri net modelling,”INT. J . PROD. RES.,26,2,pp.237-248, 1988.
[8] Bitran, G. R. and D. Tirupati,“Multiproduct Queueing Networks with Deterministic Routing: Decomposition Approach and the Notion of Interference,”Management Science,34,1,pp.75-100, 1988.
[9] Buzacott, J. A. and J. G. Shanthikumar,“Design of Manufacturing Systems Using Queueing Models,”Queueing System,12,pp.135-214, 1992.
[10] Chandy, K. M. and C. H. Sauer,“Approximate Methods for Analyzing Queueing Network Models of Computer Systems,”Acm Computing Survey,10,3,pp.281-317, 1978.
[11] Carson, J, S.,”Convincing Users of Model’s Validity Is Challenging Aspect of Modeler’s Job,”Industrial Engineering,18,pp.74-85 , 1986.
[12] Chen, H., J. M. Harrison, A. Mandelbaum, A. Van Ackere, and L. M. Wein, “Empirical Evaluation of a Queueing Network Model for Semiconductor Wafer Fabrication,”Operations Research,36,2,pp.202-215, 1988.
[13] Connors, D. P., G. E. Feigin and D. D. Yao,“A Queueing Network Model for Semiconductor Manufacturing,”IEEE Transaction on Semiconductor Manufactring, 9,3,pp.412-427, 1996.
[14] Denning, P. J. and J. P. Buzen,”The Operational Analysis of Queueing Network Models,”ACM Computing Surv.,10,3,pp.225-261, 1978.
[15] Disney, R. L. and D. Konig,“Queueing Networks: A Survey of their Random Processes,”SIAM Rev.,27,3, pp.335-403, 1985.
[16] Dai, J. G., V. Nguyen and M. L. Reiman,“Sequential Bottleneck Decomposition : An Approximation Method for Generalized Jackson Networks,”Operations Research,42,1,pp.119-136, 1994.
[17] Gordon, W. J. and G. F. Newell,”Closed Queuing Systems with Exponential Severs,” Operations Research,15,pp.254-265, 1967.
[18] Gaver, D. P. and G. S. Shedler,”Approximate Models for Processor Utilization in Multi-Programmed Computer System,”SIAM J. Comput.,2,pp.183-192, 1973.
[19] Gelenbe, E.,”On Approximate Computer System Model,”J. Assoc. Comput. Mach., 22 ,pp.261-269, 1975.
[20] Ho, Y. C., M. A. Eyler and T. T. Chien,”A Gradient Technique for General Buffer Storage Design in a Serial Production Line,”Internat. J. Production Res.,17,6,pp.557-580, 1979.
[21] Harrison, J. M. and M. I. Reimann,”On the Diostribution of Multidimensional Reflected Brownian Motion,”SIAM J. Appl. Math.,41,2,pp.345-361, 1981.
[22] Harrison, J. M. and V. Nguyen,”The QNET Method for Two-moment Analysis of Open Queueing Networks,”Queueing system,6,pp.1-32, 1990.
[23] Hatono, I., K. Yamagata and H. Tamura,”Modeling and On-Line Scheduling of Flexible Manufacturing Systems Using Stochastic Petri Nets,”IEEE Transactions on Software Engineering,17,2,pp.126-131, 1991.
[24] Harrison, J. M. and V. Nguyen,”Brownian Models of Multiclass Queueing Networks:Current Status and Open Problems,”Queueing systems,13,pp.5-40, 1993.
[25] Harrison, J. M. and M. T. Pich,“Two-Moment Analyssis of Open Queueing Networks with General Workstation Capabilities,”Operations Research,44,6,pp.936-950, 1996.
[26] Hasslinger, G. and E. S. Rieger,“Analysis of Open Discrete Time Queueing Networks: A Refined decomposition Approach,”Journal of the Operational Research Society,47, pp.640-653, 1996.
[27] Iglehart, D. L. and W. Whitt,”Multiple Channel Queues in Heavy Traffic.Ⅱ.Sequences, Networks and Batches,”Adv. in Appl. Probab.,2,2,pp.355-369, 1970.
[28] Jackson, J. R.,”Networks of Waiting Lines.”Operations Research,5,pp.518-521, 1957.
[29] Kobayashi, H.,”Application of Diffusion Approximations to Queueing Networks. Part Ⅰ. Equilibrium Queue Distributions,”J. Assoc. Comput. Mach.,21,pp.316-328, 1974.
[30] Kelly, F. P.,”Networks of Queues with Customers of Different Types,”J. Appl. Probab., 12,pp.542-554, 1975.
[31] Kleinrock, L.,“Queueing System,”Vol. 2,John Wiley & Sons,New York, 1976.
[32] Kuehn, P. J.,“Approximate Analysis of General Networks by Decomposition,”IEEE Transaction Communications,27,pp.113-126, 1979.
[33] Kleijnen, J. P. C.,”Statistical Tools For Simulations Practitioners,”Marcel Dekker Inc,N.Y., 1987.
[34] Lemoine, A. J.,”Networks of Queues---A Survey of Equilibrium Analysis,” Management Sci.,24,4,pp.464-481, 1977.
[35] Law, A. M. and M. G. McComas,”Secrets of Successful Simulations Studies,” Industry Engineering,pp.47-48,51-53,72, 1990.
[36] Law, A. M. and W. D. Kelton,”Simulation Modeling & Analysis,”McGraw-Hill,Inc., N. Y., 1991.
[37] Newell, G. F.,”Applications of queueing Theory,”Chapman and Hall,London, 1971.
[38] Pao-Long Chang, Ming-Guang Huang, and Ying —Chyi Chou,”Evaluating the System Performances for Semiconductor Fabrication Using Open General Queueing Network,”數量管理辦法與應用研討會論文集,pp.37-46, 1998.
[39] Reiser, M. and H. Kobayashi,“Accuracy of Difffusion Approximation for Some Queueing Systems,“IBM Journal Research Development,18,pp.110-124, 1974.
[40] Ramamoorthy, C. V. and G. S. Ho,”Performance evaluation of asynchronous concurrent systems using Petri nets,”IEEE Transactions on Software Engineering,6,pp.440-449, 1980.
[41] Reiser, M. and S. S. Lavenberg,”Mean Value Analysis of Closed Multchain Networks,”J. Assoc. Comput. Mach.,27,2,pp.313-323, 1980.
[42] Schweitzer, P.,”Approximate Analysis of Multiclass Closed Network of Queues,” presented at International Conference,Stochastic Control and Optimization,Amsterdam, Netherlands, 1979.
[43] Shanthikumar, J. G. and J. A. Buzacott,“Open Queueing Network Models of Dynamic Job Shops,”International Journal of Production Research,19,3,pp.255-266, 1981.
[44] Suri, R. and M. A. Zazanis,”Perturbation Analysis Gives Strongly Consistent Estimates for the M/G/1Queue,”Division of Applied Sciences,Harvard University, 1984.
[45] Welch, P. D.,”On The Problem of Initial Transient Steady-State Simulation,”IBM Watson Research Center,Yorktown Heights,N. Y., 1981.
[46] Whitt, W.,“The Queueing Network Analyzer,”Bell System Teachnical Journal,62,9, pp.2779-2815, 1983.
[47] Wolff, R. W.,“Stochastic Modeling and The Theory of Queues,”Prentice Hall, Englewood Cliffs,NJ, 1989.
[48] Whitt, W.,“Approximations for the GI/G/m Queue,”Production and Operations Management,2,2,pp.114-161, 1993.
[49] Whitt, W.,“Towards Better Parametric-Decomposition Approximations for Open Queueing Network ,”Annals of Operations Research,48,pp.221-248, 1994.
[50] Whitt, W.,“Variability Functions for Parametric-decomposition Approximations of Queueing Networks,” Management Science,41,10,pp.1704-1715, 1995.
[51] Zazanis, M. A. and R. Suri,”Comparison of Perturbation Analysis with Conventional Sensitivity Estimates for Regenerative Stochastic Systems,”Division of Applied Sciences,Harvard University, 1984.
二、中文部分
[1] 姚景星,劉睦雄,”作業研究”,華泰書局;1987。
[2] 楊育嘉,”門診藥局等候理論之探討” ,碩士論文;1998。
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