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研究生:張嘉芳
研究生(外文):Chia-Fang Chang
論文名稱:改善骨科部創傷醫學組門診病人之等候時間-利用系統模擬方法
論文名稱(外文):Outpatient Waiting Time Improvement in Trauma Team of Department of Orthopaedics Surgery – A Simulation Approach
指導教授:盧大平盧大平引用關係
口試委員:梁曉帆史瑞田
口試日期:2012-07-24
學位類別:碩士
校院名稱:國立臺北科技大學
系所名稱:工業工程與管理系碩士班
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2012
畢業學年度:100
語文別:英文
論文頁數:44
中文關鍵詞:門診病患等候服務品質骨科門診系統模擬
外文關鍵詞:Outpatient waiting timeService qualityOrthopaedics clinic Simulation
相關次數:
  • 被引用被引用:5
  • 點閱點閱:436
  • 評分評分:
  • 下載下載:75
  • 收藏至我的研究室書目清單書目收藏:1
近幾年醫療競爭的環境下,人們對於醫療品質是日漸受到重視,而等候時間是影響病人滿意度的重要因素,亦是目前醫院門診普遍的問題,根據桃園國軍總醫院對於病人滿意度調查顯示門診等候時間是最不滿意地方,骨科創傷組的現場掛號病人平均等候時間約為2小時。由於醫院同時服務預約和現場掛號病人,現場掛號的數量及到達時間的不確定性可能造成病人等候時間變長的原因,不同於非亞洲大部分國家只接受預約服務制度。
為了能夠改善病人滿意度,本研究利用系統模擬分析方法改善病人等候時間,實施對象為桃園國軍總醫院骨科部創傷醫學組。首先本研究分析創傷組兩位醫師在過去兩個月服務病人的資料,並輸入所建立的門診模型,接著進行模型驗證使其符合現實情況。本研究提出三種不同的情境模擬,一為調整現場掛號和預約的比例,二為調整遲到病人的看診順序並降低遲到率,三為改變現場掛號和預約病人的排隊對列方式,最後使用敏感度分析方法找出最好的結果。
經由上述研究方法,其結果在第一情境裡,可降低現場掛號病人的等候時間約平均53%;第二情境等候時間並無顯著改善;而第三情境亦可降低等候平均約33%。因此,本研究經由這三種不同情境的模擬結果,認為改變現場掛號病人的比例可以大幅度降低病人的等候時間。


In recent years, people have paid attention on the service quality of healthcare providers under the competitive medical service industry. Patient waiting time is a critical factor that affects patients’ satisfaction. Based on Taoyuan Armed Forces General Hospital (TYAFGH) survey questionnaire, it showed that the long waiting time is the major problem of patient dissatisfaction. The average walk-in patient waiting time is approximately 2 hours in trauma team of orthopaedic surgery department. The hospital has a mixed registration type which accepts for both walk-in and scheduled patients. The reason of long waiting time is probably caused by the uncertain number of walk-in patients, or patient arrival time.
In order to improve patient satisfaction, this research used a computer simulation approach to simulate all consultation sections of two physicians’ outpatient in trauma team of orthopaedics surgery department in TYAFGH. In the beginning, we analyzed the real data of two physicians during two months to build a valid simulation model. Then, this research applied three main patient scheduling scenarios. The first scenario made adjustments for proportion of walk-in and scheduled patients. The second scenario applied different policies for late patients and then adjusted late patient proportion. Third, this research applied various sequences for walk-in and scheduled patients. Finally, we did sensitivity analysis to find out the influential factor for reducing patient waiting time.
The simulation results showed that the improvement of walk-in patient waiting time was average 53% in the first scenario and 33% in the third scenario. The second scenario has not shown effective improvement. Thus, in conclusion, through testing three scenarios, we could find out the adjustment of walk-ins proportion is the best way to improve patient waiting time.


摘 要 i
ABSTRACT ii
誌謝 iv
Content v
Table Content vii
Figure Content ix
Chapter 1 INTRODUCTION 1
1.1 Research Motivation 1
1.2 Research Background 3
1.3 Research Objectives 5
1.4 Research Scope and Limitation 5
1.5 Research Architecture 5
Chapter 2 LITERATURE REVIEW 7
2.1 Hospital Service Quality 7
2.2 Patient Satisfaction and Waiting Time 8
2.3 Reducing Waiting Time 8
2.4 Computer Simulation 9
Chapter 3 RESEARCH METHODOLOGY 11
3.1 Research Process 11
3.2 Data Collection and Analysis 12
3.3 Model Building and Validation 12
3.4 Simulation with Scenarios and Sensitivity Analysis 13
3.5 Result Analysis 13
Chapter 4 Simulation Execution 14
4.1 Four consultation sections 14
4.2 Simulation models 15
4.3 Model Validation 16
4.4 Scenarios testing 17
Chapter 5 Analysis and Interpretation of Results 22
5.1 Walk-ins and Scheduled Proportion 22
5.2 Late policy 25
5.3 Patients sequences 26
Chapter 6 Conclusions and Future Work 39
References 41
APPENDIX A Simulation Model 44


[1]張智凱,評估管理病患抵達行為對候診時間與醫療品質的影響,碩士論文,國立台灣大學商學研究所,台北,2006。
[2]張淑貞,在允許現掛與預約並行的醫療系統下設計及分析最佳化預約排程法則,碩士論文,靜宜大學資訊管理學系研究所,台中,2005。
[3]侯幸雨,應用模擬技術探討台灣醫院門診預約掛號系統,碩士論文,國立中正大學企業管研究所,嘉義,1999。
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