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研究生:簡采蓁
研究生(外文):Chien Tsai-Cheng
論文名稱:應用系統模擬提升手術排程績效-以雲林某區域教學醫院為例
論文名稱(外文):A Simulation to Improve Surgery Scheduling Performance-An Example from a Regional Teaching Hospital in Yunlin
指導教授:鄭博文鄭博文引用關係
指導教授(外文):Cheng Bor-Wen
口試委員:鄭博文童超塵林昭維
口試委員(外文):Bor-Wen ChengChau-Chen TorngJou-Wei Lin
口試日期:2014-07-16
學位類別:碩士
校院名稱:國立雲林科技大學
系所名稱:工業工程與管理系
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:2014
畢業學年度:102
語文別:中文
論文頁數:65
中文關鍵詞:手術延遲手術室排程系統模擬
外文關鍵詞:Surgery delayOperating room schedulingSystem Simulation
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在醫院中,手術室管理一直以來是醫院關注的課題,手術室管理最困難的就是手術排程,不佳的手術排程會因為延遲而無法順利進行,導致手術病人不可預期的風險增加,因此,如何將有限的手術室資源做有效的分配,降低延遲的問題,為管理者所關心的問題。本研究針對個案醫院門診與住院病人作為探討對象,進行手術室排程模擬,收集手術流程相關資料,建構手術流程情境模擬,評估不同的排程法則的績效,供醫院管理者作為排程之參考。
本研究以雲林地區某區域教學醫院之資料庫做為研究對象,運用模擬軟體建構三種不同排程法則之模擬模型,分別為區塊排程、長刀先排與修正區塊排程法則,並且利用病人處理量、手術房使用率、換台延遲率與護理人員閒置率來評估系統績效。其研究結果顯示本研究所提出修正區塊排程法則與個案醫院之模型相比,在換台延遲率降低了1.81%;在護理人員閒置率降低了4.28%,在整體手術房使用率有較佳的績效。因此,在使用修正區塊排程可以降低換台延遲率與護理人員閒置率,此研究結果供醫院在排程上之參考。最後針對研究結果提出建議以供後續研究者與醫療機構之參考。

Operating room management has consistently been a topic of concern for hospitals. The complex component of operating room management is surgery scheduling: poor scheduling may lead to delays in surgeries, thus increasing the risk to patients. Therefore, the efficient allocation of limited resources for reducing scheduling delays is a major concern for the manager. In this paper, we discuss an outpatient and inpatient as examples, the collection of data pertaining to a related process, and the use of these data for constructing an operating process simulation model. We evaluated the performance of various operating room scheduling rules for hospital administrators compared with scheduling rules used as a reference.
In this study, the database of a regional teaching hospital in Yunlin County was used as an example, and simulation software was used to construct a simulation model of three scheduling rules: block scheduling, longest time first scheduling, and modified block scheduling. Patient capacity, the rate of operating room use, the delay rate of change surgery, and idle rate of nurses were used to evaluate system performance. We compared the proposed and case hospital models and determined that the delay rate of change surgery and idle rate of nurses were reduced by 1.81% and 4.28%, respectively, in the proposed model. Overall, modified block scheduling exhibited superior performance regarding its application in the operating room. Finally, we provide recommendations for medical institutions and future studies.

中文摘要 i
ABSTRACT ii
誌謝 iii
目錄 iv
表目錄 vi
圖目錄 vii
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 4
1.3 研究限制與範圍 4
1.4 研究流程 4
第二章 文獻探討 6
2.1 手術室管理 6
2.2 手術室排程 9
2.3 手術延遲 11
2.4 系統模擬 13
2.4.1評估模式 15
2.4.2系統模擬的應用 15
2.4.3系統模擬在醫療上的應用 16
2.4.4績效指標 17
2.4.5模擬工具 18
第三章 研究方法 21
3.1 研究架構 21
3.2 研究對象 22
3.2.1 醫院現況 23
3.3 研究限制與假設 26
3.4 研究變項與變項之操作型定義 26
3.5 資料收集與資料前處理 28
3.6 模型建構 29
3.7 模型驗證 30
3.8 排程法則之模型 30
第四章 研究結果分析 32
4.1 模擬模型 32
4.2 模型驗證 47
4.3 研究結果分析 48
4.3.1排程法則病患處理量分析 48
4.3.2排程法則績效評估比較 49
第五章 結論與建議 51
5.1 結果討論 51
5.2 建議與後續研究方向 52
參考文獻 54

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