北京生物医学工程

基于离散系统仿真和价值流图析法的妇幼保健院就诊流程分析

Analysis of the outpatient process for maternity and child health care hospital based on discrete event system simulation and value stream mapping

作者：季孟忠董芬谢勇雷常发项薇

单位：宁波大学机械工程与力学学院（浙江宁波 315211）宁波市鄞州区妇幼保健院（浙江宁波 315100）

关键词：妇幼保健院；流程分析；离散系统仿真；价值流图

分类号：R197.3；R318.04

出版年·卷·期（页码）：2019·38·3（290-297）

摘要：

目的通过离散系统仿真和价值流图析法分析妇幼保健院就诊流程，以科学评价妇幼保健院运作效率，识别就诊流程中存在的问题。方法通过现场流程调研、历史数据收集统计，应用离散系统仿真平台建立医院仿真模型，并利用价值流图析法识别出不增值的环节。结果仿真结果显示孕妇在整个检查流程中的时间增值比低于40%，等待检查时间过长，分析得出该院各科室的平均利用率为51.9%，存在较高的资源浪费。结论利用离散系统仿真及价值流图分析可以为医院实现精益医疗改善提供量化依据，进而从资源配置、流程改善及预约导诊等方面给出改善建议。

Objective In order to scientifically evaluate the operation efficiency, and identify the problems in the outpatient process，we analyse the outpatient process for maternity and child health care hospital by discrete event system simulation and value stream mapping. Methods Through survey and statistical analysis on historical data, the discrete event simulation model is established and the value stream mapping is used to identify non-value-added process. Results The simulation results show that the value added ratio is less than 40% during the entire process; patients have long waiting time for examination; the average utilization rate of each department is 51.9%, and the hospital has resource waste. Conclusion The analysis based on the simulation and value steam mapping can provide a solid quality basis for the lean medical improvement for maternity care hospital. Several improvement suggestions from resource configuration, procedure improvement and appointment are given to solve the problems.

参考文献：

[1] 陈丹妮，邹冬冬，张志锋，等.上海市三级公立医院门诊病人逗留时间及相关满意度分析[J].中国卫生资源，2017, 20(6):464-468.

Chen DN, Zou DD, Zhang ZF, et al.Analysis on outpatient stay in tertiary public hospitals in Shanghai and relative patient satisfaction degree[J].Chinese Health Resources, 2017, 20(6):464-468.

[2] 李玉萍，梁志江，徐昊立，等.广东省城市及农村妇幼保健机构运行效率比较[J].中国妇幼保健，2018，33(17) : 3845-3848.

Li YP, Liang ZJ, Xu HL.Comparison of operational efficiencies of maternal and child health care institutions between urban and rural areas in Guangdong[J].Maternal and Child Health Care of China, 2018, 33(17) :3845-3848.

[3] 陈迪，王耀刚.基于超效率DEA中国妇幼保健院效率分析与评价[J].中国妇幼保健，2017，32(12) : 2522-2524.

Chen D, Wang YG.Efficiency analysis and evaluation of maternal and child health care hospitals based on super-efficiency DEA in China[J].Maternal and Child Health Care of China, 2017, 32(12) :2522-2524.

[4] 孙令国，刘娟，马千云，等.精益管理在大型医院门诊流程改造中的运用[J].中国医疗管理科学，2018，8(3) : 35-39.

Sun LG, Liu JM, Qian Y, et al. Application of lean management in improving outpatient service in large hospitals[J].Chinese Journal of Medical Management Sciences, 2018, 8(3) : 5-39.

[5] Steere L, Rousseau M, Durland L.Lean six sigma for intravenous therapy optimization: a hospital use of lean thinking to improve occlusion management[J].Journal of the Association for Vascular Access, 2018, 23(1) :42-50.

[6] Sweety J，Kantipudi S，Kumar PN.Improving scan reporting time using lean and six sigma[J].International Journal of Research Foundation of Hospital and Healthcare Administration, 2018, 6 (1) :1-5.

[7] 柯兰兰，陈伟飞，洪卢晓.利用价值流图提升办理入院手续患者满意度的实践[J].医院管理论坛，2017，34(12) : 15-18.

Ke LL, Chen WF, Hong LX.Study on reconstruction of admission procedure to improve patient satisfaction using value stream map[J].Hospital Management Forum, 2017, 34(12) :15-18.

[8] Sayyida G, Fahma F, Iftadi I.Process improvement in outpatient installation RSUD dr. soediran mangun sumarso using lean hospital approach[J].Materials Science and Engineering Conference Series, 2018, 319(1) : 12-77.

[9] 刘爽, 吕超.基于仿真的医院药房分拣系统分析与优化[J].系统仿真学报, 2018, 30(11):431-438.

Liu S, Lv C.Analysis and optimization of sorting system of hospital pharmacy based on simulation[J]. Journal of System Simulation, 2018, 30(11):431-438.

[10] 刘胧, 卞齐昊, 李萍.运用WITNESS的医院排队模型仿真[J].工业工程, 2010, 13(2):73-75.

Liu L, Bian QH, Li P.Queuing theory model for hospital and simulation by using witness[J]. Industrial Engineering Journal, 2010, 13(2):73-75.

[11] 马长越, 刘清昭, 陈赛峰, 等.基于离散事件系统的手术室仿真研究[J].科技与管理, 2016, 18(6):34-38.

Ma CY, Liu QZ, Chen SF, et al.Simulation study of operation room based on discrete event system[J]. Science-Technology and Management, 2016, 18(6):34-38.

[12] 孙亚彬. 精益生产实战手册[M].深圳：海天出版社，2006.69-78.

[13] Dagkakis G, Heavey C.A review of open source discrete event simulation software for operations research[J].Journal of Simulation, 2016, 10(3):193-206.

[14] 马克·格雷班.精益医院[M]. 张国萍，王泽谣译.2版.北京：机械工程出版社, 2012：23-45.

Mark Graban.Lean Hospital(Second Edition)[M].Beijing：China Machine Press, 2012：23-45.

[15] 蒋帅.广西卫生财政投入与县级医院发展现状研究及效率评价[D].南宁:广西医科大学, 2015.

Jiang S.Study on status of the fiscal investment and the development of county-level hospitals in guangxi and efficiency evaluation[D].Nanning: Guangxi Medical University, 2015.

[16] 秦善春，陶燕霞，李洪涛. 公立医院与社区医院医疗资源整合实施效果的调查[J].中国医药导报,2018,15（30）：48-51，57.

Qin SC，Tao YX，Li HT. Investigation on the effect of integrating medical resources between public hospital and community hospital[J]. China Medical Herald，2018,15（30）：48-51，57.

[16] 许欣悦，曾多，田玮，等.北京某三甲医院预约挂号对患者候诊时间的影响分析[J].中国医院管理，2015，35(10):38-40.

Xu XY, Zeng D, Tian W. Analysis of reservation registration effect on outpatient waiting time in One Grade 3 First-class Hospital[J]. Chinese Hospital Management, 2015, 35(10):38-40.

服务与反馈：

【文章下载】【加入收藏】

提示：您还未登录，请登录！点此登录