【作者】 张健；

【导师】 贾建民；

【作者基本信息】 西南交通大学 ， 工商管理， 2013， 硕士

【摘要】 随着我国医药卫生体制改革的逐步深化,国内医疗市场竞争日益激烈。社会经济的不断发展,患者对医疗护理服务期望值不断提高,需求呈现多元化发展趋势。医院面临正在发生变化的内外部环境,只有提升医疗护理服务质量,提高管理效能降低运营成本,才能赢得核心竞争力,实现经济和社会效益双丰收。手术室是医院的核心部门,是外科系统运转的枢纽,流程的瓶颈。手术室建设成本高,医疗资源密集,如何充分利用和有效运转手术室有限的人力与物力资源,提高手术室医疗护理工作质量,为患者提供增值的医疗护理服务,提高患者满意度；大幅度减少手术室人力、物力和设备的闲置时间,手术周转时间,减少库存和流程中的浪费现象,降低手术室的运营成本,成为手术室乃至医院管理工作的当务之急。本文的研究目的在于利用精益管理的理论和方法,针对SC医院手术室运营现状进行分析并实施改进；对SC医院实施精益管理提升手术室效率的实践及效果进行分析,从而为SC医院更好的应用精益管理提升手术室效率提供建议,并为其他医院手术室效率提升的管理提供经验借鉴。本文将综合运用调查研究、文献研究、专家访谈及精益管理的技术和工具,简化SC医院手术室工作中的相关流程,消除一切浪费,节约手术室资源,有效减少手术患者的等待时间,缩短手术患者无效住院时间,降低患者费用,提高医院床位周转率和劳动效率。通过实施精益管理,识别和消除管理浪费点,优化和完善管理流程,手术医护人员责任更明确、工作更规范；首台手术准点下刀率从68%提高到90%；接送患者平均时间从40分钟减少到20分钟；手术护士为完成手术的平均准备时间较改善前缩短了约15分钟；术后手术患者滞留手术间现象得到了缓解；在未增加手术室人力物力资源的情况下,完成的手术量提高了6.65%；手术室护士、医生与患者的满意度显著提高(P<0.01)；手术室护士在参与精益化管理实践中,逐步树立起了“消灭浪费、精益做事、持续改善”的精益思想和质量意识,提高了他们发现问题、解决问题的能力,激发了他们的管理活力,提升了手术室工作效率。SC医院手术室通过运用精益管理,很好地优化了手术室接台手术流程,提高了手术室护士工作积极性和协调性,改善了全体员工的满意度。通过本项目的实践,我们认为精益管理应用于手术室效率的改善,既能产生明显的改善效果,又具有较强的操作性。更多还原

【Abstract】 Along with the gradually deepening the reform of medical health system, the domestic medical market competition is increasingly fierce. Patients with the continuous development of social economy, the expected value of medical care service is improving continuously, the demand for present diversified development trend. Hospitals facing is changing internal and external environment, only improving the quality of medical care services, improve management efficiency to reduce operating costs, to win the core competitiveness, achieve economic and social benefits double harvest.Operating room is the core of the hospital, is a hub of the surgical system work, the process bottleneck. Operating room construction cost is high, the medical resource, how to make full use of the efficient and effective operation and the operating room limited human and material resources, improve medical care quality of work, provide value-added services, medical care for patients to improve patients’ satisfaction; Greatly reduce human, material and equipment idle time, turnaround time, reduce inventory and waste phenomenon in the process, reduce the operating costs of the operating room, operating room and the priority of hospital management.The purpose of this study lies in the use of lean management theory and method, in view of the SC hospital operating room operation present situation carries on the analysis and implementation of improvement; For SC hospital implementation of lean management, promote efficiency of operating room and effect were analyzed, and the practice of hospital is better for SC provides Suggestions for the application of lean management, promote efficiency of operating room, and for other hospitals to provide experience for the management of operating room efficiency.This article will combination of survey research, literature research, expert interview and lean management techniques and tools to simplify the SC in the work of the hospital operating room related processes, eliminate all waste, save operating resources, effectively reduce the waiting time for surgery patients, shorten the surgery patients with invalid length of hospital stay, reduce the cost of patients, improve the efficiency of hospital beds turnover and labor. Through the implementation of lean management to identify and eliminate waste management, optimize and improve the management process and operation staff responsibility more clear and work specifications; The first calibration point cut rate increased from68%to90%; Transport in patients with an average time reduced from40minutes to20minutes; Average surgery nurse to complete the preparation time is shorten by about15minutes before the improvement; Postoperative surgical patients eased stranded phenomenon between surgery; Without any increase in the operating room human resources, complete since increased by6.65%; Operating room nurses, doctors and patients’ satisfaction increased significantly (P<0.01); In operating room nurses participate in lean management practice, gradually set up a "elimination of waste, the lean work, continuous improvement" of the lean thinking and quality consciousness, improve their ability to find and solve problems, stimulate their management vitality, improve the working efficiency of the operating room.SC hospital operating room through the use of lean management, optimize the operating room after surgery process well, improve the operating room nurses working enthusiasm and coordination, improved the satisfaction of all employees. Through the project practice, we think the lean management is applied to the improvement of operating efficiency, can produce obvious improving effect, and has stronger operability.更多还原