静脉用药调配室应用六西格玛管理的效果研究

Study on the effect of Six Sigma management applied in Pharmacy Intravenous Admixture Service

目的研究分析静脉用药调配室（PIVAS）应用六西格玛管理在优化工作流程，提高工作效率方面的效果。方法2015年1月起，本院静脉用药调配室的管理开始运用精益六西格玛管理理念，根据六西格玛五步法，界定并测量本院目前PIVAS工作中的非增效因素，然后针对性的制定相应的改进措施。在六西格玛管理过程中，针对包括医院电子信息化、PIVAS药品物品摆放布局问题、调配人员的工作分工协作、科室药物送药的及时性准确性共四个非增效因素进行了整改优化。结果运用六西格玛管理优化后，本院静脉用药调配室的药品配置完成时间和药品送达科室的完成时间较优化前明显提早，让科室静脉药品的及时供应更有了保证。而静脉用药调配室的药品调配速度达到114．8袋／人比优化前的85．4袋／人明显加快，而差错几率为0．65％与优化前的2．78％相比显著降低，差异均有统计学意义（均P〈0．05），工作效率和工作质量都有了很大程度的提升。结论在静脉药物调配中心，运用六西格玛理念实施管理，对工作流程实施优化，显著提高工作效率，降低送药错误几率，保证药品能够准确及时的送到科室病区。

Objective To study and analyze the effect of Six Sigma management in optimizing work flow and improving work efficiency in Pharmacy Intravenous Admixture Service （PIVAS）. Methods Since January 2015, Lean Six Sigma management concept had been applied to the management of PIVAS in our hospital. According to the five steps method of Six Sigma, the non synergistic factors of PIVAS in our hospital were measured and defined, and the corresponding improvement measures were made. In the Six Sigma management process, a total of four non synergistic factors including electronic information for the hospital, PIVAS drug items layout, work division and cooperation of personnel department, timeliness and accuracy of drug delivery were rectified and optimized. Results After the optimization with Six Sigma management, the completion time of drug allocation and the completion time of drug delivery to department in our hospital shorten obviously, which ensured timely department intravenous drugs supply. The drug dispensing speed in PIVAS obviously improved after optimization （114.8 bags per person vs. 85.4 bags per person）, and the error probability significantly decreased after optimization （0.65% vs.2.78%）, with statistically significant differences （P〈0.05）. The working efficiency and quality improved significantly. Conclusion The implementation of Six Sigma management in PIVAS can optimize the work flow, significantly improve the work efficiency, reduce the error rate of drug delivery, ensure that drugs can be sent to the department ward accurately and timely.