运用精实方法提升新生儿重症监护室人力运用效能

Improve the Human Performance of Neonatal Intensive Care Unit by Using Sophisticated Methods

目的运用精实方法,整合夜间作业,减少不必要的浪费,使护理工作简单化,合理化,工作流程顺畅,降低大夜班护理人力耗用及经营成本,提升护士工作满意度,增进工作效能。方法调查本院2016年2—12月NICU大夜班工作内容,罗列工作细项及流程表,透过团队讨论减少不必要的浪费,对比同级医院工作方式,组织医护团队协商各项处置执行时机,对每个细项进行于以标准化,以目视化执行避免信息化不足及共享改善成果,解决根本问题。结果 2017年2—5月,以占床率80%计算,平均为27床,大夜班人力可缩减1~2人。平均每人每月减少2个大夜。改善后大夜班工作耗时(309.98±0.02)分钟/人,较改善前(579.96±0.04)分钟/人,减少(269.97±0.03)分钟;人员对工作流程及夜班工作满意度由改善前60.00%提升至85.00%。结论利用精实方法检视作业流程和工作内容,可以减少大夜班工作,提高人员满意度,进而强化整体医疗服务质量。

Objective To improve the job satisfaction and improve the working efficiency of the nurses by using the precise methods,the operation at night,reducing the unnecessary waste,simplifying the nursing work,rationalizing the work flow,reducing the labor consumption and operating cost of the night shift nursing,improving the job satisfaction of the nurses and improving the working efficiency.Methods To investigate the work contents of the night shift of NICU from February 2016 to December 2016,to list the work details and the process table,to discuss and reduce unnecessary waste through the team discussion,compare the working methods of the hospital in the same level,and organize the medical care team to negotiate the disposal execution time.Carry out standardization for each fine item to visually perform the avoidance of information deficiency and share change good results,and solve the fundamental problems.Results From February 2017 to May 2017,80%of the bed rate was calculated,with an average of 27 beds,and the labor of night shift could be reduced by 1~2 persons.An average of 2 nights per person per month.After the improvement,the working time of the night shift(309.98±0.02)minutes per person,before the improvement(579.96±0.04)minutes per person,decreased(269.97±0.03)minutes,and the satisfaction of the personnel to the work process and the night shift was raised from 60.00%to 85.00%.Conclusion The work flow and work content can be viewed by using the precision method,and the night shift worker can be reduced to do,improve staff satisfaction,and then strengthen the overall quality of medical services.