宋亚军，何亦红，范荣林

(东阳市人民医院，浙江 东阳 322100)

·医院管理·

应用TPS方法缩短首台择期手术患者在手术室的等待时间

宋亚军，何亦红，范荣林

(东阳市人民医院，浙江 东阳 322100)

目的：应用TPS方法缩短首台择期手术患者在手术室的等待时间。方法：成立由麻醉医生、手术室护士、外科医生、护理部主任组成TPS改善小组。通过问题与背景分析、现状把握、流程现状分析、目标设定、确定数据类型，分别对30例病人进行改善前后数据根本原因分析，确定解决问题的方案。结果：30例病人应用TPS方法改善后， 首台手术病人切皮前在手术室的等待时间平均缩短了13.1分钟，等待时间降低了23.3%，差异有高度统计学意义(P<0.01)。结论应用TPS方法缩短首台择期手术患者在手术室的等待时间，有效利用手术室人力物力资源，使流程合理化，降低了医院的运行成本，减少医疗资源浪费。

TPS方法；缩短；手术；等待时间

Abstract: [Objective] Using the method of TPS to reduce the waiting time in operating room of the first operated patients of elective operation. [Method] The improvement group of TPS including anaesthetists, theatre nurse, surgeons and director of nurse was established. We analyzed the fundamental reasons of changes in 30 patients’ data before and after improved. The methods of analysis included problem and background analysis, grasping actuality, analysis of flow actuality, aim enactment and determining data type. Then, the solution was made. [Result] Compared with the waiting time before improved, the waiting time in operating room of the first operated patients before incision of skin is reduced 13.1minutes (23.3 percent in average) after TPS improved. There is a remarkable difference by t test(P<0.01). [Conclusion] Using the method of TPS can reduce the waiting time in operating room of the first operated patients of elective operation. TPS can make use the operating room’s resources be utilized effectively， the operation procedure more rationalization, reduce the running cost of hospital and reduce the waste of medical resources.

Keywords:TPS；reduce ；operation；waiting time

随着现代医学的发展和医疗体制改革的深入，一个有竞争力的医院应该具备“高的质量、最快的速度、最低的价格”向病人提供医疗服务的能力，而这个能力取决于医院核心业务流程效率的能力。丰田生产方式(Toyota Production System，TPS)是提高流程效率行之有效的工具，它的目标是：以低成本、高效率、高质量地进行生产，最大限度地使顾客满意，其核心理念是消除浪费、持续改善。医院手术室作为医院外科系统核心业务的主体，如果其流程效率不高不仅会延长病人无效住院时间，增加经济负担，而且将直接影响医院的经济效益和社会效益[1]。缩短首台手术在手术室的等待时间是一个高效率的手术室应有的特性，同时也是影响手术室利用率的重要因素，更是有效利用手术室人力物力资源、降低成本、减少浪费的基础。……