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題名 | 醫院氣送系統之氣送桶維修改善專案--以某區域醫院為例=Improvement of the Capsule in a Pneumatic Tube System in a Regional Hospital |
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作者姓名(中文) | 林宗茂; 柯清彬; 陳明晃; 陳家盈; | 書刊名 | 醫務管理期刊 |
卷期 | 11:2 2010.06[民99.06] |
頁次 | 頁146-154 |
分類號 | 419.27 |
關鍵詞 | 氣送系統; 氣送桶; 羊毛氈; 維修成本; Pneumatic tube system; Capsule; Wool felt; Maintenance costs; |
語文 | 中文(Chinese) |
中文摘要 | 目的:長時間使用氣送系統,氣送桶上的兩條羊毛氈會遭磨平,致使氣送桶與輸送管之間隙變大,造成氣漏現象,導致輸送速度變慢、氣送系統故障。本改善案的目的是在不影響輸送品質下,將氣送桶上之羊毛氈內凹槽以增厚方式,延長羊毛氈的使用壽命,減少氣送系統的耗材費和維修費用。方法:經團隊成員使用多種替代材料及方式試驗後發現,利用『絕緣膠布』墊厚氣送桶上、下羊毛氈之凹槽,再將已磨損之羊毛氈裝上,可以延長羊毛氈的使用壽命;因此用同一袋血液,製成40支標準檢體,將檢體隨機分配成兩組,做定點對定點的輸送,測試兩組之傳送時間差異。並收集改善前(2008年1月1日至8月27日止)及改善後(2009年1月6至8月31日止)的故障次數,估算改善前後的年耗材/維修費用差異。結果:一、在單趟輸送上,改良氣送桶的傳送時間比全新氣送桶平均慢2秒,但不影響醫療品質和病人安全;二、改善後比改善前故障率下降許多(p<0.001),達統計學上顯著差異;三、使用改良式氣送桶比使用全新氣送桶的年度耗材和維修費花費低,約可節省580,845元。結論:因爲影響故障次數的因素很多,本文是一個臨床情境實驗,無法對資料收集的場域做到完全相同的情境控制,試驗結果可提供醫務管理者對於氣送系統之改善決策的參考。 |
英文摘要 | Objectives: After a pneumatic tube system has been used for a long time, the two strips of wool felt on the capsule might be rubbed down. This would result in a space between the capsule and the pneumatic tube and lead to leakage of air, lower delivery speed, and failure of the pneumatic pipeline. Our objective was to thicken the groove in the wool felt on the capsule by an innovative method without affecting the quality of delivery, as well as prolonging the service life of the wool felt and decreasing the costs of material consumption and maintenance of the pneumatic tube system. Methods: After team members experimented with various substitution materials and methods, it was found that the use of "insulating tape" to thicken the bottom of the grooves in the wool felt (upper and lower) on the capsule could prolong the service time of the wool felt. We divided the same bag of blood into 40 standard specimens, and then randomly assigned these specimens to two groups in order to carry out fixed point-to-point delivery and test the difference in delivery time between the two groups. We counted the number of times the system failed before improvement (January 1~August 27, 2008) and after improvement (January 6~August 31, 2009) and estimated the difference in the cost of annual material consumption/maintenance before and after that improvement. Results: (1) For a single-trip delivery, the improved capsule was, on average, 2 seconds slower than the original capsule; however, this had no impact on quality or patient safety; (2) the rate of system failure after improvement was significantly lower than before improvement (p<0.001); (3) the cost for material consumption/maintenance after improvement was lower than before improvement, as it was reduced by NT580,845. Conclusion: Many factors can cause pneumatic tube system failure so that this solution may not work in every situation; however, it should be considered when improvement is needed. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。