Time in Motion - Testing Efficiency in the Dermatology Procedure Setting
Time in Motion - Testing Efficiency in the Dermatology Procedure Setting
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DOI：
10.1111/j.1524-4725.2009.01076.x
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发表时间：
2009-03-01
影响因子：
2.4
通讯作者：
Henderson, Catriona
中科院分区：
文献类型：
--
作者：
Fisher, Jonathan;Lotery, Helen;Henderson, Catriona
运动时间研究是确定效率和识别复杂工作环境中延迟来源的有效手段。这种分析技术被应用到皮肤外科服务提供的一所大学医院的皮肤科departmentofdermatology.Objective找出任何来源的低效率在皮肤外科服务的提供，并提出建议，以提高efficiency.METHOD三种类型的皮肤外科手术会议观察（顾问主导的程序列表，护士主导的程序列表，皮肤科日间手术列表）。工作人员的活动，注意到每2分钟在整个会议，并在Microsoft Excel.RESULTS的结果显示，皮肤科患者的治疗与日间手术的效率和成本效益比其他设置的数据进行汇编处理。由顾问主导的程序清单效率最高。护士主导的会议费用较低，但效率也低于领事馆主导的名单。文书工作和一般沟通被确定为非手术时间的主要组成部分。结论皮肤科手术最有效的设置是顾问主导的手术列表。文书工作和一般通信被确定为服务延迟的来源。对这些问题的可能解决办法提出了建议。我们展示了广泛的，客观的实践评估的优势，而不是数字目标驱动的方法，未能解决具体方面的效率。
BACKGROUND Time-in-motion studies are validated means of determining efficiency and identifying sources of delay in a complex working environment. This analysis technique was applied to the dermatological surgical services provided by a university hospital department of dermatology.OBJECTIVE To identify any sources of low efficiency in dermatological surgical service provision and to make recommendations for increasing efficiency.METHOD Three types of dermatology surgical sessions were observed (consultant-led procedure list, nurse-led procedure list, and dermatology day-surgery list). Activities of staff were noted every 2 minutes throughout the sessions, and the data were compiled for processing in Microsoft Excel.RESULTS The results show that treatment of dermatology patients with day surgery was less efficient and cost effective than the other settings. Consultant-led procedure lists were the most efficient. Nurse-led sessions were less expensive but also less efficient than the consultant-led lists. Paperwork and generic communication were identified as major constituents of non-operating time.CONCLUSIONS The most efficient setting for dermatological procedures is the consultant-led procedure list. Paperwork and generic communication are identified as sources of service delay. Suggestions are made regarding possible solutions to these problems. We demonstrate the advantages of broad, objective appraisal of practice as opposed to numerical target-driven approaches that fail to address specific aspects of efficiency.