The Development of the Evaluation Method of University Hospital Management in the 21^<st> Century Based on the Time-motion study

大学医院有三大使命：医疗实践、医学研究和医学教育。本研究以时间运动研究为基础，探讨目前大学医院医疗照护实习制度之特性与未来展望。(1)实际工作特性之调查：本研究在三年期间，以大学医院、综合医院及肿瘤中心为研究对象，进行时间运动研究。分析了工作类的频率和周期性，提出了新的分类术语。设计了护士总工时的估算方法。分析了护士在病房的转运情况。对引进全电子病历系统的效果进行了调查。(2)病人护理需求公式的发展：调查病人的医疗状况与医疗时数的关系，提出新的病人护理需求公式。(3)时间运动研究辅助软件的开发：为了使时间运动研究数据的分析更加方便、简单，开发了辅助系统。(4)日常护理工作安排的合理性评价：合理的工作安排有助于减少病区医疗差错的发生。提出了护理工作安排的新概念。

A university hospital has following three missions, medical care practice, medical research and medical education. In this study, we investigated the current characteristics and the future view of the medical care practice system in the university hospital based on the time motion study.(1) Investigation of actual working characteristics : We conducted time motion studies in university hospital, general hospital, and cancer center during the three years. The frequency and the periodicity of the job-class was analyzed and new classification terms were proposed. The estimation method for the total working hours of a nurse was contrived. The transit of nurse in a ward was analyzed. The effect of the introduction of the full electric medical chart system was investigated.(2) The development of the formula of the patient's care demand : The relation between the patient's medical status and the medical care hours were investigated and new formula for the patient's care demand was suggested.(3) The development of assisting software for the time motion study : In order to analyze more easily and simply the time motion study data, assisting system was developed.(4) The evaluation of the goodness of the arrangement for the daily nursing job : The adequate scheduling of work would help to reduce the medical error in a ward. A new concept presenting the arrangement for the daily nursing job was proposed.