社團法人臺灣臨床藥學會

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【原著】精實六標準差在醫院藥品庫存管理探討及分析
A Probe into Application of Lean Six-Sigma in the Hospital Pharmaceutical Inventory in Feasibility Analysis
六標準差、精實生產、精實六標準差、DMAIC、FMEA、EOQ、Six Sigma, Lean Production, Lean Six-Sigma, DMAIC(Define, Measurement, Analysis, Improvement, Control), FMEA---(Failure Mode and Effects Analysis), EOQ--- (Economic Ordering Quantity)
湯淑貞Shu-Chen Tang1 、廖茂宏Mao-Hung Liao2 、李主成Chu-Cheng Lee*3
1天主教耕莘醫院會計室主任 、2天主教耕莘醫院人資室主任 、3天主教耕莘醫院藥劑部主任
背景:六標準差品質系統在美國醫療院所上已經逐漸受到重視,並被視為提升醫療服務品質的重要工具。將「精實生產」和「六標準差」兩者結合的新興管理方式-精實六標準差,   成為改進產品和流程品質、生產效益及全面獲利的最佳方式。
方法:本研究結合「精實方案」及「六標準差」理論基礎,導入藥品庫存管理。透過「精實方案」之減少浪費理念進行流程調查及簡化,運用 ABC 庫存管理,找出重要 A 類藥品。再以「六標準差」DMAIC 步驟,加以改善庫存管理問題。使用 FMEA  分析,比較採取行動前後差異。在庫存成本方面,使用 EOQ 模式解決庫存管理問題。
結果:在 FMEA 風險優先度衡量,實施後較實施前改善;藥庫各項 A 類藥品的最高庫存成本由 23,367,862.84 元,降至 10,889,103.08 元,降低 12,478,759.76 元。藥局各項 A 類藥品的最高庫存成本由 10,856,171.8 元,降至 9,732,836.94 元,降低 1,123,334.86 元。
結論:本研究將精實六標準差應用於醫療產業之藥品管理,並由正確績效改進基礎支援的情況下,結合精實方案和六標準差所產生的綜效,降低庫存成本及改善庫存管理的問題。

Backgrounds: The Six Sigma geared quality system is gradually gaining increasing emphasis in the hospitals and clinics in the United States and is deemed as a key tool to upgrade the quality of medical care & treatment services. The method that combines the “Lean Production” and “Six Sigma” into a whole as a newly emerged method, known as “Lean Six-Sigma”, now becomes the optimal choice to upgrade the quality of products and process, production efficiency and overall profitability.
Methodology: The present study brings the rationale of “Lean Project” and “Six Sigma” into a whole, guiding the combination into the pharmaceutical inventory control. By means of the survey and streamlining with the concept of “Lean Project” to minimize waste, using ABC inventory control, it tries to locate Category A pharmaceuticals. Further by means of the step of “Six Sigma” DMAIC (Define,
Measurement, Analysis, Improvement, Control), it will better and inventory control and solve the problems. Using FMEA(Failure Mode and Effects Analysis) analysis, it compares with the differences before and after actions. In the aspect of inventory costs, it uses EOQ(Economic Ordering Quantity) model to solve problems in inventory management.
Results: In the priority measurement of FMEA (Failure Mode and Effects Analysis) risks, results of betterment were significantly seen compared with the performance before enforcement. In the pharmaceutical inventory, the inventory costs of all pharmaceuticals in Category A came from the highest of NT$23,367,862.84 down to NT$10,889,103.08, dropping by 12,478,759.76. In pharmacies, the inventory costs of all pharmaceuticals in Category A came from the highest of NT$10,856,171.8 down to NT$9,732,836.94, dropping by NT$1,123,334.86.
Conclusions: The present study is intended to have Lean Six-Sigma applied to management of pharmaceuticals in the hospitals and clinics. By means of accurate improvement of performance and fundamental support, combining the concerted performance (synergy) yielded by the Lean Project and Six Sigma, it will try to bring inventory costs down and solve problems in inventory management.
 
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