| Summary: | 碩士 === 東海大學 === 工業工程與經營資訊學系 === 101 === In the medical center of middle Taiwan (called TVH in this study), patients often face a long wait for radiological examination, e.g. a one-month waiting average for Magnetic Resonance Imaging (MRI) scan and half-month waiting average for Computed Tomography (CT) scan. The prolonged waiting can cause patient's sense of insecure and increases the risk of delay in diagnosis and treatment. Based on system simulation and analysis of annual value, this research has provided plans which are useful in improving the efficiency of radiological examination and increasing the economic values.
According to routine procedure of radiological scans in TVH, we plot the current value stream mapping (VSM) to obtain the cycle time for all the working spots in both MRI and CT scan, by which we find out the waste during the process, analyze the problem, plot the fishbone diagram and develop different improvement methods.
To evaluate the relative efficiency of different methods, we conduct a system simulation and an analysis of annual value for all the proposed methods. First of all, we input the collected data and parameters into the simulation model and verify that it matches the practical setting of MRI and CT scan. Then, we input the proposed improvement methods into the simulation model and conduct an analysis of annual value to obtain improvement outcomes.
Simulation study indicates that for MRI, if we add two four-hour work radiologists to night shift (plan A), patient's average waiting time can be reduced by 5 days, 2160 more patients can have a MRI scan annually, and the economic value can be increased by $15,858,260. By adding one machine, patient's average waiting time can be reduced by 7 days, 2880 more patients can have a MRI scan annually, and the economic value can be increased by $9,357,917 if a new machine is purchased (plan B1) and increased by $6,335,475 if a rental machine is used (plan B2). For CT scan, if we add one nurse (plan A), patient's average waiting time can be reduced by 2 days, 1358 more patients can have a CT scan annually, and the economic value can be increased by $4,101,132. By the increase in working time of two hours per day (plan B), patient's average waiting time can be reduced by 7 days, 7190 more patients can have a CT scan annually, and the economic value can be increased by $18,041,660.
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