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目的评价精益六西格玛法对某院医疗废物管理进行干预的效果。方法调查某三级甲等医院住院病区和手术室的医疗废物处理相关情况,并随机抽取13个住院病区作为试点。2014年12月—2015年3月为干预前,了解医疗废物管理现状的基线数据,2015年4—7月为干预后,利用精益六西格玛法规范医疗废物的分类、处置流程,并对改进效果进行评价。结果医疗废物处理费用影响因素分析结果表明,共有7项影响因素且呈4级递进结构,管理部门间职责不明确为根源层,从而导致医疗废物分类标准不统一,最终影响医疗废物处理的费用。试点病区和手术室的医疗废物分类合格率分别由干预前的69.22%、71.88%上升至干预后的80.42%、81.00%,差异均有统计学意义(均P<0.01);医疗废物重量试点病区由(1.11±0.14)kg/床日下降至(0.91±0.18)kg/床日,手术室由(10.77±0.33)kg/床日下降至(7.26±1.04)kg/床日,差异均有统计学意义(均P<0.05)。效益成本比为6.09,即医院投入1元可以节省6.09元。结论通过精益六西格玛管理方法,可以有效降低每床日医疗废物重量和花费,具有一定的卫生经济学价值。
Objective To evaluate the effect of Lean Six Sigma intervention on medical waste management in a hospital. Methods Investigate the medical waste treatment of hospital inpatient wards and operating rooms in a Class 3 first class hospital and randomly select 13 inpatient wards as a pilot. December 2014-March 2015 Prior to intervention, baseline data on the status of medical waste management were collected. After intervention in April-July 2015, the Lean Six Sigma process was used to standardize the classification and disposal of medical waste and to improve the results Evaluation. Results The analysis of the influential factors of medical waste treatment costs showed that there were 7 influential factors with a 4-level progressive structure and unclear responsibilities among management departments, which led to the disaggregation of medical waste classification standards and ultimately the cost of medical waste treatment . The percentages of medical waste classification in pilot ward and operating room increased from 69.22% and 71.88% before intervention to 80.42% and 81.00% after intervention, respectively (all P <0.01); the weight of medical waste pilot The ward decreased from (1.11 ± 0.14) kg / bed to (0.91 ± 0.18) kg / bed, and the operating room decreased from (10.77 ± 0.33) kg / bed to (7.26 ± 1.04) kg / bed. There was statistical significance (all P <0.05). Benefit cost ratio of 6.09, that is, the hospital invested 1 yuan can save 6.09 yuan. Conclusion The Lean Six Sigma method can effectively reduce the weight and cost of medical waste per bed and has certain health economics value.