精益管理和平台赋能改善消化内镜中心的运营效果评估:基于中断时间序列分析OA
Evaluation of lean management and platform empowerment in improving the operational performance of a digestive endoscopy center:an interrupted time series analysis
目的 评估精益六西格玛管理和信息化平台在多院区模式下消化内镜中心运营改善中的实施效果,为提升整体运行效率与患者满意度提供实践依据.方法 2023年4月,医院消化内镜中心采用精益六西格玛管理模型与一体化预约平台进行管理改革.收集2022年7月—2025年7月内镜中心的预约天数、预约数、完成数、取消率、诊室日均完成数等核心指标,通过中断时间序列模型分析改革效果.结果 实施管理改革措施后,预约天数立即显著缩短了4.86天(β2=-4.86,P=0.006),每月额外减少0.44天(β3=-0.44,P＜0.001),完成数的趋势发生显著的积极变化(β3=263.15,P＜0.001).诊室日均完成数在改革后瞬时显著提升1.58个(β2=1.58,P=0.015),改革前后均呈上升趋势(β1=0.64,P＜0.010;β3=0.18,P＜0.001).改革后取消数(β3=-15.27,P=0.004)和取消率(β3=-0.01,P＜0.001)的斜率均呈下降趋势,完成率变化趋势改善(β3=0.62,P=0.016).结论 多院区模式下的消化内镜中心采用精益六西格玛管理与一体化预约平台,可较大程度改善资源利用率、系统吞吐量和患者的就医体验,实现了多院区资源均衡与效率提升,为大型医院多院区同质化、高效化运营提供了实践依据.
Objective This study attempts to evaluate the implementation effectiveness of Lean Six Sigma management and an integrated appointment platform in improving the operational performance of a digestive endoscopy center under a multi-campus model,and to provide empirical evidence for enhancing overall operational efficiency and patient satisfaction.Methods In April 2023,the hospital's digestive endoscopy center implemented management reforms using the Lean Six Sigma model and an integrated appointment platform.Core indicators were collected from July 2022 to July 2025,including appointment waiting days,number of appointments,number of completed procedures,cancellation rate,and average daily completions per procedure room.The effects of these reforms were analyzed using an interrupted time series(ITS)model.Results Following the implementation of the management reforms,the appointment waiting days were immediately and significantly reduced by 4.86 days(β2=-4.86,P=0.006),with an additional monthly reduction of 0.44 days(β3=-0.44,P＜0.001).The trend in the number of completed procedures showed a significant positive shift(β3=263.15,P＜0.001).The average daily number of completions per procedure room increased significantly by 1.58 immediately post-intervention(β2=1.58,P=0.015),with upward trends observed both before and after the reform(β1=0.64,P＜0.010;β3=0.18,P＜0.001).After the intervention,both the number of cancellations(β3=-15.27,P=0.004)and the cancellation rate(β3=-0.01,P＜0.001)showed decreasing trends in slope,and the trend in completion rate improved(β3=0.62,P=0.016).Conclusion The application of Lean Six Sigma management and an integrated appointment platform in a multi-campus digestive endoscopy center can substantially improve resource utilization,system throughput,and patient experience.This approach facilitates resource balance and efficiency enhancement across multiple campuses,providing empirical evidence for the homogenized and efficient operation of large multi-campus hospitals.
陈金祥;祁宝琦;宋燕;邵维君;陈漪;庄旭
上海交通大学医学院附属仁济医院,上海 200127上海交通大学医学院附属仁济医院,上海 200127||清华大学医院管理研究院,广东 深圳 518055上海交通大学医学院附属仁济医院,上海 200127上海交通大学医学院附属仁济医院,上海 200127上海交通大学医学院附属仁济医院,上海 200127上海交通大学医学院附属仁济医院,上海 200127
医药卫生
一院多区消化内镜精益六西格玛一体化预约平台中断时间序列分析
multi-campus hospital modeldigestive endoscopyLean Six Sigma managementintegrated appointment platforminterrupted time series analysis
《健康发展与政策研究》 2026 (2)
202-208,7
国家卫生健康委医院管理研究所医疗质量(循证)管理研究项目(YLZLXZ23K008)
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