ارائه یک مدل شبیه‌سازی گسسته ‌پیشامد برای بهبود کیفیت خدمات (مطالعه موردی در واحد اورولوژی یک مرکز فوق‌تخصصی کلیه)

نوع مقاله : مقاله پژوهشی

نویسندگان

1 کارشناسی ارشد مهندسی صنایع، دانشکده مهندسی صنایع و سیستم‌ها، دانشگاه تربیت مدرس، تهران، ایران

2 ) استادیار، دانشکده مهندسی صنایع و سیستم‌ها، دانشگاه تربیت مدرس، تهران، ایران

چکیده

زمان انتظار برای دریافت خدمات درمانی یکی از مهم‌ترین شاخص‌های رضایتمندی بیماران محسوب شده که تاثیر قابل توجهی بر اثربخشی و کیفیت خدمات ارائه شده به بیماران دارد. مطالعه شبیه‌سازی برای بهبود جریان بیمار، کاهش زمان انتظار و افزایش رضایت بیماران به عنوان یک ابزار مؤثر به‌کار می‌رود. مطالعه حاضر به بهبود کیفیت خدمات درمانی در یک واحد اورولوژی واقع در یک مرکز فوق‌تخصصی کلیه در تهران، پرداخته است. هدف از این مطالعه کاهش زمان انتظار، نرخ کنسلی بیماران و نیز افزایش کارایی فرایند‌های روش سنگ‌شکنی برون‌اندامی (ESWL) بوده است. یک مدل شبیه‌سازی گسسته‌پیشامد با استفاده از نرم‌افزار iGrafx توسعه یافته که از آن به همراه نرم‌افزار MATLAB، جهت تشکیل و ارزیابی سناریو‌های بهبود‌‌ دهنده واحد اورولوژی در سه دسته شامل تغییر زمان‌بندی حضور تکنسین‌ها در طی شیفت‌های کاری، تغییر زمان‌بندی مراجعه بیماران و نیز بررسی عوامل کاهش دهنده نرخ کنسلی بیماران، استفاده شده است. نتایج حاصل نشان‌ دهنده بیش‌ترین تفاوت در به‌کارگیری سناریو‌های زمان‌بندی مراجعه بیماران در معیار‌های زمان انتظار و طول مدت اقامت به میزان متوسط 23.33 و 22.81 دقیقه نسبت به وضعیت موجود است. علاوه براین، نتایج بررسی عوامل کاهش دهنده نرخ کنسلی بیماران، نشان‌دهنده کاهش در تعداد موارد کنسلی به میزان متوسط 1.44 مورد در روز می‌باشد. برای هر دسته از سناریو‌های پیشنهادی، اعمال تغییرات بر ‌اساس سناریوی برگزیده، بهبود قابل توجهی در معیار‌های عملکردی واحد اورولوژی ایجاد نموده که در این میان، تاثیر سناریو‌های زمان‌بندی مراجعه‌ بیماران در مقایسه با سایر سناریو‌ها به مراتب بیش‌تر بوده است. 

کلیدواژه‌ها


عنوان مقاله [English]

Developing a Discrete-Eevent Simulation Model for Improving the Quality of Services: A Case Study in Urology Unit at a Kidney Center 

نویسندگان [English]

  • Reza Mokhtarian Daloi 1
  • Bakhtiar Ostadi 2
1 e  M.Sc, Industrial Engineering, Healthcare Systems Engineering, School of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, Iran 
2 Assistant Professor, School of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, Iran,
چکیده [English]

 
The length of waiting time is considered as a key determinant of patient satisfaction level; besides, it has a significant impact on the effectiveness and quality of services which are provided to patients. In addition, Simulation study is also considered as an effective tool for improving patient flow, reducing waiting time and increasing patient satisfaction. Hence, in the present study we made use of simulation to improve the quality of health care in a urology unit which is a part of a kidney center in Tehran. Put differently, the aim of the current study was increasing the efficiency of Extracorporeal Shock Wave Lithotripsy (ESWL) method besides reducing the waiting times and the patient cancellation rates. Therefore, a Discrete-Event Simulation model was developed using iGrafx software, which was later used in conjunction with MATLAB software to form and evaluate the urology unit improvement scenarios in three categories: changing technicians’ presence schedules during different shifts, changing the schedule of patient visits, and examining the factors that reduce the patient cancellation rate. The greatest differences were resulted from the employment of scheduling scenarios of patient visits on waiting time and duration of stay with averages of 23.33 and 22.81 minutes, respectively. In addition, the results of examining the factors that reduce patient cancellation rate demonstrated that the number of cancellations were decreased with an average of 1.44 cases per day. In each category of proposed scenarios, applying changes based on the selected scenario of that category led to significant improvements in performance criteria of the urology unit. It is also worth mentioning that the impact of scheduling scenarios of patient visits was much higher than other scenarios. 

کلیدواژه‌ها [English]

  • Keywords: Discrete-Event Simulation
  • Improving the quality of services
  • Extracorporeal Shock Wave Lithotripsy (ESWL) method
  • Urology unit   
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