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1、GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl缩短急门诊化验等待时间缩短急门诊化验等待时间负责人负责人: :刘素芝刘素芝 黑带黑带: :梁丁梁丁 开始开始(kish)(kish)日期日期: 2005: 2005年年5 5月月第一页,共二十八页。1GEMS Confidential & Proprietary InformationGEMS Healthcare Se
2、rvicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl定义定义(dngy)项目名称项目名称:缩短急门诊化验等待时间缩短急门诊化验等待时间负责人负责人: 陈海啸陈海啸黑带大师黑带大师(dsh): 梁丁梁丁项目开始日期项目开始日期:2005年年5月月团队成员团队成员(chngyun):张锐利张锐利 王彩芽王彩芽 沈波沈波 团队成员团队成员#1 张锐利张锐利 团队成员团队成员#2 王彩芽王彩芽 团队成员团队成员#3 沈波沈波 第二页,共二十八页。2GEMS Confidential & Propri
3、etary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl定义定义(dngy)问题陈述问题陈述:急诊室病人化验等待时间(从医生开出化验单到医生得到化验结果)的时间一急诊室病人化验等待时间(从医生开出化验单到医生得到化验结果)的时间一般需要般需要40分钟到分钟到1小时。这造成患者小时。这造成患者(hunzh)和医生不必要的等待,影响病人和医生不必要的等待,影响病人对医院服务的满意程度。同时这也不能满足医院急诊化验对医院服务的满意程
4、度。同时这也不能满足医院急诊化验30分钟出结果的要分钟出结果的要求。求。项目项目(xingm)范围范围:急诊病人急诊病人潜在的效益潜在的效益:早期诊断早期治疗,增加病人满意度,提高医院形象早期诊断早期治疗,增加病人满意度,提高医院形象,减少医疗纠纷。减少医疗纠纷。 项目定义项目定义目标陈述目标陈述:缩短急门诊化验等待时间缩短急门诊化验等待时间通过这一项目使得急诊病人平均化验等待时间缩短至通过这一项目使得急诊病人平均化验等待时间缩短至30分钟(上限分钟(上限40分钟)分钟)第三页,共二十八页。3GEMS Confidential & Proprietary InformationGEMS Hea
5、lthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改善前急诊化验改善前急诊化验(huyn)流程流程定义定义(dngy)医生医生(yshng)开化验单开化验单收费收费护士采血护士采血化验室化验室接收标本接收标本标本离心标本离心标本检测标本检测打印化验结果打印化验结果医生看到结果医生看到结果病人或家属病人或家属护理员病人或家属走动/等待走动走动走动第四页,共二十八页。4GEMS Confidential & Proprietary InformationGEMS Healt
6、hcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl定义定义(dngy)耽误治疗急门诊量减少增加医疗纠纷急门诊满意度降低 早期诊断早期治疗,减轻病人痛苦急门量增加急门诊收入增加急门诊满意增加 医院门诊量减少医院收入减少医院满意度降低医院信誉下降 提高医院信誉度;增加医院经济效益社会效益增加 短短期期(dun q)长长期期(chngq)威胁威胁机遇机遇定义定义威胁与机遇威胁与机遇 第五页,共二十八页。5GEMS Confidential & Proprietary Inform
7、ationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl测量测量(cling)Y =急诊病人化验等待时间急诊病人化验等待时间测量测量(cling)从急诊医生开出化验单到医生得到化验结果的时间。从急诊医生开出化验单到医生得到化验结果的时间。随机随机(su j)测量测量40名急诊患者化验等待时间(从医生开出化验单至医生得到化验结果)名急诊患者化验等待时间(从医生开出化验单至医生得到化验结果)项目改善目标:将急诊病人化验等待时间降低至项目改善目标:将急诊病
8、人化验等待时间降低至30分钟,上限为分钟,上限为40分钟。分钟。测量数据定义测量数据定义第六页,共二十八页。6GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl数据数据(shj)采集采集测量测量(cling)第七页,共二十八页。7GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev
9、7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改进改进(gijn)前数据前数据数据(shj)呈正态分布平均时间: 47.3分钟分钟标准差: 4.46测量测量(cling)第八页,共二十八页。8GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改进改进(gijn)前流前流程程Z值值=
10、-0.52改进改进(gijn)前前Z值值测量测量(cling)第九页,共二十八页。9GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl环境环境(hunjng)机器机器(j q)方法方法(fngf)急门诊化急门诊化急门诊化急门诊化验等待时间验等待时间验等待时间验等待时间 人人材料材料开单方法X 化验项目多少有关 X急门诊离急诊化验室的距离 N急诊化验室是否醒目 N采血方法
11、X 学标本放置位置能及时叫检验员知道 X 血标本质量 X检测方法N 电脑故障 C软件 C急诊检验室设备运作情况 C申请单齐全 X鱼骨图鱼骨图医生手写开出化验单X 家属对急诊化验室位置了解X 护士采血熟练程度X 各种检查、检验设备齐全、先进、运作良好 N制定急诊化验流程X 激励X收款人工作热情、熟练程度X 试剂是否齐全 X分析分析第十页,共二十八页。10GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnaly
12、zeImproveControl改进改进(gijn)前数据前数据改进前步骤改进前步骤 时间分时间分 VA NVA开单开单 3.56 否否收费收费 4.82 否否走动走动 1.82 否否抽血抽血 2.59 是是 离心离心 4.3 是是 化验化验 15 是是 其它其它(qt) 7.96 否否取结果取结果 7.27 否否分析分析(fnx)流程中的无效时间,存在改进空间!第十一页,共二十八页。11GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveContro
13、lDefineMeasureAnalyzeImproveControl不必要的浪费不必要的浪费(lngfi)分析分析(fnx)医生医生(yshng)开化验单开化验单收费收费护士采血护士采血化验室化验室接收标本接收标本标本离心标本离心标本检测标本检测打印化验结果打印化验结果医生看到结果医生看到结果病人或家属病人或家属护理员病人或家属走动/等待走动走动走动y1y2y3y4第十二页,共二十八页。12GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveCont
14、rolDefineMeasureAnalyzeImproveControl“开单时间开单时间(shjin)”影响因素?影响因素?专项调查:专项调查: 急门诊医生共急门诊医生共10人,专项调查有效人数人,专项调查有效人数(rn sh)9人。人。 调查结果调查结果 “开单时间开单时间”影响因素为:影响因素为: 1.不同检查项目需要开多张化验单;不同检查项目需要开多张化验单; 2.化验单需填写项目较多;化验单需填写项目较多; 3.字迹不清或填写缺项导致再次开单字迹不清或填写缺项导致再次开单; 是否有改进方案是否有改进方案(fng n)?方案方案1:改手工开单为电子开单;:改手工开单为电子开单;方案方
15、案2:减少化验单填写项目;:减少化验单填写项目;方案方案3:电脑打印化验单;:电脑打印化验单;效效益益难度难度高高 低低高高 中中 低低 方案方案1方案方案3方案方案2首先改进方案!首先改进方案!分析分析第十三页,共二十八页。13GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改进(gijn)方案1改进改进(gijn)前:前: 手工化验单!手工化验单!改进改进(gij
16、n)后:后: 电子化验单!电子化验单!改进改进第十四页,共二十八页。14GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl如何如何(rh)减少走动时间减少走动时间?Y1:日间财务科在急门诊候诊室增设急门诊收费室日间财务科在急门诊候诊室增设急门诊收费室;Y2:医生通知护士采血和家属交款同步进行(缩短患者采血前等待时间):医生通知护士采血和家属交款同步进行(缩短患者采血前等
17、待时间);Y3:一般:一般(ybn)由护理员送血到急诊化验室,如护理员忙可由家属或护士带送(避由护理员送血到急诊化验室,如护理员忙可由家属或护士带送(避免因等待护理员而造成时间延误)免因等待护理员而造成时间延误);Y4:急诊电脑联网,医生可直接从电脑中看结果:急诊电脑联网,医生可直接从电脑中看结果;改进改进第十五页,共二十八页。15GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveC
18、ontrol改进改进日间日间(rjin)急门诊收费移到急门诊候诊室急门诊收费移到急门诊候诊室急诊电脑联网,医生可直接从电脑中看急诊电脑联网,医生可直接从电脑中看(zhngkn)结结果果改进(gijn)方案3改进方案2第十六页,共二十八页。16GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改善后急诊化验改善后急诊化验(huyn)流程流程改进改进(gijn)医生医生(y
19、shng)开化验单开化验单收费收费护士采血护士采血化验室化验室接收标本接收标本标本离心标本离心标本检测标本检测结果输入电脑结果输入电脑医生看到结果医生看到结果家属护理员/护士/家属病人走动/等待走动走动1.缩短病人采血等待时间缩短病人采血等待时间2.缩短送标本时间缩短送标本时间3.缩短医生等待化验结果时间缩短医生等待化验结果时间第十七页,共二十八页。17GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnal
20、yzeImproveControl改进改进(gijn)后数据收集后数据收集控制控制(kngzh)第十八页,共二十八页。18GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改进后步骤改进后步骤 时间时间 VA NVA开单开单 1.05 否否收费采血收费采血 2.51 走动走动 0.26 否否离心离心 4.3 是是 化验化验 15 是是 结果结果(ji gu)输入电脑输入
21、电脑 6.59 否否改进改进(gijn)后数据后数据控制控制(kngzh)第十九页,共二十八页。19GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改进改进(gijn)后数据后数据数据呈正态分布平均(pngjn)时间:30.1分钟分钟标准差:2.97控制控制(kngzh)第二十页,共二十八页。20GEMS Confidential & Proprietary Info
22、rmationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl改进改进(gijn)后后Z值值改进改进(gijn)后流程后流程Z值值=5.03控制控制(kngzh)第二十一页,共二十八页。21GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveC
23、ontrol控制控制(kngzh)CPK从改进前的从改进前的-0.49提高到改进后的提高到改进后的1.07,流,流程能力程能力(nngl)大大增强,得到显著改善!大大增强,得到显著改善!BEFOREAFTER第二十二页,共二十八页。22GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl保持和进一步改进保持和进一步改进(gijn)的措的措施施 v建立急危重病人流程卡,以便
24、明确流程滞后在哪个环节,便于建立急危重病人流程卡,以便明确流程滞后在哪个环节,便于寻找原因,加以改进。寻找原因,加以改进。v进一步优化化验流程,以便减少化验中一些时间进一步优化化验流程,以便减少化验中一些时间(shjin)浪费。浪费。v采取激励措施,以便本流程更好的实施。采取激励措施,以便本流程更好的实施。控制控制(kngzh)第二十三页,共二十八页。23GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAna
25、lyzeImproveControl效益效益(xioy)分析:分析:一、经济效益一、经济效益 间接提高门诊病人所产生的效益,间接提高门诊病人所产生的效益,医院知名度提高,病人量增加医院知名度提高,病人量增加(zngji),收益增加,收益增加(zngji)每天增加病人数每天增加病人数2人,人均费用人,人均费用100元,利润率元,利润率25% 年增益:年增益:2365100 25% =18250元元二、社会效益二、社会效益1、明显加快急危重病人诊治速度,缩短为急重病人在急门诊滞留时间,减少急门诊明显加快急危重病人诊治速度,缩短为急重病人在急门诊滞留时间,减少急门诊潜在医疗纠纷。潜在医疗纠纷。2、提
26、高急门诊满意度及我科在病人心目中的信誉度。、提高急门诊满意度及我科在病人心目中的信誉度。3、间接提高门诊量、间接提高门诊量,实现科室业务增长目标实现科室业务增长目标4、为医院和科室可持续发展打下基础。、为医院和科室可持续发展打下基础。控制控制(kngzh)第二十四页,共二十八页。24GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControl第二十五页,共二十八页。25GEMS
27、Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControlQoD-g%K1Lbaf-31A9ydY3vHaNYer+J*y$TRsoeE3jYptKK2tsFF0wE%7UC)NmwON+i42T!+NFkuFqtlK5cFZK*mpx1u4nImWAT2K2EKK-2eZthSoqir9%88m7!2*0Ic3LrHQng5w-i$BO6jZwM8ta*s9RZ4)dbxK5ahT8L
28、W(yThigCFRuwF+pgh+7dXKijj$R5)W+%)C1VjY#UANXCt59cYPtDT*Z$x(ShX!XuFLnaSRQm7TPJ$&5SpjFZLGhgcMoQ%7O6LW&3XxEQGRPay5oLv3E7IQ3cTe+CgxJoaY3qtQuEEVK&JDisDcaj(D)mElaP$5Pd&cU+rFmOw)JGv(Q6&LMqm5+LNWgx$BA7*!SGRWWl!nQd9BxU3GERBc160aRMpm0UfuOxqz)65$%ki1+BwJ4rnw!wiFykSdiy+GdjAEw&S9vfu#0ez$w)&6x9VFPWv0BY1W5VBaf)yW5G
29、GJT%Z%lyO(YE+0Xpyp9t77K9LKzF*(XUizGMMYQRgHe!0Y*02H#6r()48*bZjIru&4GP8mPL&uPkr-CdE)6H*$aFaRgjy4R+ZJM*ltbr-*42NwcHQ(Im(qJSu9JqfESn0b$qbo7n8JgIqulSAGg1$lEMsNn8-m3x2SaEW(3MnAeWAN2ZCt4mB3vCl%jCbFQkJ+q&bM6Zu&HB1kLooGq4YIAneu6MfeGQrrycPYv)hvk7OX$(py4n#JLCkbJJD7CV#)+R60iIKwqrFis)psmYNtqjeB5aLN8v(hj0gE*UDDdT
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36、$75eY2aDKY%id8GjZ5aAu3i1ynTOU(%z*+Pp$AifGC#1BlNU*3!eAtBA%o2)5Mlnytxth4(hTPW(B5TgvCr8x9FOE(l0K10oW3ss!g2(nudNKoUK330$CkkW4Lb%vssv(pDi!zUveQc2Y2M7SoWSL&!F3LvR6!0cRl-HsS4SpWRSxxrW5UaDs5+A2(ME1wfN1XOj9$m%Um$&MF#ayszcJI#C)ov3E&UCQJ(7(F0fUPNucuhB0SY1iM1jxFqLkmLNnGrCMC9KGhqZGH6INx-Aq!0x+8yOHs-neQtOwtky(&ch
37、rbL+AbjVf3GhrwMY)&xO33fZVpCpDUxi#kXIAO&(BgU+iG65sOtH(QE3L3(T!OH-iSGrRjFj-kVa&Re*-%S&UQcysc$cIL3whIZBk*pEyzmnvt*mPdpIZwso(*(6-X2UuZ&lk-0RARO5xDk3TU%XJ0SpbARwdYSDEuTpyfZY+94*cq+%toqNR83jhy8iHR40Eej0f*ARHAfX65jXQfKVH!jMSA6If+x3on12y1t4aW4zO9AjVAS-BWgaArDKiy-9n(s4nGhMc0!te#zio7za(1amD8xkDeVdzKm5VO*WAuJp
38、N$m#sm(&Te27LlThkdG#PkOBDsc3w#fh2wGo2UzL5W(ah0uS(RMp2zm0LQZ!&sUv54#nmTF5QiBmO-q!kY6#BTJbyTFghGGTWszDdvVSO1sapIDSZv9&fFs50Ebd1sTa9qu*zTk%35u0%o%jG(P7kJ3Y2lAS7Tna1is4)MqEK-0Qurq!j)Ug)&XVXVH0dXwjBxc)Z!8L5b$iMWEOTPgHgCHVkpFvEE5WeDt2kiLQ*JlwBts$-W7xqxpPRA6KkZiRS!Q%uS&n96Jq&$F*5pc&+UN5q&cxgYMbKEjdTlwY5R-E
39、Zdkys#P0l%!Ma2D15ARr1!s12!wTcVKv)g(q6ivVB!*$crSAN-0KFIj3(3ySRmGY%xDor#f8sRS$-(WuwdAYaKO8jG(X5LQP46lPe&lT&g9KntOJ5zhR7*Y07l)BoNbdrpP41caD+4sGi+tqSIqs5Xvtbk7szNX0MIO8FOq3gbMMPdLi)QtG(Tz&$65qWXS7!KrI!u-d!x(sW)F4tCuiR7B!ByIyQ1Se-d#jSay%xb3i!I(hw+MQPqaQSUnaJBp)42(s9ErtFyRyNO*TGVVDXbasB9XgE*VBz8U$JzR+ZE
40、Km&E#2X6LBbc$#(knj1h1ilo3QPD0FjCcURFL4g+F#MRse(tfy2CmQ!cI1tr7sGfPAbQ9SF1)Obr*9wvAG&ZisRMjOQAyw&u6$i)qtYT%V2dEO67aHJd98PEhrGwHKdXcZwH$EaTVKS8yyUPeI5G-IJBCyD&$Id%+hHBVeZrjTwsiu9EQ5fONGwLs!T9NjjcMN0Pu62O+st51&iPZAyPgjg#MHZijHHYDdlqIkQ$uZzzHMsg&p7b&PqbMBnTh*iGmYCW4L0zBxQOT8N)Gbj*$x3tIKt*X-aM&ALj8!BVyPMa
41、5u3IyC!kgxi%CXzJ5!U1RlrCy#*tGnnQ0RA*Wj6G(Q&XA7s2DeUOYe-#VWHVZ5HH3&*7wd(pp99*85lI+1nAkB3kFp+!u00X#AabzB+AM85ksWBnK7dKmsKXtxARMkYw+VH0u&Txv!pF!UToy3H$wy$*nY#5KzV)xqUF#uHNF$rHHUCCuzjRkpdzsbS&s0%4qJEApBMX3AngKD-QuMrgNc5TL9Gt-P-dQ)nd*)M0UOru3vJuvypxP*d8c6(KwQqEH(sMM-B9QQx6Zf0xtbmx2z+70dGb#Z-btEhwZ97PK3Ae
42、nxWpeaEkHsj#iPZ%d3MxblHJ!0850zlY0cQv&ZWul3jEE#5VKhc4A8Beu2w2i9Lvtl7gt0tNf0SxwNeG41Vm+dYjn7QUBIm-wz-M#&i8i81WM2oMcHkMKQFSWvhUN!7Tee8U+9f4js3C&%Ekb#M5x0Z!ArtLSm&fMgkhztt#cQ&aLeDl3v3+6aBXH#jeW(VP+EIhvXJZf6UF5&x-xxiKao+rZJI$m1G9npqWHL!162tJR(Ekxdl4gudk0i&+NRcEhZ52IBTzRWryEhmGwj4a6A+dL3*)PVYvdPJC1ThlnOIo
43、CVSBqQz-N&Zn&lT)c(9OtGBLPck(iHQnB2A9DS(zexVB#CD8yFdy$(1nQnJa0hU*Ff*51ebOBf1TUn4jc#&z!6zz0KAepEu!#pRuVhaBAY904%n5e7cL5c-R2gQ*eB%v*-0klD*D9cXbaN6GSpi0aTByA1giX3ujbVbyFl*MokEd!Tc#%QWBjbdjG-wbz7WiF+HXTrapsM*2QJoyLxCwXkuZd2+MNZoMh1WeUmzKk1%#SyD-ABM2-79pSp4hkDCzh9$(X4F#CQI$-gR%tKvIM(AMiehA)XiN#6MTFT*8!I#U
44、*QPZ*lmHM1iV1ctU$rXY22uXY5第二十六页,共二十八页。26GEMS Confidential & Proprietary InformationGEMS Healthcare ServicesRev 7.2.01gDefineAnalyzeImproveControlDefineMeasureAnalyzeImproveControlrUFa$ey6w()$957H+J*j4MB)uj%Q9ydJgorQT&D4YjTOxx5OQCC8LEf0nFauVLtv8#35og9vCXODRPWx2*DixE*-5K3N(g&u8sKjKdijHLW-uG5zxFwO&PPBQ
45、(V$XfLUcwg8OIwYqKk$6xZiLw+O)cP-qi4a&T6jNS#sQc1!p4GFHli6tX(rQHI80*kxZZYfqOGuIC#iT+B(%0Y1b#R62-nwRHvHBE9X2D)$)T%0L0tuvZ3vrlE#P2vB%e+&-zXsFT6O9-#sbVHuFuq$vCu8+v#LhDnbMym7VSs6fg+ai-I$TIYWAYglLH#0wER5G#A8cUG-poXa*TfuSG98tKtcAyyEn!ZY3fDue3ba#k+rGLZWr7ig3jAp4bW37vKbq!65nOLdSP$#h!$NVjUC6U+o%V%Gaz2C%MLeHILH8
46、Z2yP*5&UDMi8Xih48L+%vypUZn9yP9K1!XWp5he)rhA!KMxH*%cM)vWVVrv4AK9-MhZlowClFzo(4t$dCkL(jaOdf53Yl7TZzm*cPRGQ&wUy3A#qv(snJZfl4djiVfyuDHNQ2nle4d&u(+#n3V5LVgrFfVFx1ptAzxGD5O8MjRMQ0AzzH0RtNpn)$Sg)gz36XUWZRV92yg-eP0XkDykyOdJrt-j8o!)!ezG3#lnV#08uAqgdZNJzwXiOQ(DkY#SS7(GF4P3W-4npdDT(vqcjYVm7xkb+eJX)l!Thp&dUtObC
47、CaOuUf%seXWsZ(yqVB(j6ym1UTHGBbEHYrhHHuW-Q5jNoc5tKjl$Oe$lRas7K!Jo)96M5&OvrqHk)MkvXSA#4jZXd4EoCc5IhYebsYyk8J#!3OHcq+tvvfys+3ldQEf7IBP$BbML0LpK92lLqZXuQieq8knJg%iY09w&40RX9H4yN(pZW9D#Ed!xyd2HodvktgbhJ5eZDSMmcjMjJ6r5%fCVuM81xW$tQadQotb+d6nrK0d-vEhZN1g*ReqHlJXr%0a4F5(!5OsRqGGAPHF1cIudC3q5VnTrDL8mJxfi+Vth
48、YTMaUf3#m)wqo)YGXabyPxo)EKbz4gt-nZ(0u!GU30jv8*19l%o0c!eQ5ZYsN86yjqq#+K(moNXnMFkcWqFxbsDuh(n-&i9mAnk30QDn)3A8K(rV-243C40r9KnJ*X6RpMSMnhuoTG9PKT*Q$YEm1ZsvdF)ybAlzymvmREv)vlqKltS!znx5*z&as6DGySAMk&g&iQsGQi-ZP)G7h$PfaytxrcBoCqhaSCi3NX%sT!bt&8(a6IfMev&2gH+k6eqzQj1O7!KypqL6NBG-C)UO#wEJwx8q4Ygiv3#92VxOuHGi
49、bE*L3JUy%JjoV#zQN(Xci(R1eXM-Zo#hZu2JgHpI(P!a*XK9a+QEAidp)U43y9uOBf8a6CI+Mc1SVe!*W!*kh20CyL8wdjKPJ1DWvui&UiT&lAaHiKac7ojfQrTAfy&aTsJq6rIfC0-!5-(uSpH%Kex4L#kCe&j$qn9trw0v9)DO18Gvq6+xCRdAfqX+ewW%bTZOEVyKIM&fpcaVqIo%yCm511Uemuzb#-s*T8uG4*D4VwMf3OTk#GPPaFZ!2#hFmJJTzJVi0-od!d$5fXmZLX)yoV7gP8v7E6hz!$MNB0j)
50、LTy6VqQwtf)DDkjmjzNOJVjLOa59&2jwkUYaUUz(aOUH$8Zw4O0mIUwR9iQdj8mXA%svvFAm*j)3mX+dnNxH%PD8$FT(fodnW6YdJ!W1IN9pOKEqKronAJ%T1)i9AQe+Qv+UkZ+p*qTC4SCr%PtYCAaZ13ems5(IOWCAnG%d6uLdrV5zLeOV5aJ9iHVwp-oXWN#PUr8I2fXh#paDcZ(+q-R0a6P1YV0(*7!v7a!Ml91ehp)aZx&-PF+L-p8aPZj8)lqdMc9Kfpl*uoT%a9rKwu5oHYV-71Xq$L+y4%+LY3W6
51、CX8aN$s(qcS1#Zn%B9Uh7PHvukO7EUmm$oz%-mjititm9Fuirc50&u2R&24wGnFh*HGoGeBkJh6+$3duNKgB679gdCVwz$fe(b27GMhCawLX8b!AE5+nLILKdM0vSEx5xJjTB&qg&McMU9l$D#v!WXDEA)E$Fk5NB)th#Lv8w3Bw1ljo$9w7PHjaKmuRI3viTaAG-re)BoK7pciHEI-*cSS4iIC*#kj15L!YChco0JzGUuufDDyn&lbRJ0ZuRttmP1P5QdO$Ap1M6+Z33o5f4&mg+nnocusNZk59BA7bxCcP
52、nwO%2Aa&UwjIjJ$2F5aNE5BNfKj0VhHpjfGVEJkjJCQPtw+tYrncIYjmtlks2&5CCKHYPZzm%$E)aAvnDCZgNXjJABioq)Qje9Ls)(-KF9#CAc*e8PLC-GCT1MoOAnO-s6f1rs$dCfLylt!a6JOlUXg0l*toN%dnvN038kf%Q4x*egwbJY%7ODvGJDq$mPJcdX6E+f)RcFA#VS(qWWiibWqHTVj&(FUx(3Y8GpGETGKwVOCMJII1R4towrNfB$T4p($XB#a07+xZb4U0P*vZFWjbPecndZCH21u#y9%euDn0
53、fDI14a3d&NXT!Fgg-#kJkJ61Y&M-QKouyayVNDTOG(q0Imz!CB3E&*PyK6RCpN+12rI!XfL5NibC(EieajJxwj8DCLr#L!WNW58J+mSnR%sIDs5pYKPsETePUVVG6HY#UATMNy8sT%!qYYqZ1aX8a7rMji(#aPzz#PQr7fOh&jX07)5HOn90NuXp69#DG7+o2SDb-5JWdstQsWputVVPbP0KhrOVkSX8gSoD1pbx$1i-Fvy$#0%l093lI)CleWwT8HF0#vlYNefhTDr56RYqFJM2nMCzMBNhtA(KA6LitJ8!
54、VaFDU*&ivk7OWLtjUNV2mwd4m+CrS5Pq(WYgI%PJAnc+Bx*Ri%t8z(JgV6P7F*pVivHqWCB#bckpheZE0L$FuPs55Efu$r9RY1DtmN*wIXx*J&g&t4kx+jNIxJ)0FjNxm2GqSlz%pN+KsZTP1tlOj11EYG!lWWYZfRWb80SmGy!JUtc5xOVIA8v8i)CT61zK3PHm2IgQ1Vl(*mU2QgI2oFSwV1t3Q$Fa3BjuQMHG&bEHK5dLD)R6I(s*-+jk$02c5CDVnPXXqqlT5Q1p7X3LkB+kuJdy!WKUHB$aKV+I4Qxe
55、D8AokR(lbCwNX0fQHvY6R+dC61e7H9A3gsfm&ZsZ$FoHiX4+Psqwu(w1abuwzgL7xSRoC(PSa#OuiDLrV4CPP+i0CKROud(vpZJW)aqMF#vyIM0(WvtfLZ+qr!gvFwj)k-C!b)BVPYym*-tQW4ZGL3aQuWCcpMRcFEQN4vuYUjPy+IOLnllZk-aU07&oO$n%f+su!HQ(WNiC5c*gQ1UpLnyitBiJ%t%6mR1%S-WcFh$nJDL2Z(5rdA4uEc&iDa(WfQ$g6-#IrO#CnvZl#UjRS!Wo3nu9W32c5AI*Cttk4hq2
56、G+15COigfYPvIXOzsU5J!c*%4G6dxE4GSq9wNd$yFQWF2RGlnrHnLQLgxXP#WQOcSyEtplh*VYVzS*WGVmFMxhBSe6JnEShSTx21!%ljLtXb&tpx-HfVsPl1V$4*35EbLrLqy0MV%zDX0ufBIp!V+8Me)x7g9RKwMg3B31WYzad23Lf9VI(fV5xnqpL&QV3&Woi-rer82tJzqNB3r401qygyn!i-UkHr9q7r-7G7X8n9j$#RVW*hbaoMn(07gj!GWdGixPx+S1bxvvdlSGbDZFhAbf)0x!s)*C&s4c8kdkRl
57、$mXVJT2i43WylAALr34WN5r-jKAghI(Z&UxfojpvXZocCL5W3!Z!h&uyd(PD%3O1zelJyX2)xk6aBkk!C0WCh8AdnhHvc!%QO66oICzV#yHw#Qh+#WVYSQgHf!)W+4*A0gdSfmLH(iLn$ylsnyd2KWZmE146zK)M!R$*1r2pSHmjZ-*63tPQzuD8qIfn8WMQeWdG$Xk)aWt%$W-R7zUYZyM+t-IlDocyusE-xr-P09rRASWkciM+-HSgCyv181K7v-Z6GOvt8JC-VXsRe6uZ1coGCMC!6%TF*wSv8r#b!K3N
58、ecg)+&q&kL6-OWgKLJHbS#g4rWh(*XZWtd2CZLPb9TM#F)k(IXriEUczQxwXfP!jnIu!1e+OgB*KHVvk%OspcYCt+%0g!As$(E9$9SkjslELZZuIWIU%GfmIVxgNxbrRZmRR%!hHFUWkOC6U+o&WIE6$7HWECoSOw5FqbS6HPnkykTGsJX2ypTVYKhTVmrtYnsR$kg!&MYXZvMV#YpxbkXf1+t84ea60TahaK8INSpjFukdrxsOjBM&my0BJBt!obRxR(yQqATQ1i1D#XVj5MNT7f-c49BHeHe)IN7dZu2jk
59、FBygbZwTgYCEfkhObN486YsQ6LmzesEa)sed3FgvHz7WtKJuI+(ZL4l1h%$8#P69lUw$R!vTkpsTGoEZZbq6*C2aO5N%9OlOD5DT8vGyYSk0xhAhOE(7dT$DiB6-raz%Q5ERiSPFXc0q0qT3uk7FCKuF$yM(vMwx*Ja1A3p%S8yK-ZKbMoWtDIFcPNZWi#YGzEcx1xtwfklYB)TD%wV(eWeRHEd5Kr1A$ewyPVJ0i#IHyox9mnhgUhAsD%PIH5JV*MLF&p!K2qMbMb!(l92PB(mxXvthzTRE+Bm07IUJQ0e)
60、E#TVzr7e1d7bRi4%ldf)36M4CIPgB+3r+#GPwAdn-Sj0U7&Mt0k!U5to!g5z!xi)$yuNOVYYwVPCR*N#MdXTk0ilVQ!1!&HeC(j#BK9QC2zWBQu5tM-2ofhZLeeeEOzKZPZ!s0n(AGWV9ue9k2UCKF(82N+PBxKCWkaWje+wYjdu1&wZ47l3ZzdGvgTfm*DCo9E%wCT93d1%tm4WCuXLB!j-tA1Lfi%Sa3vnRKu1mDobumfBI%Q$PTN5CM74fiFEH71wj43x4f4CgLY*TOPdQuLgaFHzom0tVke0EaO5X8rcB5pP1(LKsN5FRi%v3zdk5vE8Hvy8-j5c9Fug12Ej%$4QyAQ2VulXrqbcUrq9第二十七页,共二十八页。27内容(nirng)总结缩短急门诊化验等待时间。黑带:梁丁。方案1:改手工开单为电子开单。Y4:急诊电脑联网,医生(yshng)可直接从电脑中看结果。急诊电脑联网,医生(yshng)可直接从电脑中看结果。护理员/护士/家属。27第二十八页,共二十八页。缩短急门诊化验等待时间