- I - 摘要 看病难、看病慢是现在大多数医院里患者就医所面临的问题，很多的公立医院 行政管理水平不高与医疗工作效率偏低是问题根源之一。“十三五”期间，我国提出 新的医改目标，加快了现代医院管理机制与综合监管机制的改革进程，提升了全民 医疗保障机制运作的整体效率，秦皇岛市第一医院承担着秦皇岛市及周边地区患者 的救治工作，巨大的门诊量对于现有就诊流程构成较大压力。本文提出秦皇岛市第 一医院需要在国家医改的环境下，优化门诊就诊流程，提高医疗服务质量与工作效 率，从而提升医院综合实力。 首先，本文在分析研究背景、研究意义及梳理国内外相关领域的文献的基础上， 阐述业务流程再造的含义、方法和原则，医院流程再造的含义、原则、特点、关键， 以及几种流程再造方法。 其次，对秦皇岛市第一医院的基本情况、组织结构和运营的几种流程进行概述， 对门诊流程进行了描述和现状分析，指出门诊就医过程中出现的问题，逐一分析原 因。 再次，本文以流程再造理论与方法为指导，利用 BPR 理论、ASME 流程分析法、 鱼骨图分析法和 ECRS 分析法对秦皇岛市第一医院的门诊流程进行再造，实现缩短 等待时间，提高患者满意度，增强医院竞争力的目标；并围绕再造目标设计了具体 的实施方案和关键管控点。 最后，本文从医院领导、资金保障、软硬件建设、行政管理配合、全体医护人 员培训及新流程宣传等方面提出门诊流程再造的实施保障。 关键词，医院流程；秦皇岛市第一医院；门诊；流程再造燕山大学工商管理硕士学位论文 - II - Abstract Difficulty and slowness in seeing a doctor are the problems faced by patients in most hospitals nowadays. One of the root causes of these problems is the low level of administration and the low efficiency of medical work in many public hospitals. During the 13th Five-Year Plan period, China put forward new goals of medical reform. The construction of modern hospital management system and comprehensive supervision system was accelerated, and the national medical security system was more efficient. The First Hospital of Qinhuangdao City was responsible for the treatment of patients in Qinhuangdao City and its surrounding areas. The enormous amount of outpatient services put great pressure on the existing medical treatment process. It points out that the first hospital of Qinhuangdao needs to optimize the outpatient treatment process and improve the quality and efficiency of medical services under the environment of national medical reform, so as to enhance the comprehensive strength of the hospital in the paper. Firstly, on the basis of analyzing the background, significance and literature in related fields at home and abroad, it expounds the meaning, methods and principles of BPR, the meaning, principles, characteristics and key points of hospital BPR and several methods of BPR in this paper. Secondly, the basic situation, organizational structure and operation processes of Qinhuangdao First Hospital are summarized, the outpatient process is described and analyzed, the problems in outpatient treatment process are pointed out, and the reasons are analyzed one by one. Thirdly, guided by the theory and method of process reengineering, the outpatient process of Qinhuangdao First Hospital is reengineered by BPR theory, ASME process analysis method, fishbone diagram analysis method and ECRS analysis method, in order to shorten waiting time, improve patient satisfaction and enhance hospital competitiveness; and around the goal of reengineering, the specific implementation plan and key control points are designed. Finally, it puts forward the implementation guarantee of outpatient processAbstract - III - reengineering from the aspects of hospital leadership, fund guarantee, hardware and software construction, administrative cooperation, training of all medical staff and publicity of new process in this paper. Keywords: hospital process; qinhuangdao first hospital; outpatient service; process reengineering目 录 - V - 目 录 摘要..................................................................................................................................I ABSTRACT ....................................................................................................................... II 第 1 章 绪 论...................................................................................................................1 1.1 研究背景及研究意义 .............................................................................................. 1 1.1.1 研究背景 ............................................................................................................ 1 1.1.2 研究意义 ............................................................................................................ 2 1.2 国内外研究现状 ...................................................................................................... 2 1.2.1 国外研究现状 .................................................................................................... 2 1.2.2 国内研究现状 .................................................................................................... 4 1.2.3 国内外研究评述 ................................................................................................ 6 1.3 研究内容及方法 ...................................................................................................... 6 1.3.1 研究内容 ............................................................................................................ 6 1.3.2 研究方法 ............................................................................................................ 7 第 2 章 相关理论基础.......................................................................................................9 2.1 业务流程再造的基本理论 ...................................................................................... 9 2.1.1 业务流程再造的含义 ........................................................................................ 9 2.1.2 业务流程再造的方法 ...................................................................................... 10 2.1.3 业务流程再造的原则 ...................................................................................... 10 2.2 医院流程再造的基本内容 .................................................................................... 11 2.2.1 医院流程再造的含义与原则 .......................................................................... 11 2.2.2 医院流程再造的特点 ...................................................................................... 12 2.2.3 医院流程再造的关键 ...................................................................................... 13 2.3 几种流程再造的方法 ............................................................................................ 13 2.3.1 ASME 流程分析法 .......................................................................................... 13 2.3.2 鱼骨图分析法 ................................................................................................. 14 2.3.3 ECRS 分析法 .................................................................................................. 15 2.4 本章小结 ................................................................................................................ 16 第 3 章 秦皇岛市第一医院门诊流程现状及分析.........................................................17 3.1 秦皇岛市第一医院医院简介 ................................................................................ 17 3.1.1 医院基本情况 .................................................................................................. 17 3.1.2 医院组织结构 .................................................................................................. 18燕山大学工商管理硕士学位论文 - VI - 3.1.3 医院运营的几种流程 ...................................................................................... 18 3.2 医院门诊流程 ........................................................................................................ 19 3.2.1 门诊流程描述 .................................................................................................. 19 3.2.2 门诊流程现状分析 .......................................................................................... 22 3.3 医院门诊流程存在的问题及原因 ........................................................................ 24 3.3.1 患者无效移动过多 .......................................................................................... 27 3.3.2 患者就诊时间成本过高 .................................................................................. 28 3.3.3 信息共享不到位导致工作效率偏低 .............................................................. 31 3.4 本章小结 ................................................................................................................ 32 第 4 章 秦皇岛市第一医院门诊流程再造方案设计.....................................................33 4.1 门诊流程再造的原则和目标 ................................................................................ 33 4.1.1 门诊流程再造的原则 ...................................................................................... 33 4.1.2 门诊流程再造的目标 ...................................................................................... 34 4.2 门诊流程再造的总体方案和主要内容 ................................................................ 34 4.2.1 门诊流程再造的总体方案 .............................................................................. 34 4.2.2 门诊流程再造的主要内容 .............................................................................. 37 4.3 门诊流程再造的关键控制点 ................................................................................ 45 4.3.1 门诊流程再造的关键控制点所在 .................................................................. 45 4.3.2 门诊流程再造的关键控制点的设置 .............................................................. 45 4.3.3 门诊流程再造关键控制点的设置效果 .......................................................... 46 4.4 流程再造前后的对比及再造后的预期效果 ........................................................ 46 4.5 本章小结 ................................................................................................................ 48 第 5 章 门诊流程再造实施的保障措施.........................................................................49 5.1 高层重视 ................................................................................................................ 49 5.2 资金保障 ................................................................................................................ 49 5.3 软硬件配备 ............................................................................................................ 50 5.4 行政管理配合 ........................................................................................................ 50 5.5 全员培训 ................................................................................................................ 50 5.6 新流程宣传 ............................................................................................................ 51 5.7 组织文化建设 ........................................................................................................ 51 5.8 本章小结 ................................................................................................................ 52 结 论...............................................................................................................................53