本文關(guān)鍵詞： 急危重癥 院前急救 Petri網(wǎng) 馬爾可夫鏈 流程優(yōu)化　出處：《山東大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：院前急救是急救醫(yī)療服務(wù)體系中最重要的一個(gè)環(huán)節(jié),它在維護(hù)人民健康和社會(huì)安定方面,發(fā)揮著不可取代的作用。在我們周圍,每天都會(huì)有很多急危重癥病例的發(fā)生,院前急救工作面臨的任務(wù)非常艱巨。在急救指揮中心調(diào)度員受理急救電話并制定調(diào)派計(jì)劃后,急救小組需要快速出診,以盡可能快的速度到達(dá)指定地點(diǎn)對患病或受傷人員進(jìn)行緊急處理,然后將患者運(yùn)送回醫(yī)院,傾盡全力挽救患者的生命。院前急救的時(shí)間每縮短一秒鐘,患者生命的延續(xù)就多一份可能。隨著社會(huì)的進(jìn)步,我國對院前急救工作越來越重視,但與國外的急救數(shù)據(jù)進(jìn)行對比后發(fā)現(xiàn),我國的院前急救工作依然存在很多問題,急危重癥患者在院前急救中的生存率極低,對院前急救進(jìn)行優(yōu)化改進(jìn)勢在必行。近些年來,我國對于院前急救領(lǐng)域的研究越來越多,但是缺乏通過建模對院前急救流程進(jìn)行優(yōu)化的研究。所以,本文利用相關(guān)工具對院前急救流程進(jìn)行建模分析、確定流程的瓶頸環(huán)節(jié)并進(jìn)行優(yōu)化,以此減少院前急救的時(shí)間,提高院前急救流程的效率。首先,本文通過對當(dāng)前急危重癥院前急救背景的分析和對急救領(lǐng)域國內(nèi)外文獻(xiàn)的綜述,確定了運(yùn)用相關(guān)建模工具對院前急救流程進(jìn)行建模研究的必要性。然后,對院前急救、流程優(yōu)化、常用流程建模方法等進(jìn)行了介紹,通過對流程建模方法的比較分析確定了用Petri網(wǎng)對急危重癥院前急救流程進(jìn)行建模分析。接下來,本文對國內(nèi)院前急救流程的現(xiàn)狀進(jìn)行了描述和分析,考慮到我國院前急救模式的多樣性和數(shù)據(jù)獲取的難度,選取濟(jì)南市急救中心作為分析對象。根據(jù)調(diào)研資料,確定急危重癥院前急救流程的共性流程圖,運(yùn)用Petri網(wǎng)對其進(jìn)行建模,并利用ExSpect仿真軟件對Petri網(wǎng)模型進(jìn)行多次仿真,確定流程各個(gè)環(huán)節(jié)的執(zhí)行時(shí)間。最后,同構(gòu)馬爾可夫鏈計(jì)算出流程模型的穩(wěn)態(tài)概率,通過對穩(wěn)態(tài)概率的排序確定流程瓶頸,做出針對性分析,發(fā)現(xiàn)流程瓶頸中存在問題的原因,通過對急救中心專家咨詢和查閱文獻(xiàn),提出相應(yīng)的改進(jìn)方案,對急危重癥院前急救流程進(jìn)行優(yōu)化。通過優(yōu)化前后流程各項(xiàng)執(zhí)行時(shí)間的對比,確定本文的研究可以縮短急危重癥的院前急救時(shí)間,在優(yōu)化院前急救流程方面具有現(xiàn)實(shí)意義。
[Abstract]:Pre-hospital first aid is the most important link in the first-aid medical service system. It plays an irreplaceable role in maintaining the health and social stability of the people. The task of first aid before hospital is very arduous. After the dispatcher of the emergency command center receives the first aid call and formulates the dispatch plan, the first aid team needs to make a quick visit. Arrive at a designated place as quickly as possible for emergency treatment of a sick or injured person, and then transport the patient back to the hospital, with every effort to save the patient's life. With the progress of society, our country is paying more and more attention to the work of pre-hospital first aid. However, comparing with the data of emergency treatment abroad, we find that there are still many problems in the work of pre-hospital first aid in our country. The survival rate of critically ill patients in pre-hospital first aid is very low, so it is imperative to optimize and improve the pre-hospital first aid. In recent years, more and more researches have been done in the field of pre-hospital first aid in China. However, there is no research on how to optimize the pre-hospital first aid flow through modeling. Therefore, this paper uses the relevant tools to model and analyze the pre-hospital emergency flow, to determine the bottleneck of the process and to optimize, so as to reduce the time of pre-hospital first aid. First of all, through the analysis of the background of the current emergency emergency before hospital and the literature review of the field of emergency treatment, The necessity of modeling the pre-hospital first aid flow with relevant modeling tools is determined. Then, the pre-hospital first aid, process optimization, common process modeling methods and so on are introduced. Through the comparative analysis of process modeling methods, Petri net is used to model and analyze the pre-hospital emergency flow. Then, this paper describes and analyzes the current situation of pre-hospital emergency flow in China. Considering the diversity of pre-hospital emergency treatment mode and the difficulty of obtaining data, Jinan emergency center was selected as the analysis object. According to the investigation data, the general flow chart of emergency treatment flow chart was determined, and the Petri net was used to model it. The ExSpect simulation software is used to simulate the Petri net model for many times to determine the execution time of each link of the process. Finally, the stable probability of the process model is calculated by the isomorphic Markov chain, and the bottleneck of the process is determined by ranking the steady-state probability. To make targeted analysis, find out the causes of the problems in the process bottleneck, through consulting the experts of the emergency center and consulting the literature, put forward the corresponding improvement plan, Through the comparison of the execution time before and after the optimization, it is determined that the research in this paper can shorten the pre-hospital emergency time of the critical and critical cases, which is of practical significance in optimizing the pre-hospital emergency flow.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R459.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前5條

1 呂傳柱;中國院前急救的標(biāo)準(zhǔn)化問題[J];中華急診醫(yī)學(xué)雜志;2004年08期

2 譚愛梅;陳碧華;楊秋俊;陳佳;;醫(yī)療失效模式與效應(yīng)分析在院前急救風(fēng)險(xiǎn)管理中的應(yīng)用[J];護(hù)理管理雜志;2014年06期

3 楊麗娟;糜慶;魯玲玲;;珠海市院前急救反應(yīng)時(shí)間影響因素的研究[J];中外醫(yī)學(xué)研究;2012年05期

4 陳劍銘,王芳,楊新春,胡燕生,張永珍,馬謝民;北京市某三級甲等綜合性教學(xué)醫(yī)院急性心肌梗死院前診療流程與急診診療流程評價(jià)[J];中國醫(yī)院管理;2005年06期

5 杜敏;余猛進(jìn);;急性左心衰竭患者不同院前急救模式的效果比較[J];中國急救醫(yī)學(xué);2008年10期

相關(guān)碩士學(xué)位論文 前3條

1 劉艷;基于突發(fā)事故的礦山醫(yī)院急救流程再造[D];山東科技大學(xué);2009年

2 楊光潔;面向中小企業(yè)的工作流系統(tǒng)的設(shè)計(jì)與實(shí)現(xiàn)[D];華東師范大學(xué);2009年

3 丁光彩;基于GSPN的心臟病院前急救流程再造[D];天津大學(xué);2009年

，

本文編號(hào)：1534731