背景 : 台灣醫療就業環境日漸惡化，導致急診醫療人力嚴重流失，急診暴力、工作量大、作息不正常、工作壓力等等，都是主要因素。目的 : 利用電腦輔助排班，提供更快速的急診醫師工作班表分派，降低排班謄寫的耗費及錯誤：（1)建置可行的電腦排班系統、（2）發展班表指標評估作業的程式模組、（3）評估電腦輔助排班前後的效益。方法 : 以某醫學中心急診醫師班表為例，在微軟 Excel 工作環境下，建立排班的資訊模組，並制定班別的評量指標，作為下期(月)優先約班條件的基礎，再利用系統動態模擬評估其效益。結果 : 研究結果顯示此一醫師排班作業資訊模組，只需很少時間內（約10分鐘）可以完成百人班表的資料分析。提升部門成員的排班滿意度，也能符合政府法令的規範。結論 : 本研究建立一套評核指標計分程式資訊模組，來分析及比較各部門班表之排班是否適當及是否符合勞基法，也對部門排班系統之建立及部門人員班表評核計分做出介紹。模擬分析 100 週後的成效，本系統可以節省全院成本每月 60 多萬元的人力，遠高於目前人工排班作業的效益。 Background: Taiwan's medical employment situation deteriorating leads to a serious loss of emergency medical manpower. Emergency violence, heavy workload, rest is not normal, working pressure, etc., are the main factors.Objectives: A computer-aided staff-scheduling system (CASSS) rapidly and effectively allocates the physicians needed in a hospital’s emergency department. It reduces transcription time and human data input errors. An efficacious indicator of whether the staffing result meets government regulations and fits the hospital’s policy is urgently required. Besides programming a CASSS, we develop an objective indicator for a physician staffing schedule of an emergency department as well as simulate the benefit comparing between prior and post CASSS.Methods: A set of criteria for assessing a reasonable hospital physicians’ staffing schedule was collected. An Excel VBA module was programmed and incorporated with a rating scale to judge monthly physicians’ staffing schedules in a hospital’s emergency department. A system dynamic simulation using Vensim software was used to compare the efficiency and cost-effectiveness of traditional hand-plus-human-brain and digital methods after considering various strategies, e.g., feasible scheduling periods (daily, weekly, fortnightly, and monthly), judgments by a human brain versus those by a computerized method with variables related to time, staff, and expenses required to create the feasible and acceptable schedules.Results: The developed staff scheduling module significantly saved time just 10 minutes to finish more than a hundred physicians’ staffing schedule workload and increased work satisfaction. The staffing results were forced to fit government regulations and hospital staffing policy.Conclusion: The Excel VBA staffing and assessing module simulated scenario was more efficient and effective than the traditional manual method. Additional studies are recommended to determine whether this module is also appropriate for staff scheduling in other departments in a hospital. With this computerized system compared to the traditional human brain method, more than NT$600,000 per month could be saved on the manpower cost after 100-week total simulating implementation in a hospital.
