急診室服務系統 (emergency department service system) 為醫療服務系統中重要系統之一，病患主要透過一系列診療程序從檢傷分類至離院程序來進行診治。在急診服務系統之工作站中包含檢傷護理人員、護理人員及醫師等不同職位，因此工作站之產能呈現隨機狀態。為了評估工作站之產能，本研究導入多階狀態網路(multistate network) 之評估模型，以利於後續績效之評估。在急診室服務網路 (emergency department service network, EDSN)中，包含節點 (node) 與傳輸邊 (route) 分別代表等候區 (waiting area) 與工作站 (workstation)。為了符合實際狀況本研究導入人員配置 (staff assignment),而不同配置組合下其系統可靠度會產生不同的變化。其中系統可靠度定義為急診室服務系統成功滿足病患量之機率。然而，急診室人員產能因模糊之不確定性而難以衡量，因此導入模糊數學並擴展為模糊多階狀態網路(Fuzzy multistate network)。其中系統可靠度定義為急診室系統成功滿足病患量之可能性。在模糊數學中利用到平均數和標準差，來建構模糊隸屬函數，進而衡量急診室工作站之狀態。本研究分別透過所提出演算法於五級檢傷與四級檢傷等兩實際急診室例子來評估系統可靠度。在決策觀點上，管理者可運用所提出兩演算法來評估在不同需求、人員配置、模糊數學下之系統可靠度，此績效指標有助於管理者可依據這些參數變化，進而作適當的管理決策

An emergency department service system provides medical service to patients who are prioritized for medical care, starting with triage categories and ending with discharge formalities. In this thesis, the emergency department service system is modeled as a multistate network called emergency department service network (EDSN), in which each arc is regarded as workstation with multistate capacity and each node represented as waiting area. In addition, the staff assignment has been considered in this system. The system reliability is a performance index that system reliability defined the probability that an emergency department service system can provide necessary treatment to the patients. However, the staff’s exact probability distribution does not easily obtain, because of the vagueness in measuring human capability. For solve this situation, we further expanding EDSN into fuzzy multistate network by utilizing the fuzzy mathematics. The system reliability defined as possibility that an EDSN can provide necessary treatment to the patients. Since each workstation is fuzzy multi-state, we proposed a method to generate the membership function by utilizing statistical parameters, such as average and standard deviation. The workstation reliability can be derived from the membership function. The system reliability is subsequently evaluated with fuzzy intersection corresponding to the workstations’ reliabilities. In this thesis, two algorithms are developed in chapter 3 and chapter 4, respectively and two practical examples are then performed with historical data from a Taiwan hospital to evaluate the system reliability by proposed algorithm. For make decision, system reliability in term of useful performance index provide emergency department manager to apply

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