ാ䛝᪉ᨵ㠉 䝖䝑䝥䝬䝛䝆䝯䞁䝖◊ಟ inᮐᖠ 2020.2.6.

䠘஦౛⤂௓䠚᪫ᕝ㉥༑Ꮠ⑓㝔䛷䛾ྲྀ䜚⤌䜏᪫ᕝ㉥༑Ꮠ⑓㝔㝔㛗 ∾㔝᠇୍
© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

1᪫ᕝ㉥༑Ꮠ⑓㝔䛾ᴫせ䝧䝑䝗ᩘᛴᛶᮇ୍⯡䠍
ᩆ࿨ᩆᛴ
ICU

480ᗋ
430
446⫋ဨᩘ
་ᖌ
┳ㆤᖌ
デ⒪⛉ᩘ

1125
128ྡ
640ྡ
27⛉

ᡭ⾡௳ᩘ
ᩆᛴ㌴ᦙධྎᩘ

7500௳
4700ྎ

䠠䠬䠟≉ᐃ⑓㝔⩌ᩆ࿨ᩆᛴ䝉䞁䝍䞊
㐨໭䝗䜽䝍䞊䝦䝸ᇶᆅ⑓㝔
ᆅᇦ་⒪ᨭ᥼⑓㝔ᆅᇦ䛜䜣デ⒪㐃ᦠᣦᐃ⑓㝔ᆅᇦ⅏ᐖ་⒪䝉䞁䝍䞊䜶䜲䝈デ⒪ᣐⅬ⑓㝔ᆅᇦ࿘⏘ᮇẕᏊ་⒪䝉䞁䝍䞊© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.
2་ᖌ䛾ാ䛝᪉ᨵ㠉䛾ၥ㢟• ་ᖌ䛿⮬ศ䛜ປാ⪅䛷䛒䜛䛸䛔䛖ㄆ㆑䛜䛺䛔– ฟ໅䞉㏥໅᫬㛫䛾⏦࿌䜢⾜䜟䛺䛔• 䝍䜲䝮䝺䝁䞊䝎䞊䜢タ⨨䛧䛶䜒฼⏝䛧䛺䛔• Ỵ䜑䜙䜜䛯᫬㛫㏻䜚䛻ฟ໅䛧䛺䛔• ㉸㐣໅ົ᫬㛫䛿⏦࿌䛩䜛– 䝍䜲䝮䝺䝁䞊䝎䞊䛻䛶ฟ㏥໅᫬㛫䜢⟶⌮䛧䛯䛸䛧䛶䜒䚸䛭䛣䛷ᢕᥱ䛷䛝䜛㝔ෆ⁫ᅾ᫬㛫䛜䛩䜉䛶ᴗົ䛾᫬㛫䛸䛿㝈䜙䛺䛔• 䠄᫇䠅㯞㞛䞉㣧䜏఍䠄௒䠅 ⮬ᕫ◊㛑3© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

་ᖌ䛾ാ䛝᪉ᨵ㠉䛾ၥ㢟• ᫬㛫እ໅ົ䛿ୖྖ䛾ᴗົ࿨௧䛻䜘䜚ᐇ᪋䛩䜛䜒䛾䛸䛔䛖ㄆ㆑䛜䛺䛔– ⮬ศ⮬㌟䛾ุ᩿䛸㒔ྜ䛷⾜䛳䛶䛔䜛– デ⒪㒊㛗䜒㒊ୗ䛾᫬㛫እᴗົ䛾ᐇ᪋≧ἣ䜢☜ㄆ䛩䜛䛣䛸䛺䛟䜑䛟䜙ุ䜢ᢲ䛧䛶䛔䜛– ⩦័ⓗ䛻ᐃᮇⓗ䛺䜹䞁䝣䜯䝺䞁䝇䜔ᅇデ䜢᫬㛫እ䛻⾜䛳䛶䛔䜛– ఇ᪥䛾ᅇデ䜒་ᖌ⮬㌟䛾ุ᩿䛷ᐇ᪋䜢Ỵ䜑䛶䛔䜛
4© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

᪫ᕝ㉥༑Ꮠ⑓㝔䛾ྲྀ䜚⤌䜏20185© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

་ᖌ䛾ാ䛝᪉ᨵ㠉䠄་ᖌ䜢ປാ⪅䛸఩⨨௜䛡䛶䠅䛾ྲྀ䜚⤌䜏 2018
• 2018ᖺ䛾ാ䛝᪉ᨵ㠉䛷་ᖌ䛿ປാ⪅䛷䛒䜛䛸䛾఩⨨䛵䛡䛜☜ᐃ– 䛭䜜䜎䛷䛿䚸⮬ศ䛯䛱䛿㏻ᖖ䛾ປാ⪅䛸䛿㐪䛖䛸䛔䛖⮬㈇䛜䛒䛳䛯䠄ᑡ䛺䛟䛸䜒㒊㛗䞉๪㒊㛗䜽䝷䝇䠅• 36༠ᐃ䛿඲⫋ဨ୍ᚊ䛷⤖䜣䛷䛚䜚䚸௒ᚋ䛿་ᖌ䜒䛭䛾༠ᐃ䛾⠊ᅖෆ䛻᫬㛫እປാ䜢཰䜑䜛ດຊ䛜ᚲせ䛸䛾ព㆑ᨵ㠉䛻╔ᡭ– ୍㒊䛾ᩆᛴᑐᛂ䛜ከ䛔デ⒪⛉䛿㞴䛧䛔䛜䚸䛭䜜௨እ䛾་ᖌ䛿᫬㛫እ໅ົ䜢ᑡ䛺䛟䛩䜛ດຊ䛜ᚲせ䛸䛾ㄆ㆑䛷ᑐᛂ
6© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

36༠ᐃ 䠄᪫ᕝ㉥༑Ꮠ⑓㝔䠅• ໅ົ䜢ᘏ㛗䛩䜛䛣䛸䛜ฟ᮶䜛᫬㛫
– 1᪥
4᫬㛫
– 1䜹᭶ 45᫬㛫
– 1ᖺ
360᫬㛫

• ⮫᫬䛻㝈ᗘ᫬㛫䜢㉸䛘䛶⾜䛖᫬㛫እປാ䛾ᘏ㛗᫬㛫䠄≉ู᮲㡯䠅– 1䜹᭶

80᫬㛫 䠄ᖺ6ᅇ䜎䛷䠅

7© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

䜒䛸䜒䛸ྲྀ䜚⤌䜣䛷䛔䛯䛣䛸• ་ᖌ䛜ᮏ᮶䛾௙஦䛻ᑓᛕ䛷䛝䜛䜘䛖䛻– ་ᖌ䛷䛺䛟䛶䜒ฟ᮶䜛௙஦䜢௚⫋✀䛻⛣⟶䛣䛾ྲྀ䜚⤌䜏䛿ᑡ䛺䛔་ᖌ䛷䜒㧗䛔✌ാ䜢ᣲ䛢䜛䛣䛸䛜䛷䛝䜛䜘䛖䛻ྲྀ䜚⤌䜣䛰䜒䛾

8© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

་ᖌ஦ົసᴗ⿵ຓ⪅䠄15ᑐ䠍䠅• ᐇ᪋䛧䛶䛔䜛ᴗົ䠄୺䛺䜒䛾䠅– デ᩿᭩సᡂ䠄ୗ᭩䛝䠅– ㏥㝔䝃䝬䝸䞊సᡂ䠄ୗ᭩䛝䠅– 䜽䝸䝔䜱䜹䝹䝟䝇㐺⏝ᝈ⪅䛾୍ᣓᣦ♧ධຊ(ὀᑕᣦ♧䜢ྵ䜐䠅– ୍㒊䛾እ᮶䛷䛾デ⒪⿵ຓ• እ᮶䛷䛾㟁Ꮚ䜹䝹䝔ධຊ䠄ၥデ䞉᳨ᰝཬ䜃ᨺᑕ⥺ᣦ♧䞉ண⣙➼䠅– 㟁Ꮚ䜹䝹䝔䜈䛾䠄஦ᚋ䠅ධຊ• ཱྀ㢌ᣦ♧• ⣙᮰ᣦ♧䛾ᐇ᪋• ୍㒊䛾ᡤぢグ㍕䠄≉䛻デ⒪ሗ㓘䛻䛛䛛䜟䜛䜒䛾䠅– ୍㒊䛾⑓Ჷ䛾་ᖌ䛜ཧຍ䛩䜛䜹䞁䝣䜯䝺䞁䝇䛻ཧຍ䛧䛶་ᖌ䛾䝁䝯䞁䝖䜔ᣦ♧䜢㟁Ꮚ䜹䝹䝔䛻グ㍕– ་⒪Ᏻ඲䞉ឤᰁ⟶⌮䞉䛜䜣Ⓩ㘓䞉Ꮫ఍㛵㐃䝕䞊䝍䝧䞊䝇ධຊ➼9© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

䜒䛸䜒䛸ྲྀ䜚⤌䜣䛷䛔䛯䛣䛸• ་ᖌ䛜ᮏ᮶䛾௙஦䛻ᑓᛕ䛷䛝䜛䜘䛖䛻– ་ᖌ䛷䛺䛟䛶䜒ฟ᮶䜛௙஦䜢௚⫋✀䛻⛣⟶• ་ᖌ஦ົసᴗ⿵ຓ⪅䛾᥇⏝• ┳ㆤᖌ䛾䠄⊩㌟ⓗ䠅༠ຊ– ་ᖌ஦ົసᴗ⿵ຓ⪅䛜㟁Ꮚ䜹䝹䝔௦⾜ධຊ䜢⾜䛖䛾䛻ᚲせ䛺᝟ሗ䜢ධຊ䝅䞊䝖䛻グ㍕• 䝯䝕䜱䜹䝹䝇䝍䝑䝣䜈䛾ጤㆡ– ㉸㡢Ἴ᳨ᰝ– ேᕤ࿧྾ჾ䛾タᐃ䞉⟶⌮– ⸆๣ᖌ䛻䜘䜛ฎ᪉ኚ᭦䞉ᣢཧ⸆ධຊ䞉ฎ᪉ᥦ᱌䛺䛹– ⟶⌮ᰤ㣴ኈ䛻䜘䜛἞⒪㣗ᥦ᱌䛺䛹

10© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

᪂䛯䛻ྲྀ䜚⤌䜣䛰䛣䛸䠄་ᖌ䠅• ་ᖌ䛾ാ䛝᪉䜢ぢ┤䛩– ᫬㛫እ䛾ᝈ⪅䞉ᐙ᪘䜈䛾ㄝ᫂䜢⾜䜟䛺䛔䠄᥎ዡ䠅– ୺἞་ไ䛛䜙䝏䞊䝮ไ䜈䛾⛣⾜䠄᥎ዡ䠅– ᫬㛫እ䛾䝏䞊䝮ᅇデ䜢⾜䜟䛺䛔䠄᥎ዡ䠅– ୍ᐃ᫬㛫䜢㉸䛘䛯㏻ᖖᴗົ䠄⥭ᛴᛶ䛾䛺䛔䜒䛾䠅䛻䛴䛔䛶䛿୺௵㒊㛗䛾஦๓ᢎㄆ䜢ᚓ䜛

11© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

᪂䛯䛻ྲྀ䜚⤌䜣䛰䛣䛸䠄඲⫋ဨ䠅• ఍㆟䛿ྍ⬟䛺㝈䜚໅ົ᫬㛫ෆ䛻⾜䛖• ఍㆟᫬㛫䛿ྍ⬟䛺㝈䜚▷᫬㛫䛸䛩䜛䠄┠ᶆ15ศ䠅• 㝔ෆ◊ಟ఍䛾ᩚ⌮䛸eͲlearning䛾ά⏝• ་ᖌ䛾┳ㆤᖌ䜈䛾᫬㛫እ䛾ᣦ♧ฟ䛧䜢᪥୰䛻䠄౫㢗஦㡯䠅– ་ᖌ䛾ാ䛝᪉ᨵ㠉䛾䜏䛺䜙䛪┳ㆤᖌ䛾᫬㛫እປാ䛾๐ῶ䜒┠ᣦ䛧䛯2019.3.⌧ᅾ

12© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

఍㆟䛾ᕤኵ• ఍㆟䛾┠ⓗ䜢᫂☜䛻䛩䜛– Ỵᐃ– ᝟ሗఏ㐩– ἲⓗ䛻ᚲせ• ▷᫬㛫䛷⤊䜟䜙䛫䜛– Ỵᐃ䞉㆟ㄽ䛜ᚲせ䛺䜒䛾䛿ᑡேᩘ䛷– ᝟ሗఏ㐩䛿⡆₩䛻– ἲⓗ䛺䜒䛾䛿⢔䚻䛸• ௒ᚋ䛿䚸㟁Ꮚ఍㆟䞉᭩㠃఍㆟➼䜒฼⏝13© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

་ᖌ䜈䛾᝟ሗఏ㐩• ་ᖌ䛻䛿᝟ሗ䜢┤᥋ఏ䛘䛺䛔㝈䜚ఏ䜟䜙䛺䛔– ྛデ⒪⛉䛾㒊㛗䛻ఏ䛘䛯䛣䛸䛜䚸ྛ⛉䛾་ᖌ䛻ఏ䜟䜛䛸䛿㝈䜙䛺䛔• ᪫ᕝ㉥༑Ꮠ⑓㝔䛷䛿་ᒁ᪩ᮅ఍㆟䛩䜉䛶䛾་ᖌ䛜ཧຍ➨1䞉䠏 ᭶᭙᪥ᮅ䠔䠖䠍䠑䡚 15ศ⛬ᗘ❧䛳䛶⾜䛖デ⒪㒊㛗఍㆟᭶1ᅇ䛣䛣䛷ఱ䛛䜢Ỵ䜑䜛䛣䛸䛿䜋䛸䜣䛹䛺䛟䛺䛳䛯14© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

2018ᖺᗘ䛾ྲྀ䜚⤌䜏⤖ᯝ་ᖌ䛾㉸㐣໅ົ᫬㛫ྲྀ䜚⤌䜏๓ᚋ䛾ẚ㍑
೧ౕҲਕฑ‫ۋ‬ʤ݆ʥ㉸㐣໅ົ᫬㛫ู2017ᖺᗘ͸2018ᖺᗘẚ㍑
20182017ᖺᗘ

162018ᖺᗘ

1412108

ҫࢥ਼ʤ݆ฑ‫ۋ‬ʥ6420

࣎ؔ֐߻‫ܯ‬ʤ݆ฑ‫ۋ‬ʥ ึᮇ⮫ᗋ◊ಟ་䜢㝖䛟15© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

2018ᖺᗘ䛾ྲྀ䜚⤌䜏⤖ᯝデ⒪⛉ู䛾་ᖌ୍ேᙜ䛯䜚㉸㐣໅ົ᫬㛫䞉་ᖌᩘ䞉᪂ධ㝔デ⒪⛉ู㉸㐣໅ົ᫬㛫ᩘ䛾ኚ໬ᝈ⪅ᩘ䛾ᕪ䠄2017vs.2018)་ᖌ୍ேᙜ叀叫㉸໅᫬㛫ቑῶ咁᫬㛫 咂་ᖌᩘ叏ቑῶ呍᪂ධ㝔ᝈ⪅ᩘ叏ቑῶ咁ே咂

20䛸་ᖌᩘཬ䜃᪂ධ㝔ᝈ⪅ᩘ䛾ᕪឬᢅѮѦ଺᧓ࠀίஉ࠯‫ר‬ὸҔࠖૠỉ‫ف‬ถૼλᨈधᎍૠࠀίஉ࠯‫ר‬ὸ
୺἞་ไ

15

10

50

Ͳ5

Ͳ10

Ͳ15

Ͳ2016

© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

2018ᖺᗘ䛾ྲྀ䜚⤌䜏⤖ᯝྲྀ䜚⤌䜏䛾ホ౯• ་ᖌᩘ䛾ቑῶ䞉᪂ධ㝔ᝈ⪅ᩘ䛾ቑῶ䛜᭱䜒㉸㐣໅ົ᫬㛫䛾ቑῶ䛻ᙳ㡪䛧䛯• ୍㒊䛾デ⒪⛉䛷䛿୺἞་ไ䛛䜙䝏䞊䝮ไ䜈䛾⛣⾜䜔䚸ᴗົ䛾᫬㛫㓄ศ䜢ぢ┤䛩䛣䛸䛷䛒䜛⛬ᗘ䛾ຠᯝ䜢ᣲ䛢䜛䛣䛸䛜ฟ᮶䛯

17© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

18© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

2019ᖺ3᭶་ᖌ䛾ാ䛝᪉ᨵ㠉䜈䛾ᑐᛂ
䠄3Ͳ6༠ᐃ 2019ᖺ䠅་ᖌ⏝୍⯡⫋ဨ⏝•໅ົ䜢ᘏ㛗䛩䜛䛣䛸䛜ฟ᮶䜛᫬㛫
– 1᪥
4᫬㛫
– 1䜹᭶
45᫬㛫
– 1ᖺ
360᫬㛫

•

໅ົ䜢ᘏ㛗䛩䜛䛣䛸䛜ฟ᮶䜛᫬㛫
– 1᪥
4᫬㛫
– 1䜹᭶
45᫬㛫
– 1ᖺ
360᫬㛫

•⮫᫬䛻㝈ᗘ᫬㛫䜢㉸䛘䛶⾜䛖᫬㛫እປാ䛾ᘏ㛗᫬㛫䠄≉ู᮲㡯䠅•⮫᫬䛻㝈ᗘ᫬㛫䜢㉸䛘䛶⾜䛖᫬㛫እປാ䛾ᘏ㛗᫬㛫䠄≉ู᮲㡯䠅

– 1᪥
– 1䜹᭶
– 1ᖺ

– 1䜹᭶

15᫬㛫130᫬㛫
1400᫬㛫

1980᫬㛫䠄ᖺ6ᅇ䜎䛷䠅© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

2019ᖺᗘ

ྲྀ䜚⤌䜏䛭䛾ᚋ㉸㐣᫬㛫ู25
2017ᖺᗘ೧ౕʤ৏ൔ‫غ‬ʥ2018ᖺᗘ

2019ᖺᗘ

2015Ҳਕฑ‫ۋ‬
10ҫࢥ਼5

᪂䛯䛺3Ͳ6༠ᐃ䜢స䜚᫬㛫እປാ䜢ᐜㄆ䛩䜛⤖ᯝ䛸䛺䛳䛶䛔䜛020© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

་ᖌ䛾ᴗົ㈇Ⲵ䜢㍍ῶ䛩䜛䛯䜑䛾䛥䜙䛺䜛᪉⟇• ௒䜎䛷་ᖌ䛜⾜䛳䛶䛝䛯䛣䛸䜢௚䛾⫋✀䛻䛥䜙䛻ᢸ䛳䛶䜒䜙䛖• 䛭䛾䛯䜑䛻䛿௚⫋✀䛾ᴗົ䜢㍍ῶ䛩䜛䛣䛸䜒
ᚲせ21© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

༠ຊ䜢ᚓ䜛䛯䜑䛻䛿䚸ྛ⫋✀䛾ᴗົ㍍ῶ䛜ᚲせ• ஦ົ⫋ဨ䠄་ᖌ஦ົసᴗ⿵ຓ⪅䠅䛾ᴗົ㍍ῶ
– 䠮䠬䠝䠄RoboticProcessAutomation)䛾ᑟධ• 䝁䞁䝢䝳䞊䝍䞊䠄㟁Ꮚ䜹䝹䝔䜢ྵ䜐䠅䛻䛶⾜䛖⧞䜚㏉䛧సᴗ䜢䝻䝪䝑䝖䜢⏝䛔䛶⮬ື໬䛩䜛• 䠄⑓Ჷ䠅┳ㆤ⫋ဨ䛾ᴗົ㍍ῶ
– 䠬䠢䠩䠄PatientFlowManagement)䛾ᑟධ• ධ㝔ᨭ᥼䝉䞁䝍䞊䜢ᕤኵ䛩䜛䛣䛸䛷䚸⑓Ჷ┳ㆤᖌ䛜ධ㝔᫬䛻⾜䛖ᴗົ䜢๐ῶ– ᪥ᖖ䛾┳ㆤᴗົ䛾ぢ┤䛧• ୍㒊䛿䠥䠰䜢฼⏝22© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

ਗ਼৕ढ़ঝॸध৴௚खञ෫୍઎‫ق‬ϤΩϨΠνροʥΝ݆͖Δ಍೘ংॖॱঝ೾৒ஓ॑ऊकघटऐद‫॑ॱشॹؚ‬ਗ਼৕ढ़ঝॸपఃஈ‫آ‬َୢ௜਍৸भ਱঱َُ่૧঵ਜभ஍૨৲ُपఞଖघॊ

23© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

ংॖॱঝ೾৒ஓ॑ऊकघटऐद‫॑ॱشॹؚ‬ਗ਼৕ढ़ঝॸपఃஈ‫آ‬υʖνൕӫ଎ఈߴ໪ʁରԻɼ݄ѻɼ݄౸ɼ6S2ɼຼധ
ుΩϩൕӫ

24

© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

௒ᚋ䛾኱䛝䛺ၥ㢟• ᐟ᪥┤䛾ྲྀ䜚ᢅ䛔– ᩆᛴ䜢ከ䛟ྲྀ䜚ᢅ䛖⑓㝔䛷䛾ᐟ᪥┤䛿䚸ᖹ᪥䛾᪥୰䛸ྠᵝ䛻ᴗົ䜢䛧䛶䛔䜛䛸䜏䛺䛥䜜䜛• ஺௦໅ົไ䜈䛾⛣⾜䛜ᚲせ• ᚑ᮶䛾䜘䛖䛻๓᪥䛛䜙໅ົ䜢⥅⥆䛧䛯ሙྜ䛻䛿㐃⥆28᫬
㛫つไ䛻䜘䜚⩣᪥༗ᚋ䛿௙஦䛜ฟ᮶䛺䛔• ᪥୰䛻໅ົ䛩䜛་ᖌ䛜ᑡ䛺䛟䛺䜚䚸᪥୰䛾デ⒪ไ㝈䠄୍⯡እ᮶䛾ไ㝈䛺䛹䠅䛜ᚲせ䛸䛺䜛– デ⒪⛉䛻䜘䛳䛶䛿᏶඲䛻᪥୰䛾ᶵ⬟䛜㯞⑷䛩䜛ྍ⬟ᛶ• ⌧ᅾ䛾ᶵ⬟䜢⥔ᣢ䛩䜛䛯䜑䛻䛿་ᖌ䛾ቑဨ䛜ᚲせ་ᖌ䛜ᑡ䛺䛔ᆅᇦ䛷䛿་ᖌ䛾ቑဨ䛿ᐜ᫆䛷䛿䛺䛔
25© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.

䛤Ύ⫈䛒䜚䛜䛸䛖䛤䛦䛔䜎䛧䛯26© Kenichi Makino, Japanese Red Cross Asahikawa Hosp.