ʧЧģʽÓëÓ°Ïì·ÖÎö(Failure Mode and Effects ysis£¬FMEA)ÊÇÃÀ¹úÒ½ÁÆ»ú¹¹ÁªºÏÆÀÉóίԱ»á(JCAHO)ÍƼöµÄÒ»ÖÖÒ½Ôº°²È«·çÏÕÆÀ¹À·½·¨¡£
½üÄêÀ´£¬Ëæ×ÅÏû»¯ÄÚ¾µ¼¼ÊõµÄѸËÙ·¢Õ¹£¬Ïû»¯ÄÚ¾µÒѹ㷺µØÓÃÓÚÁÙ´²¼²²¡ÕïÁÆ£¬ÆäËäÓд´ÉËС¡¢¿ÉÖ±ÊÓµÄÓÅÊÆ£¬µ«ÔÚÕû¸ö¼ì²é¹ý³ÌÖÐÈÔ´æÔÚÒ»¶¨·çÏÕ¡£¶Ô´Ë£¬½Î÷Ê¡¸ÓÖÝÊÐÈËÃñÒ½ÔºÓÉÏû»¯ÄÚ¿ÆÖ÷ÈΡ¢»¤Ê¿³¤¡¢Ò½»¤¹Ç¸É¼°ÖÊÁ¿¹ÜÀí°ì¹«ÊÒ¡¢ÐÅÏ¢¿Æ¡¢»¤ËÍÖÐÐĵÈÏà¹Ø¹¤×÷ÈËÔ±×é³ÉÁË9È˵ÄFMEAÍŶӣ¬½ÓÊÜFMEA֪ʶÅàѵ£¬Ó¦ÓÃFMEA½µµÍÁËסԺ»¼ÕßÄÚ¾µ¼ì²é·çÏÕ¡£
1.Á÷³Ì·ÖÎö
´Ó½¹µãÁ÷³ÌÖÐÕÒ³öʧЧģʽ£¬ÁгöDZÔÚ·çÏÕÔÒò¡£
ͨ¹ýΣº¦·ÖÎö(ÑÏÖضȡ¢·¢ÉúƵÂÊ)¡¢¾ö²ßÊ÷·ÖÎö£¬¾ö¶¨¼±Ðè²ÉÈ¡´ëÊ©¼°Ê±¸ÄÉƵIJ¿·Ö£¬½«RPN´óÓÚ8µÄ·çÏÕÖµÏîÄ¿ÁÐΪ±¾´Î»î¶¯¸ÄÉÆÖص㡣
2.¸Ä½ø´ëÊ©
2.1 ÍêÉÆÒ©Æ·¹ÜÀí£¬ÓÅ»¯»¼Õß¼ì²éÁ÷³Ì
Ò½ÖöÉèÁ¢ÌײͷÖΪÎÞÍ´ºÍÆÕͨ£¬±ÜÃâ³öÏÖÉÙ¿ª¡¢¶à¿ª¡¢Â©¿ªµÈÏÖÏó¡£ËùÓÐҩƷͳһ¹ÜÀí£¬Óɲ¡·¿»¤Ê¿Ö±½ÓËÍÈëÏû»¯ÄÚ¾µÊÒ£¬²¢½¨Á¢ÄÚ¾µÆ·½»½Ó¼Ç¼±¾£¬×¨È˹ÜÀí¡£²¡ÈËÖ»ÐèÄÃÔ¤Ô¼µ¥µ½ÄÚ¾µÊÒ¼ì²é¼´¿É£¬±£ÕÏÁË»¼ÕßÓÃÒ©°²È«£¬Ìá¸ßÁËסԺ»¼ÕßÂúÒâ¶È¡£
2.2 ¼ÓÇ¿Åàѵ£¬Ìá¸ßÄÚ¾µÕïÁƼ¼Êõˮƽ
¿ÆÊÒÔÚÄê³õÖƶ¨½øÐ޼ƻ®£¬·Ö±ðÅÉ4ÃûÒ½Éú¡¢»¤Ê¿Ç°ÍùÉϼ¶Ò½Ôº½øÐÞÄÚ¾µ¼¼Êõ¡£ÖØе÷ÕûÅŰ࣬°²ÅÅÄêÇáÒ½ÉúÔÚÄÚ¾µÊÒѧϰ£¬²ÉÓÃPBL½Ìѧģʽ£¬Ò»ÈË´ø½Ì£¬¶àÈË°ï·ö£¬ÊÖ°ÑÊÖ½øÐÐÄÚ¾µ²Ù×÷Åàѵ¡£ÖØÐÂÐÞ¶©ÄÚ¾µ¼¼ÊõÕïÁƹ淶(Ò½ÁÆ)¡¢Î§ÊÖÊõÆÚ»¤Àí¼°ÆÀ·Ö±ê×¼²¢ÂäʵÅàѵ¼°¿¼ºË¡£
2.3 ʵʩ¶àÑùʽ¡¢¶àÔª»¯½¡¿µÖ¸µ¼
ÖÆ×÷סԺ»¼Õß°ÙÊÂͨ£¬ÄÚÈÝ°üÀ¨Éú»îÖ¸ÄÏ¡¢Òûʳƪ¡¢ÌØÊâ¼ì²éƪ¡¢ÖÎÁÆƪ¡¢¼²²¡½¡¿µ½ÌÓýƪ£¬·ÅÖÃÔÚÿ¼ä²¡·¿¡£Öƶ¨12²áÏà¹Ø¼ì²é¡¢Ðû½Ì×ÊÁÏ£¬Õ³ÌùÉÏǽ¡£Öƶ¨ÈëÔº»¼Õß½¡¿µÐû½Ì¸æÖªµ¥£¬ÔðÈλ¤Ê¿ÔÚ»¼ÕßÈëԺʱ½øÐÐÐû½Ì£¬²¢ÒªÇó»¼Õß»ò¼ÒÊôÇ©×Ö£¬Ìá¸ß»¼Õß½¡¿µ½ÌÓýÖªÏþÂÊ¡£ÉèÁ¢Ïû»¯Äڿƽ¡¿µ½ÌÓý±í£¬ºÏÀí°²Åſγ̡£ÖØÐÂÉè¼ÆÄÚ¾µÔ¤Ô¼µ¥£¬°üÀ¨×¡ÔººÅ¡¢ÐÕÃû¡¢¼ì²é²¿Î»¡¢Ïà**************ÒâÊÂÏîµÈ¡£
2.4 Ôö¼Ó¹¤×÷ÈËÔ±¼°Ï´ÏûÉ豸
Ñϸñ°´¡****************Ú¾µÇåÏ´Ïû¶¾¼¼Êõ²Ù×÷¹æ·¶¡·¡¶Ò½Ôº¸ÐȾ¹ÜÀí°ì·¨¡·ÅäÖÃÏ´ÏûÈËÔ±¼°É豸£¬ÐÂÔö¼ÓÁ½ÃûרҵϴÏûÈËÔ±¼°Á½Ì¨È«×Ô¶¯ÄÚ¾µÏ´Ïû»ú¡£ÑϸñÅàѵ£¬ËùÓÐнøÈËÔ±±ØÐëÊìϤÄÚ¾µÇåÏ´Ïû¶¾¼¼Êõ²Ù×÷¹æ·¶¼°ÄÚ¾µ²Ù×÷Á÷³Ì¡£Ð»¤Ê¿±ØÐëÅàѵ1¸öÔ£¬×¨ÒµÏ´Ïû¼¼ÊõÈËÔ±Åàѵ3¸öÔ£¬ºÏ¸ñºó·½ÄܽøÐÐÏÂÒ»²½Ñ§Ï°¼°¹¤×÷¡£
2.5 Éè¼ÆÄÚ¾µÖÎÁƽ»½Óµ¥£¬¿ªÍ¨ÂÌɫͨµÀ
Éè¼ÆÏû»¯ÄÚ¾µÕïÁƽ»½Ó±í£¬°üÀ¨²¡ÈËÐÕÃû¡¢×¡ÔººÅ¡¢¼ì²éÃû³Æ¡¢ÊÖÊõÃû³Æ¡¢¸÷Àà¹Ü·¡¢ÊõÇ°ÓÃÒ©¡¢ÊõÇ°×¼±¸µÈÏà¹ØÄÚÈÝ£¬²¡·¿»¤Ê¿ÓëÄÚ¾µ»¤Ê¿½øÐн»½Ó²¢Ç©×Ö£¬´æÈ벡Àú¡£¿¼Âǵ½ÄÚ¾µ¼ì²é·;ңԶ¡¢Â·¿öÇ·¼Ñ£¬¸ü»»×ªÔ˹¤¾ß£¬Í³Ò»Ê¹ÓÃרÃŵÄÇÀ¾È³µ×ªÔ˲¡ÈË¡£ÎªÔ¤·À²¡ÇéÍ»·¢±ä»¯£¬Éè¼ÆÄÚ¾µ×ªÔË;Öеļ±¾ÈÏ䣬°üÀ¨ºí¾µ¡¢¼òÒ׺ôÎüÆøÄÒ¡¢Æø¹Ü²å¹Ü¡¢Ïà¹Ø¼±¾ÈÒ©Æ·¡¢ÎïÆ·µÈ£¬²¢½¨Á¢¼±¾ÈÏä½»½Ó±¾£¬Ã¿°àÇåµã£¬°à°à½»½Ó£¬ÒÔ±£Ö¤¼±¾ÈÏäÎïÆ·ÍêºÃÂÊ¡£¸ù¾Ý¿ÆÊÒÐÂÖƶ¨µÄ¡¶×¡Ôº²¡ÈË°²È«×ªÔËÖƶȡ·¹æ¶¨£¬ ΣÖز¡ÈËÐÐÄÚ¾µ¼ì²é±ØÐëÓɾ¹ÜÒ½Éú¼°ÔðÈλ¤Ê¿Åãͬ£¬×î´óÏ޶ȵر£ÕÏ»¼Õß°²È«¡£
2.6 ¼ÓÇ¿Íó´ø¹ÜÀí
ÈëÔº»¼ÕßͳһÅå´øÊÖÍó´ø£¬½øÐÐÉí·Ýʶ±ð¡£ÓÉÔðÈλ¤Ê¿Ö´ÐУ¬Ïò»¼ÕßÐû½ÌÊÖÍó´øÅå´øµÄÖØÒªÐÔ£¬Ìá¸ß»¼ÕßÈÏÖª¡£ÓÉ»¤Ê¿³¤¼°¸ßÔð×鳤¼à¶½¼ì²é£¬ÈçδÂäʵ£¬ÄÉÈ뿼ºË£¬²¢ÔÚ»¤Ê¿Àý»áÉÏͨ±¨ÅúÆÀ¡£
2.7 ½¨Á¢µç×ÓÔ¤Ô¼¼°½ÐºÅϵͳ
²ÉÓý¨Á¢ÐÅÏ¢»¯Ô¤Ô¼¡¢½ÐºÅϵͳ£¬ÓëÒ½ÔºHISϵͳ¹²Ïí×ÊÔ´£¬Ö±½Ó¼È뻼ÕßסԺºÅ£¬¼´¿É¼ìË÷µ½Ïà¹ØÐÅÏ¢£¬¸ù¾Ý¼ì²éµ¥ÉêÇëÀàÐͽøÐÐÔ¤Ô¼¡£ÄÚ¾µÖÐÐÄ´óÌüÉèÓÐ3¸öÆÁÄ»½ÐºÅϵͳ£¬·Ö±ðΪÄÚ¾µ¼ì²éµÈ´ýÁÐ±í¡¢ÄÚ¾µÖÐÐIJ¡È˼ì²éÇé¿öÏÔʾ¡¢ÄÚ¾µ¼ì²éÕïÊÒºòÕïÁÐ±í£¬ÓÉÔ¤Ô¼¡¢Ñ²»Ø»¤Ê¿·Ö±ð°²ÅÅ»¼Õß½øÐмì²é¡£
3.Ч¹û·ÖÎö
ÄÚ¾µ¼ì²é·çÏÕÖµ¸ÄÉÆÇ°ºó¶Ô±È·¢ÏÖ£¬»î¶¯Ç°RPN´óÓÚ8µÄ·çÏÕÖµ¾ùÔڻºóµÃµ½½Ï´ó¸ÄÉÆ¡£
ͨ¹ýÔËÓÃFMEA£¬´ÓÈÕ³£¹¤×÷ÖÐÕÒ³ö±¡Èõ»·½Ú£¬·ÖÎö´æÔÚʧЧģʽ£¬Ìá³ö¸Ä½ø´ëÊ©²¢ÂäʵÕû¸Ä¡£±¾ÏîÄ¿´Ó2016Äê1ÔÂ-9ÔÂÀۼƽÚÊ¡¿ÆÊÒÒ©Æ·¿ªÖ§Ô¼ÍòÔª£¬Ò½»¤¼¼ÄܲÙ×÷¿¼ºËͨ¹ýÂÊÓÉ87.6%ÌáÉýÖÁ97.8%£¬×¡Ôº»¼ÕßÂúÒâ¶ÈÓÉ90%ÌáÉýÖÁ98.7%£¬»¼Õß½¡¿µ½ÌÓýÖªÏþÂÊÓÉ69%ÌáÉýÖÁ90%£¬ÊÖÍó´øÅå´÷ÂÊÓÉ75%ÌáÉýÖÁ100%£¬»¼ÕßÄÚ¾µ¼ì²éƽ¾ùµÈºòʱ¼äÓÉ70minËõ¶ÌÖÁ48min£¬ÄÚ¾µ¼ì²éÖÎÁƽ»½ÓÖ´ÐÐÂÊÓÉ65%ÉÏÉýÖÁ100%¡£
4.½áÓï
FMEAÊÇ¿ÆѧµÄ¹ÜÀí¹¤¾ß£¬ÏÖÒѹ㷺ӦÓÃÓÚÁÙ´²Ò½ÁÆ¡¢»¤Àí¹¤×÷¡£Èç¹ûÊÇ¿ç¿ÆÁ÷³Ì£¬ÐèÒª×é³ÉÒ»¸ö¿ç²¿ÃŵÄÍŶӣ¬ÓÉÒ½Ôº¹ÜÀíÖ°ÄÜ¿ÆÊÒǣͷ×éÖ¯¡£³ÉÔ±ÒÔ7¡«9ÈËΪÒË£¬×îºÃ²»Òª³¬¹ý10ÈË£¬ËùÓгÉÔ±±ØÐë½ÓÊÜFMEAÅàѵ£¬¾«Í¨Ê¹ÓÃFMEAÖÊÁ¿¹ÜÀí¹¤¾ß£¬Äܸü¼Ó¿Í¹ÛµØ¶Ô¸÷¸öʧЧģʽµÄRPNÖµ½øÐÐÆÀ¹À¡£
±¾Ñо¿²ÉÓõÄÊÇÁ÷³ÌʽFMEA£¬ÓÃͼ±íÃèÊöÁ÷³Ì£º(1)ÍŶӳÉÔ±¹²Í¬½«ËùÓв½ÖèÓÃÁ÷³ÌͼÁгö£¬²¢½«Ã¿¸ö²½Öè±àºÅ;(2)Èç¹ûÁ÷³Ì¸´ÔÓ£¬°´ÕÕÓÅÏÈ´ÎÐò£¬ÕÒ³ö½¹µã»·½Ú£¬Áгö×ÓÁ÷³Ì±àºÅ;(3)¶ÔËùÓÐÁгö²½Öè´ï³É¹²Ê¶£¬ÒÔÈ·±£»³öµÄÁ÷³ÌͼÄÜÕýÈ·µØÃèÊö¹ý³Ì¡£Í¨¹ý´ËÏî·½·¨£¬Äܸü¼ÓϸÖµØÊáÀí³öÁ÷³ÌÖдæÔÚµÄÎÊÌ⣬ÕÒ³ö×î¸ù±¾µÄÔÒò²¢¸Ä½ø;ͨ¹ýÍ·ÄԷ籩£¬½èÖú¶à²¿ÃÅÐ×÷£¬¹²Í¬½â¾öÁË¿ÆÊÒÔÚʵ¼Ê¹¤×÷ÖеÄÄÑÌâ;Õë¶Ô´æÔÚÎÊÌ⣬С×é³ÉԱͨ¹ýÊÂÏÈÆÀ¹À¡¢ÊÂÏÈÔ¤·À¡¢ÓÅ»¯Á÷³Ì£¬ÓÐЧµØ±ÜÃâÁËÒ½ÁÆ»¤Àí²»Á¼Ê¼þµÄ·¢Éú£¬Ìá¸ßÁËÒ½ÁÆ»¤ÀíÖÊÁ¿£¬±£ÕÏÁË»¼Õß°²È«¡£