提升門診護理人員操作電腦計價正確率

Improvement of Medical Bill Charges through the Accurate Use of a Computer Charging System

醫療體系順應時勢推動各項資訊化措施，期能簡化作業流程，藉以提高醫療品質、病人滿意度，並降低醫療人員的負擔。本單位因護理人員操作電腦計價不完整，造成門診衛材盤虧率為17%；護理人員需花費時間緊急借用衛材，造成醫師看診中斷，且病人等候時間久，引起病人及家屬抱怨，引發專案小組成立的動機。專案初期之限制，因同仁對於電腦計價操作步驟及內容不熟悉，需利用下診休息時間參與。為提升門診護理人員操作電腦計價正確率，藉由舉辦教育訓練、製作操作電腦計價自學影帶、製作衛材批價碼套餐範本、訂定衛材批價碼套餐護理作業資訊化及建立查核制度等改善方案後，門診護理人員操作電腦計價正確率由65.3%提昇至92.0% 。顯示本專案達到預期目標。建議未來能將門診資訊化之經驗，平行推廣至病房，提高護理效益，減少醫院成本負擔。

Electronic information systems have been well-applied to various measures in healthcare systems to simplify operational workflow; promote quality of care, service, and patient satisfaction; and lower the workload of workforce in healthcare. A study demonstrated that, in the outpatient unit, nurses inaccurately operated the computer charging systems for medical bills, and the inventory loss of medical supplies was as high as 17%. Nurses spent more time borrowing supplies from other departments, which interrupted physicians' seeing patients. A longer waiting time for patients to see doctors caused service complaints. The promotion strategies included educating nurses, producing a self-study video using the computer charging system for medical bills, using coding mode for price charging, designing an operation package with pricing code for reference, and establishing a monitoring system. With these promotional measures, the rate of outpatient nurses accurately operating the computer charging system improved from 65.3% to 92.0%, and the goal of this project was achieved. The author suggests that this project be expanded to other inpatient units to maintain care effectiveness and reduce the hospital's capital costs.