高雄長庚醫院出院準備服務作業之建構與評值

Implementation of Discharge Preparation Service at Chang Gung Memorial Hospital, Kaohsiung

此篇係闡述本院設立出院準備服務專責部門的過程及具體成果，俾提供其他醫療機構參考。綜合相關文獻後，顯示推動此作業四大基本要件為：1.具備健全組織結構2.訂定病患篩選系統3.設立病患需求評估4.制定病患轉介、追縱與後送機構之聯絡合作模式。本院係運用持續性品質改善理念，推動此項工作模式，實施近二年後經評值結果得知：住院病患暨家屬對本院轉介服務及對所安排後送機構滿意度均有提升；再入院率並無明顯差異；全院平均住院日於實施前為10.78天，實施後二年降為8.97天；醫護人員轉介配合度由67.8%提升為85.3%；合約後送機構由6家增加至9家。由本院臨床經驗顯示，出院準備服務確能提升醫護照顧品質，且能有效縮短平均住院日，及落實醫療資源重分配。

This crticle describes the set up of the discharge preparation service and the results at Chang Gung Memorial Hospital, Kaohsiung(KCGMH). From literature, there are four major steps In setting up this service: (1) Readiness of a complete and flawless organization, (2) Establishment of the patients selection system, (3) Establishment of the evaluation of request from patients, (4) Establish-ment of the model of contact and cooperation with patients transfer, Follow-up and evacuation facilites. During the impression of the increasing satisfaction rate of all prospection of this service from in-patients and their families. There was no difference of re-admission tate between patients received this service or not. Average length of stay after discharge prearation service available was 8.97 days per patient as compared with 10.78 days without this service. The willingness of using this service was increased from 67.8% to 85.3% at this hospital. The number of contracted evacuation hospitals increased from six to nine. We concluded that the discharge prepartion service offered a chance of improved quality of services, decreased length of stay and possible redistribution of medical resources.