急診病患就診流程再造之專案

Reengineering the Visiting Process for Emergency Room Patients

急診病人特徵為焦慮、緊張和容易發脾氣，同時希望在最短時間內快速處理病患就診問題以解除痛苦(Budassi & Barber, 1981)。寧(2000)提出消費者的服務需求是彈性與速度，今後的競爭除了品質以外還要加上時間，必須縮短流程的花費時間，以提升競爭力。本專案針對急診就診流程花費時間深入探討，實地觀察95位病患，經分析就診流程花費時間及服務滿意度調查結果顯示：就診流程項目等候時間過長，且病患家屬對就診流程服務滿意度低。透過醫療部門檢討改善及整合服務作業流程再造，執行具體可行方案為簡化檢傷、掛號作業同步完成，整合護理人員執行醫囑處置作業，葯囑標準化、專用領藥窗口作業，簡化急診住院病患批價繳費手續，其結果平均每位病患就診總花費時間由原5小時56分縮短至3小時37分，且病患家屬對就診流程服務滿意度平均達2.53(Range1-3)。秉持著以病人為中心之理念，用心改造流程達最佳化效果，以確保病患之權益與服務品質，大幅提升醫療服務效率。

Budassi and Barber (1981) pointed out that the characteristics of emergency room (ER) patients were anxiety, neurosis, and irritability; therefore, their problems need to be managed immediately. Ning (2000) mentioned that consumers needed more flexible and efficient care. Ning (2000) also stated that hospitals should not only provide quality care but also reduce service time to increase competition with each other. The purpose of this project was to analyze the visiting process and waiting time and patient and family satisfaction at an ER of medical center in Taipei. Ninety-five patients were surveyed with a structured questionnaire. Results indicated that the average waiting time was long (5 hours and 56 minutes per patient) and patient and family satisfaction was low The average satisfaction score was 1.49 (range 1-3). Based on the findings, the visiting process was reengineered and included simplifying the registration process, simplifying triage, medical orders, billing, and admission practices, and improving communication and coordination with other medical departments in order to integrate services. Post-implementation the average visiting waiting time was reduced to 3 hours and 37 minutes per patient. The average satisfaction score was high (2.53, range 1-3). In conclusion a patient-centered reengineering process was implemented to improve outcomes, ensure quality care and patient rights, and to increase efficiency.