骨科病房病患出入院流程改善專案

Improving Patient Admission and Discharge Processes on an Orthopedic Ward

本專案旨在改善骨科病房病患出入院流程，實行病房為南部某醫學中心骨科病房，病人流動率大，平均為19.7％。在出院流程方面，由於護理人員處理醫囑時間較晚，家屬延遲辦理手續及工友延誤清床時間，而造成流程的冗長。專案實施時間為民國89年3月28日至民國89年6月12日，實施專案前病房辦理出院流程平均耗時201.89分，入院流程耗時111.11分。經白班護理人員交班後立即辦理出院、設立出院醫囑欄、工友優先清床、志工協助製作新病歷等改善措施後，出院流程比改善前縮短37.75分，入院流程則縮短28.18分。由於辦理出入院手續耗時縮短，病人的不安與抱怨相繼減少，而間接提昇護病關係及醫療品質。

The purpose of this project was to improve the processes of admission and discharge. An orthopedic ward at a medical center in southern Taiwan was selected. The average turnover rate of patients on this ward was 19.7. Nurses' delay in processing orders resulted in delayed completion of discharge procedures with patients and families and in delayed cleaning of beds and rooms by housekeeping. This project was conducted from March 12, 2000 to June 12, 2000. Before this project, the time to complete an admission of a patient was 111.11 minutes and the time to complete a discharge was 201.89 minutes. After implementing three improvement strategies - creating a specific column for admission and discharge processes, setting a priority for housekeepers to clean beds, and using volunteers to make new charts - the admission time was shortened to 28.18 minutes and discharge time was shortened to 37.75 minutes. In addition, patients' anxiety and complaints were reduced and nurse-patient relationships and quality of care were indirectly improved.