精神科門診就診模式與品質改善專案

The Improvement of Visiting Process and Quality for the Psychiatric Outpatients

本專案目的為改善精神科門診就診模式及提高病人就診品質滿意度。統計2006年1月至6月本科門診延診情況為全院之冠，平均延診時數為34.9小時／週，相較其他科多出17.7小時／週，導致醫療人員與病人抱怨，且門診病人就診滿意度偏低，平均為3.49分（滿分為5.0）。經現況調查後發現：就診流程不一致及診次時間分配不均、看診空間與衛教區缺乏隱密性與區隔性、其他專業人員以及精神病人受症狀干擾無法久候，而不斷敲門、進出診間中斷看診，以致門診延診與影響就診品質。故成立專案小組，針對以上問題，擬定改善方案：(1)增設看診等候室形成雙診模式；(2)增訂精神科門診雙診間跟診標準化流程規範。經實施方案後，連續評估六個月之門診延診時數降至27.3小時／週，每週減少7.6小時／週，共降低22％，人力薪資成本費用每月節省5,403元；病人就診品質滿意度提昇至4.1分。顯示專案透過制度面將傳統單診就診模式改善為雙診模式，能有效提升門診就診醫療服務品質，發揮護理人員專業功能及降低人力成本。

The purpose of the project is to improve the process and quality of a psychiatric outpatient visit. The survey, done between January and June, 2006, found that the psychiatric outpatient treatment had the average delay of 34.9 hours/week (17.7 hours/week longer than the average in other departments) with low patients’ satisfaction level (average 3.49 points). The problems were: non-standardized treatment process, unfair assignment of treatment period, lack of treatment privacy due to no distinctions between treatment room and health education areas, and treatment interruptions and interference by other medical professionals’ frequent entering and leaving the treatment room. The project included (1) implementation of a new dual-treatment model with a dedicated clinic waiting room for health education areas, and (2) amendment of the process of the psychiatric outpatients’ visit according to the new dualtreatment model.?In 6 months period, the project reduced the delay of the outpatient’s treatment to 27.3 hours/week with 22% improvement (7.6 hours/week), saved labor cost of NT 5,403 per month, and improved the patient’s satisfaction level to 4.1 points. Therefore, the dual-treatment model can effectively improve the quality of outpatients’ visits, enhance nurses’ performance, and reduce the labor cost.