提升糖尿病病人免散瞳眼底鏡檢查完成率之改善專案

Quality Improvement Project: To Improve Completion Rate of Non-Mydriatic Fundoscopic Exam in Diabetic Patients

提升糖尿病病人眼底鏡檢查率，能有效降低糖尿病視網膜病變風險發生。現況發現導致本院糖尿病病人免散瞳眼底鏡檢查完成率低的問題主要導因：免散瞳眼底鏡檢查開單率低、檢查標示不明確、病人看診時間受限及病人缺乏疾病認知。經解決方案：開發免散瞳眼底鏡檢查跳單提示資訊系統、規劃糖尿病病人免散瞳眼底鏡檢查動線、增加免散瞳眼底鏡檢查作業標準流程、規劃糖尿病病人檢查看診流程及提升眼底鏡檢查認知後，糖尿病病人免散瞳眼底鏡檢查完成率由65%升至76.1%，且病人對此檢查接受度與治療連續性亦深表肯定，確實達專案目標。

An improvement in the completion rate of fundoscopy in diabetic patients is known to effectively reduce the risk of diabetic retinopathy. Because the completion rate of non-mydriatic fundus photography in diabetic patients of our hospital was low, in response, we proposed a quality promotion project to identify and address the underlying issues and improve the overall completion rate. The primary causes of low completion rate were the low numbers of test orders from physicians, misleading labelling, limited consultation time at outpatient clinic, and lack of disease awareness in patients. As solution, we developed a computer system which could spontaneously notify and promote non-mydriatic fundus photography to doctors, regulate patient flow, standardize test procedure, coordinate consultation procedure of diabetic patient at outpatient clinic, and improve cognition of fundoscopy in diabetic patients. The post-implementation review revealed that the completion rate of non-mydriatic fundus photography raised from 65% to 76.1%. The diabetic patients responded positively to the new implementation with high acceptance and compliance. The project had successfully reached its intended goal.