縮短住院透析病患等候返回病房時間方案

Plan to Reduce In-hospital Dialysis Patients’ Waiting Time to Return to their Wards

本專案旨在改善住院透析病患等候返回病房時間。經統計，病患在本單位透析完畢後，平均要等19分鐘才被接回原病房，原因為1.護理人員通知醫師、勤務人員及提出人力申請單作業不一致。2.白班負責病房區同仁上班後才通知病患來透析病患無法準時到達。3.結束時逢勤務人力減縮時段。4.醫師無法立即接送病患。針對原因執行改善方案1.制定作業流程。2.建立排程電腦通知系統，先行通知勤務人員。3.提早通知醫師，挪開工作或找替代人員。實施一年後，平均等候時間由19分鐘縮短至13.1分鐘，效果維持期，縮短至12.8分鐘，病患抱怨由48﹪降低至20﹪。透過建立標準化流程及電腦排程通知系統，改善等候時間，確認本專案有顯著效益。

This case plan’s purpose is to reduce the waiting time of in-hospital dialysis patients to return to their wards. According to our calculations, when dialysis patients are finished with the dialysis process, they must wait for about 19 minutes before returning to their hospital wards. The reasons are as follow: 1. The nursing staff is inconsistent in informing the doctors and service workers, as well as in proposing electronic notification. 2. The nursing staff informed patients to come for their dialysis after their on-duty time began, causing patients to be unable to arrive punctually and thus encountering reduced service worker intervals (lunch break) when they were finished with the dialysis. 3. The doctors are unable to transfer patients immediately. The improvement plan to be executed based on the above reasons: 1. Develop a standardized work flow. 2. Establish the computer notification system to notify the service center in advance. 3. Inform the doctor ahead of time to get work out of the way beforehand or to look for substitutes from among the personnel. After executing the plan for a year, the average waiting time (19 minutes) was reduced to 13.1 minutes. By maintaining the plan, the time was reduced to 12.8 minutes. Patient complaints were reduced from 48% to 20%. The establishment of a standardized work flow and the computer notification system reduced the waiting time, thereby confirming that this case plan is indeed beneficial.