跨團隊流程再造縮短胃腸內科住院病人特殊檢查等待天數

Revamping Interdepartmental Information Workflow to Shorten Length of Stay in Hospital for Gastrointestinal Patients

有效彈性合理控制住院日與病床週轉率，可減少醫療資源浪費，提昇服務滿意 度，而住院流程再造是重要的方法之一。本專案旨在縮短胃腸內科住院病人特殊檢查 等待天數。調查發現醫師未立即開立檢驗項目、無法立即會診、入院許可證未註記特 殊檢查、指定住院日無病床、等候特定檢查日，病人未禁食致檢查延後等原因，導致 住院病人等待特殊檢查天數增加，滿意度下降。經團隊合作建置跨團隊電腦資訊整合 自動提示系統、建置生理檢查資訊系統、修正特殊檢查入院常規及特殊檢查病人住院 流程再造等，使得胃腸內科住院病人等待特殊檢查平均等候天數由4.8天下降至2.7天， 平均住院天數由9.7天下降至8.2天，病人平均滿意度由2.1分提升至3.5分（滿分4分）， 合理縮短胃腸內科住院病人特殊檢查等待天數及平均住院日，提高部門運作效率，增 加醫收降低成本，提高病人滿意度；可供類似單位或科別參考。

Effective, flexible, and reasonable control on length of stay in hospital and turnover rate could reduce the waste of medical resources and enhance service satisfaction. To achieve this goal, the reconstruction of hospitalization process is one of the major approaches. This project aims to find a way to shorten gastrointestinal patients’ length of stay of that is attributed to the waiting time of special inspections. The analysis of current process found out the main factors that lead to increased the length of stay for special examination wait and decreased satisfaction are as follow: Doctors fail to prescribe examinations in time, delayed physician consulting, relevant treatment plan not included in the admission form, false bed availability of admission time, waiting for exam date, fail to inform patients the required fasting before the exam. By establishing multidisciplinary digital information integrating and auto-reminding system, creating physiological checking information system, revising special examination admission protocols, and admission process reconstruction etc., it helped decrease the average wait times of gastrointestinal patients for special examination from 4.8 days to 2.7 days, and total hospitalization from 9.7 days to 8.2 days, and increase average patient satisfaction from 2.1 to 3.5 on the scale of 4. Hence, the study suggests that multi-disciplinary cooperation and digital process reconstruction should be able to reasonably reduce the wait times of special examination and total hospitalization of gastrointestinal patients, facilitate department efficiency, increase income by reducing cost, and enhance patient satisfaction.