某醫學中心X光檢查報告作業流程改善研究

Continuous Quality Improvement on Producing X-ray Reports

本研究主要探討某醫學中心放射線部各項檢查報告作業流程間相互關 條、影響檢查作業流程時效的相關因素、以及可能的品質改善方案。主要採 用研究者自行設計之間卷量表，包括作業流程問卷及內部人員問卷二種，於 作業流程問卷部分，你以門診患者為研究對象，總計發出1 ， 200 份問卷，回收 807 份（65%） ；另於內部人員問卷部分，勞、以放射線部工作人員為對象，進行 問卷施測，總計發出88 份，回收37 份（42%） 。此外，本研究亦引用品質管理 的工具，以暸解X 光檢查報告作業：炙手呈時效之影響因素。 研究發現'X 光檢查報告作業流程，站與站問之時問遲廷，是造成檢查 報告發出時效長之最主要變異來源、（P<0.05）' 特別是報告判讀流程之延 遲；再者，檔案借片作業之監測象統不健全，是造成檔案作業延遲的主要原 因。其中，影響X 光檢查報告發出時效長的因素，包括：醫師人力與習慣、 檔案人員、檢查數量、檔案追蹤系統、作業流程本身等因素。最後，完善的 作業：炙手呈管理與監控，包括未完成檢查報告作業之監測，將有助於X 光檢查 報告作業流程時效之改善。

Objectives: The objectives of this study were to investigate the process of delivering examination reports at the radiology department, to see the relationship among different examinations and how they affect each other in terms of process, to explore factors which affect the length of time of processing the reports, and to investigate possible actions on quality improvement of processing X-ray reports. Methods: In this study, there were two questionnaires developed by the researcher. One was section of 'business process management' to investigate the length of time of processing X-ray reports. The other one was section of 'employee’s attitudes' to address factors affecting the length of time of processing the reports, which were reviewed by five experts for content and validity and whose sampling was all employees within the radiology department. Results: The main findings of this study were, first, the main variation of resulting the longer period of time of producing the reports came from the delay of between stations. Second, the defective monitoring system of borrowing files caused the delay of files management process. Finally, the factors affecting the length of time of processing X-ray reports were manpower and behavior of physicians, manpower of file-workers amount of examinations, tracking system of files, operational procedure, etc. Conclusions: The sound process management and monitoring system will result in the improvement of producing X-ray reports in terms of efficiency.