出院準備服務病患需求等級評估量表修訂專案

A Project to Revise the Patient Needs Rank Assessment Scale for Discharge Planning

一份完整的病患需求評估工具可提供病患個別性需求服務及高品質出院計劃的執行。北部某醫學中心之出院準備服務目前使用一份篩檢所有成人住院病患之轉介問題評估表。本專案是以此醫學中心為例，使用訪談及問卷調查法，發現目前使用的等級評估表之敏感度及特異性均未大於最低標準70%，不足以正確篩選出病患需求等級分類，故修訂「出院準備服務病患需求等級評估量表」的評估項目，依各等級的需求程度訂定量化分數，計算出各等級適當敏感度及特異性之分數分切點。結果顯示修訂後的評估量表之敏感度及特異性均提升至70%以上。臨床使用滿意度方面，工作人員針對評定標準、符合臨床病患需求和正確篩選病患需求等三項等級作評值，初步結果顯示滿意度增加並達統計顯著意義（p < .05）。故此修訂後之「出院準備服務病患需求等級評估量表」可應用於臨床正確篩選病患需求等級。

A comprehensive discharge planning assessment tool facilitates the provision of services that meet individual needs thus also facilitating the implementation of high-quality discharge planning. This project used a medical center in northern Taiwan as an example, applied interviews and the questionnaire method, and found that the sensitivity and specificity of existing rank assessment scales were all lower than the standard of 70%, too low to provide accurate screening for classification of needs. In revising the assessment items of, ”The patient Needs Rank Assessment Scale for Discharge planning”, a quantified score was set for the degree of need for each rank, to compute the cut point of each rank with the appropriate sensitivity and specificity. The results show that sensitivity and specificity after revision of the assessment scale all exceeded 70%. As far as satisfaction in clinical usage was concerned, personnel sought to match assessment standards with clinical patients' needs and accurately screened three grades of patient need. Initially, the increase in satisfaction was of clear statistical significance (p＜.05). This showed that revision of, ”The patient Needs Rank Assessment Scale for Discharge planning” can be applied to achieve accurate screening of patient need grades.