提升某區域醫院口腔黏膜篩檢異常個案回診率

Project to Improve the Follow-up Rate for Patients with Abnormal Oral Mucosal Screenings at a Regional Hospital

背景：國民健康署針對口腔癌高危險群提供口腔黏膜篩檢，希望能早期發現及治療，但異常個案回診率偏低，使得口腔癌的死亡率仍持續上升。目的：提升本院口腔黏膜篩檢異常個案回診率。解決方法：經由現況分析發現民眾認知不足、回診不便、醫護人員未宣導和經濟等因素，導致個案不願回診。故自2012年6月至10月提出改善措施如下：設置專屬個管師、修訂口腔篩檢和異常個案追蹤流程與建議異常轉介、邀請醫護人員加入宣導、增加衛教內容及製作衛教單張等。結果：本院口腔黏膜篩檢異常個案回診率由64.2%提升到95.3%。結論：專案實施後，有效地提升異常個案回診率，落實了早期發現及治療的目的，值得推廣於口腔癌防治工作。

Background & Problems: The Bureau of Health Promotion provides oral mucosal screening services for those at high-risk of oral cancer in order to detect and treat early-stage oral cancer. However, the low rate of follow up for abnormal cases been associated with a rising mortality rate.Purpose: This project seeks to improve the follow-up rate of patients with abnormal oral mucosal diagnoses at our hospital.Resolutions: We analyzed the current data and found that reasons for poor follow up included: patients' lack of knowledge, inconvenience in accessing the hospital, unwillingness to pay additional fees, and inadequate health education from healthcare providers. Therefore, we proposed several action measures that were developed between June and October 2012. These measures included: designating healthcare staff for oral mucosal screening, improving procedures in oral mucosal screening, tracking and referral of abnormal cases, encouraging medical staff to provide more health education in clinical sessions, and increasing distribution of health-education materials.Result: After implementation, the follow-up rate for abnormal oral mucosal cases in our hospital increased from 64.2% to 95.3%.Conclusion: This project significantly improved the follow-up rate for abnormal oral mucosal cases as part of our overall goal of the early detection and treatment of oral cancer.