提升門診外科病人白班住院比率

Enhancing Hospitalization Rate of Day Shift in Surgical Outpatients

為能完成病人於資源多的白班簽住院，減少病人相關檢查檢驗處置之等待，引發進行此專案的動機。透過本院醫療資訊系統內床位動態即時查詢系統之電腦報表，於2014年1月1日至2014年6月30日進行資料回溯，門診外科6個病房住院病人共計2,817人，病人實際於白天15:00前完成辦理住院佔1157人，白班住院比率僅達41.1％。現況分析結果醫療人員方面：12：00簽床比率低、今辦明出率低。政策方面：通知辦理住院無統一標準及時間限制、住院櫃台僅一位書記辦理。流程方面：辦理住院流程耗時、辦理住院流程繁瑣。鑑此，本專案主要目的依本院年度品質監控目標，提升門診外科病人於白班15：00前完成住院比率達50.0％。運用團隊資源管理概念組成團隊，定期每週會同醫事、醫技、轉送及醫護等部門人員部門開會，檢討病人白班住院比率執行問題、互相提醒監控執行結果及溝通協調改善，進行簡化辦理住院流程、報到時間標準化及提早釋出床位等方案實施，落實團隊資源管理之精神。結果顯示12：00前完成簽床位比率提升16.2％、今辦明出率提升5.4％及住院流程時間縮短18.0分，最後目的門診外科病人於白班住院率由41.1％提升至50.4％，達此專案目的。

The project was mainly to enhance hospitalization rate of more resources day shift in surgical outpatients before 15:00. Retrospective data were used through medical information systems within the dynamic real-time query report of computer from January 1, 2014 to June 30, 2014. The data collection was 1,157 patients hospitalization of total 2,817 patients in six surgical wards planned hospitalized before 15:00. The hospitalization rate before 15:00 was only 41.1%. The confirmed problems included hospitalization time-consuming process, no notification hospitalization uniform standards, time limitation, and the empty bed late release. The concept of team resource management was applied, which included four domains of leadership, situation monitoring, mutual support, communication to simplify the process of hospitalization, standardization of registered hospitalization, and early release patient beds. The results showed that completely signed rate of the patient bed before 12:00 increased from 57.9 % to 74.1%. The rate of conducting discharge procedure today and tomorrow increased from 2.8% to 8.2%. The hospitalization shortened process time from 70.0 minutes to 52.0 minutes. The hospitalization rate of day shift before 15:00 increased from 41.1% to 50.4% in surgical outpatients. The project has reached the goal.