提升門診整合照護成效執行策略

Increasing the effectiveness of an integrated outpatient care implementation strategy

目的：本研究運用品管圈手法，如何以現有的醫療人力照護大量整合病人；本活動採取策略性的改善，達到持續進行全面性照護。方法：採取策略性改善（1）先篩選出優先照護之病人；（2）針對「重大傷病」病人給予最適合的藥事照護；（3）改善病人追蹤遺漏問題；（4）進行擴大衛教診間提升服務品質。結果：在降低跨院降血壓、血糖、血脂藥物日數重複率與去年同期相比分別降低75％、20％、38％。整合照護病人每月平均費用由11.26％降低至-8.01％、就醫次數由6.23％降低至-13.59％及三高方面皆有進步。結論：本活動由圈員共同進行照護，達到降低醫療資源浪費，並提升用藥安全。 Objectives: This study employed quality control circle techniques to investigate how existinghealthcare manpower can be used to care for a large number of patients. Strategic improvementswere applied to achieve continuous comprehensive care.Methods: The following strategic improvements were adopted: (1) Patients who require priority carewere identified first. (2) Patients with catastrophic illnesses were given appropriate pharmaceuticalcare. (3) Improvements were implemented to avoid patient loss to follow-up. (4) Health educationdiagnostic rooms were expanded to improve service quality.Results: The hospital-wide day repetition rate for blood pressure-, blood glucose-, and blood lipid-lowering drugs decreased by 75%, 20%, 38%, respectively, compared with data for the same periodin the former year. Thus, hypertension, hyperglycemia, and hyperlipidemia control improved. Theaverage monthly integrated patient care costs decreased from 11.26% to -8.01% and the number ofmedical treatments decreased from 6.23% to -13.59%. .Conclusions: Caring performed by circle members reduced medical resource wastage andimproved medication administration safety.