運用團隊資源管理模式提升內科加護病房急救溝通流程之完整率

Using Team Resource Management to Enhance the Integrity Rate of Medical Intensive Care Units in the Communication Process

急救若無立即處理或間斷易造成不可逆性的生命危險，本專案發現當急救時因醫護團隊無法明確傳遞醫囑內容而導致急救中斷，故引發此專案改善之動機。案旨為提升加護病房急救溝通流程完整率，經現況分析發現急救溝通流程完整率低的原因：一、現行「急救標準作業」不適用。二、醫護人員缺乏急救溝通流程行為及認知的教育訓練。三、醫護人員缺乏在急救過程中的溝通技巧。經1.增訂【急救溝通流程圖】於急救標準作業、2.設計團隊資源管理在職教育課程、3.編寫及拍攝急救溝通流程之教案影片、4.制訂醫護人員有效運用團隊資源管理技巧之獎勵辦法之解決方案，使急救流程溝通完整率由8%提升至94%，藉由專案實施增進醫護人員間在溝通完整率及照護品質。

Delay or interruption in the management of critical emergency patients can easily lead to irreversible damage or harm to the patient. In our project, we found that a lack of precise communication between medical team members leads to interruption of emergency management and jeopardizes patient safety. The motivation and purpose of this project is to ensure and enhance proper communication.
Throughout our study we found that the following reasons lead to a poor completion of medical emergency communication between medical team members:
1. Outdated standard procedures of medical emergency management. 2. The medical personnel lack of education and training in communication behavior and communication cognition for emergency management. 3. The medical personnel also lack communication skills during emergency management.
Therefore, first, we designed a flow chart for the standard operation of medical emergency management. Second, we designed a team resource management training programs. Third, we made an emergency management video to guide communication skills. Fourth, we set up an incentive scheme for medical personnel who effectively use team resource management skills. By these solutions, we were able to increase the completion rate from forty percent to ninety percent in emergency management communication. Eventually, this project will enhance care quality for ICU patients.