利用跨團隊資源改善緊急外傷照護品質三年經驗分享

Using cross-functional team resources to improve quality of emergency trauma care: experience sharing

雖處於醫療資源不足地區，本院急診每年處理緊急外傷病人平均仍超過百人，故自2016至2018年分析結果顯示，為提升醫院緊急救護能力，完善可近性及平等性高品質醫療照顧，採用以下方法提高緊急外傷照顧能力：一、加入醫中計畫，增加急診及外科系醫師，強化緊急外傷處理能力；二、簽訂軍榮醫院合作模式，落實醫療在地化；三、成立創傷小組，強化急診緊急外傷團隊處理能力；四、增設急診放射科及醫療設備。成效如下：一、緊急外傷病人轉院率下降：由56.8%下降至39.8%；二、重點科轉院率逐年下降，神經外科由47.4%降至29.9%，骨科由21.1%降至6.7%，一般外科由83.3%降至37.5%；三、外傷到院前死亡(OHCA)病人救活率上升：由15.4%上升至50.0%。由以上可知，利用跨團隊資源方式，有效改善偏遠或醫療資源不足地區緊急外傷照護品質。

 

Despite being located in an area with insufficient medical resources, the hospital handles more than 100 emergency trauma patients per year. To improve the emergency rescue capacity of hospitals and improve the accessibility and equality of high-quality medical care, the following methods were implemented: first, joining a medical plan, increasing the number of emergency and surgery department physicians, and strengthening emergency trauma treatment capability; second, signing the cooperation framework agreement of the Army Veterans Hospital and implement medical localization; third, setting up a trauma group and strengthening the emergency trauma team’s processing ability; and fourth, increasing the amount of emergency radiology and medical equipment. The results are as follows: first, the transfer rate of emergency trauma patients decreased from 56.8% to 39.8%. Second, the rate of patient transfer across key departments decreased—from 47.4% to 29.9% for neurosurgery; 21.1% to 6.7% for orthopedics; and 83.3% to 37.5% for general surgery. Third, the survival rate for out-of-hospital cardiac arrest increased from 15.4% to 50%. These results revealed that the use of cross-functional team resources can effectively improve the quality of emergency trauma care in remote or medically inadequate areas.