提升恢復室術後病人轉送作業之時效

Improving timeliness of discharge of patients from the Post-Anesthesia Care Unit (PACU) with optimizing patient flow

轉送時效延遲不僅會造成病人與家屬的抱怨，增加恢復室病人等待轉送時不可預期的風險，亦會影響開刀房手術接台排程，調查2019年7月2日至7月14日期間，恢復室尖峰時段轉送時效達成率僅達37.7%，引發專案小組改善動機，分析影響恢復室轉送時效性主要原因：缺乏人力支援及轉送服務人力分配不均、尖峰時段轉送服務量高、轉送過程常中斷、耗時重複核對現場術後等候轉送病人、轉送人員未備妥轉送工具、等候醫療電梯耗時，進而影響術後病人轉送時效。故成立專案小組擬定解決方案，改善措施如下：設置轉送中心分區駐點模式、增設醫療電梯專用感應卡與管理機制及規劃恢復室轉送時效提示牌。經對策實施後，恢復室轉送時效性達成率由37.7%提升72.0%達專案目的。期望藉此專案促進跨部門間共同合作維護手術後病人安全及提升其醫療照護品質。

A prolonged patient stay in a PACU can cause complaints from patients or their family members. It not only increases an unexpected risk to patients but also creates bottlenecks in the operating room workflow. From July 2 to 14, 2019, only 37.7% of patients were transfer in time from PACU during peak hours. The project team found that the reasons for delay were: (1) inadequate nursing staff at peak hours; (2) lack of staff and receiving nurses to help transport patients; (3) complex clerical work or administrative delays; (4) insufficient resuscitation trolley or mobile monitoring devices; and (5) Prolonged wait time for patient trolley elevators. The following strategies were introduced: (1) establishing the patient transfer center to coordinate each area of contact; (2) setting up access control function for patient trolley elevators; and (3) creating a notification board for timely patient flow. After the project, 72% of the patients were transfer in time in PACU. It achieved the desired timeliness of discharge of patients from the PACU.