B級長照機構照顧品質之實證研究

Improving the Quality of Long-Term Care at B-Level Facilities

目的：B級長照機構照顧品質攸關服務對象的安全與權益，本研究旨在分析B級長照機構評鑑實證資料，提出具體建議，以精進其服務品質。
方法：採混合式研究、次級資料分析，對178家B級長照機構實地評鑑各構面得分，與評鑑委員書寫意見做探討。
結果：受評機構優等27家（15.17%），不合格33家（18.54%）。居家式長照機構的評鑑總平均值74.94分，最需改善的是專業照護構面的基準；各類型社區式長照機構總平均值皆在80分以上，最需改善的是經營管理構面的基準。委員們對長照機構各構面服務所提待改善的前兩項基準分別為：1.經營管理效能構面的行政作業及品質管理、工作人員的定期接受健康檢查；2.專業照護品質構面的強化長照服務人員的專業知能、意外或緊急事件的預防與處理；3.安全環境設備構面的訂定符合長照機構特性之緊急災害應變計畫及演練、消防安全管理；4.個案權益保障構面的服務滿意度調查、意見反應/申訴機制的訂定與處理。
結論：依實證資料分析，提出改善長照機構評鑑四構面照顧品質的討論，與延聘、留任長照人力，提升長照人員專業知能政策面的建議，以供長照相關單位參酌。

Objective: High quality long-term care at B-level facilities is crucial for patient safety and rights. In this study, we analyzed site accreditation evidence from B-level long-term care facilities to provide concrete suggestions for enhancing care quality.
Methods: A mixed-methods approach involving secondary data analysis was adopted to determine the site accreditation scores (across various domains) of 178 B-level long-term care facilities and review evaluator comments.
Results: Of the 178 facilities, 27 (15.17%) were rated as excellent, and 33 (18.54%) were deemed unqualified. The average score for home-based long-term care facilities was 74.94, and professional care quality emerged as the primary area of improvement. The average score for community-based long-term care facilities was >80, and operational management efficiency emerged as the primary area of improvement. Key areas of improvement identified by evaluators were as follows: administrative work and quality management and regular health checkups for staff (operational management efficiency domain), enhancement of staff’s professional knowledge and accident or emergency handling skills (professional care quality domain), emergency disaster response planning and fire safety management (safety environment and equipment domain), and satisfaction surveys and feedback/complaint mechanism development (protection of individual rights domain).
Conclusion: This study highlight methods for improving the quality of long-term care across four key domains. We further recommend devising effective strategies for hiring staff, retaining long-term care staff, and promoting professional competence among staff to improve long-term care services. These suggestions should be considered by relevant units managing long-term care.