以精實手法導入心導管檢查照護流程優化之成效初探──台灣南部某醫學中心為例

Process Optimization in Cardiac Catheterization Care Through Lean Methodology: A Case Study of a Medical Center in Southern Taiwan

目的：心臟科病房以心導管檢查為主要及頻繁之檢查項目，其檢查前、後所耗費的時間可能會擠壓臨床上其他病人的照護。此研究透過導入精實品管手法優化心導管檢查流程，分析護理師及病人滿意度及其效益分析。方法：透過精實概念流程優化心導管檢查照護流程，減少不必要的步驟以有效提高的臨床作業流程，並分析改善介入前、後之成效分析。結果：心導管術式檢查優化前、後流程花費時間從8,859秒降為5,057秒（t= -13.074, p =0.000）；護理師對於整體照護流程準備改善評價分數，從72.64分提升至82.39分（t= -2.448, p =0.018）；病人對於整體檢查經驗評價分數從94.5分提升至95.8分（t= 2.320, p =0.129）。結論：透過導入照護流程優化策略，有助於提升臨床醫護及病人之正向回饋。期待透過此心導管優化流程之成效初探，提供對於複雜專科性檢查流程整合改善規畫之參考。

Purpose: Cardiology wards frequently employ cardiac catheterization in primary examinations. The amount of time before and after an examination can affect the care provided to other patients. This study optimized the cardiac catheterization process by using lean quality control methods and evaluated the benefits of and nurse and patient satisfaction with these methods. Methods: The study analyzed the effectiveness of catheterizations before and after the intervention. Results: The time required for cardiac catheterization was reduced from 8,859 seconds to 5,057 seconds (t =−13.074, p = 0.000). Nurse evaluation scores in the care preparation process increased from 72.64 to 82.39 (t =−2.448, p = 0.018). Patient evaluation scores for the overall examination experience increased from 94.5 to 95.8 (t = 2.320, p = 0.129). Conclusion: The optimized care processes received positive feedback from clinical staff and patients.