居家照顧個案接受遠距照護服務之改善方案

Improvement project for telecare in Homecare patients

遠距居家照護是科技與醫療照護服務的結合，透過遠距照護服務，確實掌握個案的生理指標變化，以做好健康管理與追蹤。統計2010年1－12月居家照護個案每月平均約138位，其中可以接受遠距照護服務者有21位，但實際收案者只有7位(33.33%)，分析其原因為缺乏跨部門溝通機制、缺乏遠距照護服務作業流程、個案經濟無法負擔、無專責居家護理師、以及醫師於照會時說明不足，導致個案無法接受遠距照護服務。本專案成立「遠距照護服務小組」，共同制定「遠距照護服務作業流程」、設置「遠距照護服務專責諮詢人員」、提供「遠距照護服務特惠方案」、規範「家醫科醫師照會準則」等改善方案，經方案執行後，統計2011年11－12月結果顯示，接受遠距照護服務者由33.33%提升至61.90%，2012年持續推動其接受遠距照護服務者為57.14%，未達本專案目標。

'Home-based Telecare' is a health care service which provides care over distance by means of technology; a patient's physiological condition can be monitored through telecare for health management. However, home care patients who received telecare care figured at less than 33.33 percent in our hospital during 2010, with the possible causes including lack of effective cross-departmental cooperation mechanisms, no standard operating procedure for telecare, economic concern of the patients and families, no specifically responsible nurse in the telecare, and introduction of the telecare for patients being the exception rather than the rule. For improving telecare quality, an 'Improvement project for telecare' was implemented during 2010-2011. The purpose of this project was to establish the 'Standard operating procedure of telecare', setup the 'telecare consulting service' and 'quality telecare plan', as well as a 'telecare consultation check-list for doctors'. This resulted in a 61.90% increase of telecare among home care patients. Continual promotion of this project from November 2012 to December 2012 showed that home care cases receiving telecare reached a figure of 57.14%.