發展病房動態管理系統以改善病患安全之研究

Development and Application of a Ward Dynamic Management System to Improve Patient Safety

近年來醫療體系的改革，不僅致力於醫療費用控管，更重視整體醫療品質與病患安全，其中建構病人安全的醫療環境更是現況照護專業之重要議題。而本研究透過發展病房動態管理系統，來掌控病患於醫院接受診療之動態，應用病患動態資訊來剖析相關異常及高風險等事件之發生與影響，以有效之管理行動，來降低風險轉為危機事件之發生率及衝擊。本研究之病房動態管理系統乃透過整合病人入出院管理、人員排派班與異常事件通報系統，以提供主管即時之病患動態、異常事件資訊，並簡化原手工作業之資料收集與通報。系統發展係透過使用者需求分析與管理功能之建構，來進行系統之規劃與建置，並以使用者代表對系統之易用性與有用性來評估系統之成效：針對病房基層主管共60位進行問卷調查，有效回收率為96.6%，問卷信度Cronbach's達0.95，而系統易用性與有用性兩因素對使用者滿意度之解釋力為78.6%。有關病患安全資訊之掌握與處理之問項滿意度介於4.10-4.71（五分法），顯示病房動態管理系統之發展在病患安全上有實質效益。

The recent reform in medical system has aimed at not only the control of medical cost, but also the overall medical quality and safety of patients, in which the construction of a safe medical environment for the patients has become a top agenda in the current nursing sector. And this research is intended to reduce the occurrence and impact of the incidents originated from risk by developing the Ward Dynamic Management System for managers to control the processes of the patients being treated in the hospital and analyzes the occurrence and impact of the relevant abnormal and high risk incidents with effective management operations. The Ward Dynamic Management System for Ward in this research incorporates the management of patients’ hospitalization and discharge from hospital, dispatch of workers and communication of abnormal case to provide the real time information of patients care processes and abnormal case for the person in charge, and simplifies the original manual collection and communication of data. The System is planned and constructed by analyzing the user demands and establishing the management functions, with the effectiveness of the System evaluated by the users representatives based on its ease of use and usefulness： 60 questionnaires were given to the persons in charge of the ward, 96.6% of which were returned effectively with a questionnaire credibility of Cronbach’s α as 0.95, while the ease of use and usefulness of the System contribute 78.6% of the users satisfaction. For survey on the possession and manipulation of safety information related to patients, the satisfaction is between 4.10 and 4.71 (Five point scale), indicating the substantial benefits on the patient safety to develop the Ward Dynamic Management System.