運用團隊資源管理（TRM）模式，整合以病人為中心的醫療資源──以南部某醫學中心為例

Integrating Patient-centered Healthcare Resources Based on Team Resource Management Model–an Experience from a Medical Center in Southern Taiwan

領導、溝通及團隊合作的良莠對於病人安全甚是重要，但醫療界在這方面的發展相對不足，因此醫療產業透過團隊資源管理（Team Resource Management；TRM），配合其工具及策略，以提高醫療品質與效能，建構安全的照護環境是必要的課題。運用TRM思維與手法，透過教育訓練及工作坊、設計符合本院特色13份相關訓練教材、以院內臨床實境為背景的4個影片、9款海報、培育18位不同職類的種子教師、建構院內的TRM專屬平台，奠基醫療工作人員在領導、溝通、守望及相助等概念。透過TRM與品管圈的結合，各圈隊推動成效如下，護理部JIT圈平均一位病人花費針數降至3.3、打針所佔用時間降至19.8、一床病人所花費護理人力降至2；內科部無縫圈急性中風病人到院後第一次由口進食前進行吞嚥篩檢的比率降低至21.8％、接受復健評估或治療的比率提升至86.0％。逐步建立本院團隊資源管理的醫療文化。

Leadership, communication, and teamwork are critical to patient safety. However, there has been relatively little development in this area in the medical sector. Therefore, it is essential for the medical industry to adopt Team Resource Management (TRM), with its tools and strategies, to improve the quality and performance of care and to create a safe care environment, and lay down the concepts of leadership, communication, watchfulness, and mutual support for health care workers. An exclusive TRM platform has been built for the hospital by applying the TRM mindset and approach through training and workshops as well asthe design of 13 training materials that meet the characteristics of the facility, 4 videos, 9 posters based on the hospital's clinical reality, and training of 18 seed teachers. Through the integration of TRM and quality control circles, the following results have been achieved: in the JIT Circle of Department of Nursing, the average number of needles used per patient decreased to 3.3, the average time spent on injections decreased to 19.8, and the average amount of nursing manpower spent per bed decreased to 2; in the Medical Seamless Circle, the percentage of acute stroke patients who had a dysphagia screening prior to the first oral intake after arriving at the hospital decreased to 21.8%, and the rate of receiving rehabilitation assessment or treatment increased to 86.0%.A medical culture of team resource management is gradually being established in the hospital.