跨職類非第一線的急診安寧團隊有助於提升內外部安寧照顧滿意度

Interdisciplinary Non-front Line Hospice Team Care Helps Elevate Both External and Internal Satisfaction

周姚均(Yao-Chun Chou) ； 林雨樹(Yu-Shu Lin) ； 葉綉碧(Shiow-Bih Yeh) ； 何帥穎(Shuai-Ying Ho) ； 白裕銘(Yu-Ming Bai) ； 余得嘉(De-Jia Yu) ； 林宏嶽(Hung-Yueh Lin) ； 賴昭智(Chao-Chih Lai) ； 璩大成(Da-Chen Chu) ； 黃勝堅(Sheng-Jean Huang) ； 洪子堯(Tzu-Yao Hung)

《北市醫學雜誌》 13卷3期 (2016/09) Pp. 53-62

https://doi.org/10.6200/TCMJ.2016.13.3.07

摘要

目的：急診室為處理急症病患第一線之場所，但近年壅塞嚴重，病患待床時間拉長，末期病患同樣具有急性醫療需求，但照護的細緻程度與對安寧的需求有別於傳統急性醫療思維，本研究目的在討論在全民健保框架下，急診「跨科室安寧團隊」建置及潛在困難之研究，以作為台灣急診安寧模式修正之參考。方法：本研究為質性評估，質性資料為「跨科室安寧團隊」內部自我評估及滿意度回饋分析。結果：以不需提供急性醫療需求之非第一線人力主導急診安寧團隊多工運作，可增加安寧緩和的內部參與意願達83.03%，而增加跨職類參與可增加意願達82.42%，而病患滿意度達91.25%。結論：「跨科室安寧團隊」為增加急診安寧品質及照護滿意度基石，以非第一線人力主導的急診團隊提供安寧照顧，可以有效提升內外部滿意度，利於急診安寧之推廣，增加受惠民眾。

關鍵字

急診安寧 ； 跨領域團隊 ； 末期病患照護

並列摘要

Objective: Emergency department (ED) is the frontline venue for delivering emergency medical care. However, the boarding time of ED patients has been lengthened as a result of increasing congestion in recent years. Patients in their end-of-life who demand emergency care require meticulous quality and hospice care which are different from the traditional emergency care. The objective of this study was to discuss the establishment of an ED Interdisciplinary Hospice Care Team, and to examine the potential challenges under the National Health Insurance framework, so as to provide a reference for improving Taiwan’s ED hospice care model. Methods: This was a qualitative analysis of the data of the internal self-assessment of the Interdisciplinary Hospice Care Team and satisfaction feedback. Results: When the hospice care team was led by the non-front line human resources that were not required to provide emergency medical services, the internal willingness for participation in hospice care improved to 83.03%. In addition, increases in interdisciplinary participation improved the willingness to 82.42%, with a patient satisfaction of 91.25%. Conclusions: The Interdisciplinary Hospice Care Team was the cornerstone for improving ED hospice care and satisfaction; the provision of hospice care in ED by non-front line human resource could effectively improve the internal satisfaction, which could in turn promote ED hospice care, so that more people may benefit from the service.

並列關鍵字

Emergency department ； Hospice Care ； Interdisciplinary Team ； End-of-Life Patient Care