- 期刊
應用史哈特循環：計畫－執行－檢查－行動模式於臨床復健醫療服務等待時間之改善
Application of Shewhart Cycle of "Plan-Do-Check-Act" Model to Improve the Waiting Time in Clinical Rehabilitation Therapy
摘要
機構單位可透過史哈特循環模式［Shewhart cycle of ”Plan-Do-Check-Act” model: PDCA（史哈特循環：計畫－執行－檢查－行動模式）］之設計、檢查、評估、改進或再設計各項計畫，進而改善服務品質。本研究首度把史哈特循環模式應用至國內臨床復健醫療，進而探討其服務等待時間之改善效益。某醫學中心復健科針對現有的臨床復健醫療服務提出問題，利用史哈特循環模式之計畫－執行－檢查－行動來改善(1)住院病患會診職能治療三日內排程達成率(2)發展遲緩兒童早期療育等待時間及(3)發展遲緩兒童心理衡鑑等待時間。透過史哈特循環模式，職能治療會診三日內排程率由76%進步至設定之閾值90%；發展遲緩兒童早期療育等待時間職能治療由半年進步至25天、語言治療由3個月進步至14天、物理治療由兩週進步至一週；心理衡鑑等待時間則由平均18日進步至5日。在史哈特循環模式實施後，早療家長健康照護品質滿意度以PedsQL-Health Satisfaction問卷評估有4%之進步。本研究證實應用史哈特循環模式的方式可以有效改善臨床復健醫療等待時間，進而提升其品質。
並列摘要
The Shewhart cycle ”Plan-Do-Check-Act” (PDCA) can be applied by organizations as a model for designing, checking, evaluating, improving, or re-designing plans to improve the quality of service. We applied the PDCA model to clinical rehabilitation services in Taiwan and discussed its effects on the improvement in waiting time. Three issues facing current clinical rehabilitation services were proposed by the Department of Physical Medicine and Rehabilitation in a medical center to which PDCA was applied: (1) arranging occupational therapy for in-patients within 3 days after consultation, (2) shortening the waiting time for therapy in children with developmental delays, and (3) shortening the waiting time for psychological evaluation experienced by children with developmental delays. The results showed that (1) the rate of scheduling occupational therapy within 3 days after consultation improved from 76% to the threshold of 90%, (2) the waiting time for occupational therapy, speech therapy, and physical therapy among children with developmental delays improved from 6 months to 25 days, 3 months to 14 days, and 2 weeks to 1 week, respectively, and (3) the waiting time for psychological evaluation was shortened from 18 days to 5 days. The PedsQL-Health Satisfaction score given by caregivers of the children with developmental delays improved 4% after the application of PDCA. Our study proved that the application of the PDCA model could improve the waiting time and quality in clinical rehabilitation services.
被引用紀錄
延伸閱讀
- 許富榕、王本正、胡次熙（2016）。以延伸型整合性科技接受模式探討行動醫療App於協助照護任務之接受度。福祉科技與服務管理學刊，4(2)，149-150。https://doi.org/10.6283/JOCSG.2016.4.2.149
- 曾耀群（2009）。應用醫療照護之失效模式與效應分析於醫療流程之改善〔碩士論文，國立清華大學〕。華藝線上圖書館。https://doi.org/10.6843/NTHU.2009.00090
- 古芳瑜（2017）。改良「職能復健評估綜合評量表」應用於社區思覺失調症個案〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU201702880
- Huang, H. Y., Lin, Y. S., Chuang, Y. C., Lin, W. H., Kuo, L. Y., Chen, J. C., Hsu, C. L., Chen, B. Y., Tsai, H. Y., Cheng, F. H., & Tsai, M. W. (2015). Application of the Transtheoretical Model to Exercise Behavior and Physical Activity in Patients after Open Heart Surgery. Acta Cardiologica Sinica, 31(3), 202-208. https://doi.org/10.6515/ACS20150204A
- 蘇喜、李敏禎（1998）。Using Simulation Method for Waiting Time analysis-take Family Medicine Deparement of a Medical Center as an Example。中華公共衛生雜誌，17(5)，395-403。https://doi.org/10.6288/CJPH1998-17-05-05