- 期刊
腫瘤個案管理師之發展與未來展望
The Oncology Case Manager: A Perspective on Future Development
摘要
個案管理是解決過去片段式醫療照護的問題，強調多科整合和協同合作的作業模式，醫療資源可以有效地整和於病人的照護中，提供高品質並且合乎經濟效益的醫療服務。其中個案管理師是系統中的靈魂人物，他們像是病人的家庭護理師，是病人的代言者和主要照護提供者，持續陪伴於病人的就醫過程，做為病人和醫療系統的主要聯繫，也是病人照護品質的把關者。台灣有越來越多的醫院接受個案管理師這個新角色，認為個案管理師對於病人的照護結果有正面的影響，再加上國民健康局於今年新版的「癌症診療品質認證基準」中明訂「癌症防治醫療機構應建立院內腫瘤個案管理照護制度」（基準4.5），腫瘤個案管理師在台灣已是癌症照護團隊中不可或缺的一員。儘管台灣的醫院漸漸接受個案管理師這個新的護理專業職稱，尤其在新的癌症認證基準下醫院的癌症中心紛紛招募或培訓腫瘤個案管理師，但是台灣腫瘤個案管理的發展仍是面臨許多困難與挑戰。原因在於國內各醫療院所對於實施個案管理的目的和意義並不清楚，以為只要設立個案管理師一職即可執行個案管理的任務，個案管理師的工作職責與角色莫衷一是，個案管理師常常要負擔過多的團隊工作因此無法充分發揮其功能。這篇文章從個案管理的目的和腫瘤病人所需要的照護模式談起，探討台灣腫瘤個案管理師的發展與未來。
並列摘要
The emerging practice of Case Management addresses the classical problem of fragmented delivery of medical and nursing care in the prior era. Case Management utilizes a multidisciplinary and collaborate approach to care practice, so that diverse medical resources can be deployed integrally for patient's total care, thereby raising the quality and cost effectiveness on to patient's total medical care. In this integrated approach the Case Manager is a spiritual anchor of the care delivery team. She serves the role of family nurse, patient's advocate and principal care provider, persistent companion in patient's treatment process, as well as the critical link between patient and the medical care system. She is the bearer of quality standard on patient's care delivery. An increasing number of hospitals in Taiwan have come to accept this new nursing role and recognize its positive impacts on patient outcomes. Moreover, the newly revised standards for ”Accreditation Program of Cancer Care” published by the Cancer Prevention Bureau of Health Promotion, Standard 4.5 mandates that ”the cancer care institute shall establish a program for oncology case management”. Over time this new functional and professional role of Case Manager has become accepted as a proper and indispensable member of the cancer care team. Accordingly the accredited oncology care center in Taiwan hospitals has stepped up its recruitment and training effort to staff such skilled practitioner. Despite of this, the ongoing development of Case Management still encounters much obstacles and challenges. This is the consequence of a lack of understanding and consensus on the critical contributions and functional scope of the manager's role, leading to his misdirected involvement within the care team, which in turn limits his potential in carrying out his critical functions in case management. This paper presents a critical review of the goals and concepts on case management practice, with an attempt to unravel the future and opportunities for the professional role of oncology case managers.