- 期刊
運用流程管理降低血液腫瘤科接受化學治療病人入院候床逾時率
Applying Process Management to Reducing the Overtime Rate of Waiting Time for Patients in Department of Hematology and Oncology
摘要
化學治療病人若入院候床時間過久，不僅會延宕治療時間，且會造成病人及家屬住院滿意度降低，故引發本專案動機來改善入院候床逾時率。經由現況分析，發現候床逾時率高的原因包括護理師正執行治療與處置、住院處未分流入院、等待醫師開立出院醫囑單、同一位護理師無法同時接多位入院病人、出院病人等待家屬接出院、出院床數多清潔人員來不及清床等，出入院流程中之各時間點延遲。經過專案團隊腦力激盪提出解決辦法，讓病人先入住病房由書記或護佐執行環境介紹、住院處修訂血液腫瘤科入院時段人流、訂定醫師執行預約出院機制、建立護理師人力調派準則、訂定出院病人離院時間、清潔人員支援機制等，經流程管理實施後，候床逾時率由改善前28.7%下降至8.6%，達專案目的，可做為其他癌症病房降低候床逾時之參考。
並列摘要
Long waiting time of admission for patients with chemotherapy not only delays the treatment time, but also decreases the satisfaction in patients and their families. Therefore, this project was motivated to improve the rate of exceeded waiting time for admission. After investigation of clinical conditions, we discovered the reasons for long admission waiting time as: nursing attendants were occupied in therapeutic administrations, admission office didnot diverge the patients properly, time wasted for admission order by physicians, overloading work to multiple patient-receivings simultaneously by one nurse attendant, waiting time of discharge patients for their family's pick-up, sanitation working speed unable to meet the plenty needs of discharge. Abnormalities at various time points in the admission and discharge process .We formulate our solutions: reception process starts with environmental introduction by secretaries or nurse assistant, adjusting admission work flow of hemo-oncology patients, formulating an integrated mechanisms of scheduled discharge by physicians beforehands, establishing an allocating logistics of nursing resources, setting proper discharge timing, and supporting system of sanitation workers. After the implementation of process management, rate of overtime admission reduced from 28.7% to 8.6%, which has attained our primary objective and this maneuver could serve as a informative reference in reducing admission waiting time of hemo-oncology ward.