標準作業程序於醫院品質改善之應用－以個案醫院檢驗部為例

Application of Standard Operation Procedure to Hospital Quality Improvement-A Case Study of a Hospital Laboratory

張顯洋(Shien-Young Chang) ； 鎮明常(Ming-Chang Cheng) ； 陳春琴(Chun-Chin Chen) ； 張勝立(Sheng-Li Chang)

《慈濟醫學雜誌》 12卷1期 (2000/03) Pp. 1-15

https://doi.org/10.6440/TZUCMJ.200003.0001

摘要

目的：自從施行全民健康保險以來，民眾對療品質的需求較過去更高，造成醫院所更加重視醫療服務品質。由於醫療服務工作是以人服務人的方式呈現，其服務品質因管理者，健保給付暨服務提供者個人的背景、經驗、知識、價值觀及認知等因素的不同而造成差異。醫療院所應降低醫療服務差異所造成的品質不隱定，並致力提升服務水準。醫療院所內各單元追求服務品質提升時，往往忽略作業的定義、醫療作業標準的確定及全面系統的品質規劃等，也不常運用統計上及科學方法的管理。充份運用品質管理的統計方法與標準作業程序的設計與執行是醫療院所提升醫療服務品質的基礎，應不容忽視。材料與方法：有鑑於標準作業程序(Standard Operation Procedure, SOP)有降低服務品質差異，隱定服務品質，並能成為品質改善及評估改進成效的基礎及準則等優點，所以SOP將十分適用於醫院的品質改善。本研究擬配合SOP來研發及應用以作業為基礎的品質管理模式(Activity-Based Quality Management, ABQM)協助管理醫院的專業及服務品質。結果：在實際運用後發現，SOP可以降低新進人員耳對新的工作程序及流程上的不安及恐懼，也成為各組組長訓練新進人員的教材。 討論：同時，以作業為基礎的品質管理模式，也可以協助醫院管理者找出造成變異的原因，並能針對變異原因提出改善，達到持續改善的目標(慈濟醫學 2000;12:1-15)

關鍵字

醫療服務品質 ； 標準作業程序 ； 作業基礎品質管理模式

並列摘要

Objective: Sine the National health Insurance program was initiated on March 1,1995,a high quality of medical service has come to be demanded by patients in Taiwan. This has stimulated our hospitals to pay more attention to quality improvement. Nonetheless, the unique quality of health care service involves medical professionals (such as physicians, nurses, and administrative staff) providing service to their clients (the patients and their relatives). Due to human factors in this service process, it is easy for a hospital to produce variations in service to their customers. Under these circumstances, reducing the variations in service and improving their quality have become primary functions of hospital in recent years. However, during the quality improvement process, hospitals often neglect their medical operation definitions and their procedures. Even worse, a complete quality improvement design program has usually been ignored. Although, statistical methods and scientific management have been applied to hospital management frequently, they have been either misused or totally distorted from their original purposes. Materials and Methods: Because the use of Standard Operation Procedure (SOP) can reduce variations, provide measurement criteria, and stabilize service quality, it is the best method for health care service quality improvement. The purpose of this research was not only to help hospitals build an Activity-Based Quality Management model consistent with the spirit of Activity-Based Management (ABM) and SOP, but also to implement it in the case of a hospital laboratory to help it improve its operational quality. Results: The study found that SOP could reduce novices’ fear of new operational procedures and become teaching materials for training. Discussions: The Activity-Based Quality Management model can help managers to discern the causes of quality variation. It especially provides suggestions for the quality improve-ment of man-made errors, helping hospitals to continue their long-term quality improvement. (Tzu Chi Med J 2000; 12:1-15)

並列關鍵字

health care service quality ； standard operation procedure ； activity-based quality management