醫策會心臟血管疾病照護品質認證作業成果初探

醫策會自2009年推出「心臟血管疾病照護品質認證」，至今已發展15項疾病別項目，為瞭解現階段國內心臟血管疾病照護團隊運作上的情形，以及目前冠狀動脈疾病、急性冠心症、急性心肌梗塞、心衰竭等4項心臟血管疾病於照護過程的問題，期能提供心臟血管疾病照護團隊精進照護品質的參考。本研究以橫斷性研究設計，針對2019年至2020年參與心臟血管疾病照護品質認證的23個疾病照護團隊，分析其認證意見報告書，並以描述性統計來分析各項基準的達成度。研究結果發現照護團隊現階段常見問題，在冠狀動脈疾病、急性冠心症、急性心肌梗塞為團隊成員溝通及醫病共享決策之執行；在心衰竭部分，需更強化病人自我照護能力，加強個別化之衛教指導。心臟血管疾病照護經過多年的努力，衛教資訊的內容多元、心臟復健的投入資源、利用資訊化系統提升照護效率等，與過去相比已有很大的成效。本研究建議心臟血管疾病照護團隊，可針對本研究所發現之問題，依各團隊特性進行檢討與強化，透過分享或標竿學習，相互成長，並可結合政府單位及學會目標，提出相關政策或照護模式，作為健保給付之參考，擴大認證效益，以增進病人照護品質。

關鍵字

醫策會；疾病照護品質認證；心臟血管疾病照護品質認證

並列摘要

Since 2009, the Joint Commission of Taiwan has developed a series of fifteen items in Disease Specific Care certification (DSC) modules aiming to encourage institutions to demonstrate their understanding outcomes by establishing integrated care model. In order to understand the current national operation of cardiovascular disease care teams, we review and analyze current issues from DSC surveyors' comments; this hopefully will provide a reference for institutions to upgrade their clinical care quality. In this cross-sectional study, we reviewed performance reports from 23 DSC cardiology teams during 2019 and 2020. We analyzed the certificate survey reports and levels of standards achievement. We found that team communication and implement in shared decision making (SDM) are common problems in coronary artery disease, acute coronary heart disease, and acute myocardial infarction care teams. In terms of heart failure care, strengthen patient's self-care ability and individualizing health education are to be improved. Contents of health education, resource-investment for cardiac rehabilitation, and applying information system have improved significantly over the years. Cardiovascular DSC teams can use this information to further enhance their care quality based on their own requirements. Through sharing or benchmarking learning, mutual growth can be combined with the goals of government units and the society; and relevant policies or care models can be proposed as a reference for health insurance payment, as well as the benefits of certification that can be expanded to improve the quality of care to the patients.

並列關鍵字

Joint Commission of Taiwan (JCT) ； disease specific care certification (DSC) ； cardiovascular diseases care certification

參考文獻

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醫策會心臟血管疾病照護品質認證作業成果初探

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