從醫院觀點探討醫院評鑑改革對醫院的影響

Effects of Hospital Accreditation System reform on a hospital from aspect of hospitals

陳珮郁(Pei-Yu Chen) ； 黃馨慧(Hsin-Hui Huang) ； 吳堯達(Yao-Ta Wu) ； 黃仲毅(Chung-I Huang) ； 王拔群(Pa-Chun Wang) ； 陳楚杰(Chu-Chieh Chen)

《醫務管理期刊》 20卷2期 (2019/06) Pp. 145-162

https://doi.org/10.6174/JHM.201906_20(2).145

摘要

目的：從2017年受評醫院觀點探討2015～2016年衛生福利部推動的醫院評鑑制度改革對醫院的影響。方法：本研究為橫斷性調查研究，以2017年接受醫院評鑑的144家醫院為研究對象。使用描述性統計分析評鑑改革對醫院準備評鑑所帶來的影響，並使用費雪精確性檢定醫院層級別與醫院評鑑改革對其影響的相關性，且另以獨立樣本t檢定及單因子變異數分析檢定不同層級別醫院間之得分是否有差異。結果：醫院填答者對醫院評鑑改革主觀感受的正面效益依序為「導入以病人為焦點的查證方式」、「導入持續性監測系統」、「醫院評鑑基準簡化」，且各層級醫院在各項的平均得分無顯著差異。結論：從醫院填答者主觀感受，導入以病人為焦點的查證方式，有助於醫院落實以病人為導向的照護流程、辨識風險、促使改善作為及強化團隊合作。本研究建議衛生福利部應落實實質簡化評鑑基準內容，以達到簡化目的，並建議醫院管理者將以病人為焦點的查證方式精神落實於日常照護中，以提升病人照護品質及安全。

關鍵字

醫院評鑑 ； 醫療品質 ； 以病人為焦點的查證方式 ； 醫院評鑑持續性監測系統 ； 評鑑改革

並列摘要

Objective: The purpose of this study is to discuss the impact of the Hospital Accreditation System reform on hospitals from 2015 to 2016 based on the perspective of accredited hospitals in 2017. Methods: This study utilized cross-sectional research of 144 hospitals that were accepted for hospital accreditation in 2017. Descriptive statistics were used to analyze the impact of preparing hospital accreditation; Fisher's exact test was used to confirm the association between hospital level and the impact of hospital accreditation system reform. The difference in the analysis of hospital scores at different levels was determined by using an independent sample mean difference t-test and single factor variance analysis. Results: The scores of the subjective descriptions of the hospital accreditation of the hospital; the top three of the evaluation are ＂implemented the Patient-Focused Methodology＂, the ＂Hospital Continuous Monitoring Management System＂ and ＂accreditation standards simplification＂. There was no significant difference in the average scores of the various levels of hospitals. Conclusions: From the subjective descriptions of hospitals, implemented the Patient- Focused Methodology (PFM) has indeed helped to implement patient-oriented care processes, identify risks, promote improvement, and strengthen teamwork. This study suggests The Ministry of Health and Welfare (MOHW) should implement simplified accreditation standards. On the other hand, hospital administrators should implement the concept of PFM in daily care processes. To improve the quality and safety of patient care.

並列關鍵字

Hospital Accreditation ； Healthcare Quality ； Patient-Focused Methodology ； Hospital Continuous Monitoring Management System ； Hospital Accreditation System reform

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