縮短辦理出院等候時間之專案

The Project for Shortening the Waiting Time of Discharge Procedure

林玉菜(Yu-Tsai Lin) ； 吳一金(Yi-Chin Wu) ； 林秀惠(Shiu-Hui Lin) ； 陳芝文(Chih-Wen Chen)

《高雄護理雜誌》 36卷1期 (2019/04) Pp. 12-23

https://doi.org/10.6692/KJN.201904_36(1).0002

摘要

本專案旨在縮短辦理出院等候時間，由於家屬及病人抱怨出院等候時間過久，醫護人員辦理出院延遲，導致工作效率低及影響急診病人待床時間長。經由現況分析確認問題後，透過專案執行改善措施為：1.全面辦理醫事人員電子簽章；2.成立電子病歷資源小組；3.辦理電子病歷教育訓練課程；4.修訂護理出院流程作業及記錄書寫簡化；5.建立電腦反黃標示出院病人；6.製作出院辦理程序衛教單張。專案執行後，辦理出院等候時間176分縮短為85分達到專案目的，降低急診待床率每日平均為2.7人次，有效改善急診雍塞及醫護工作壓力。本院護理部全面推行電子病歷，減少單張並節省列印時間及相關資源，有效降低人員工作壓力，提昇醫療效率，兼顧醫療成本及病人安全。

關鍵字

出院流程 ； 等候時間 ； 電子病歷

並列摘要

The purpose of this project was to shorten the waiting time of discharge Procedure. Patients and their family members complained that the waiting time of discharge procedure was too long. It led to low working efficiency of medical professionals and long transfer time from the emergency department to the inpatient bed ward of patients. Analysis indicated that the problem could be solved by computerizing staff' s signature, computerizing medical records, providing education and training of using electronic medical record (EMR), revising the discharge procedure, reducing paperwork, revising the discharge procedure specification for administrative staff, flag-reminding discharge patients about their medication on computers, and providing patients with a procedural sheet for discharge. After the implementation of the project, the waiting time of discharge procedure was decreased from 176 minutes to 85 minutes. The transfer time from emergency department to inpatient bed was reduced to 2.7 people per day (editor-2.7hr/person?). The situations of emergency department congestion and working pressure were improved. The nursing department trialed the EMR and it showed that the use of sheet paper and related resources was reduced, while the working pressure of staff was reduced, which improved medical practice efficiency. The project took into account both healthcare costs and patient safety.

並列關鍵字

discharge procedure ； waiting time ； electronic medical record (EMR)

參考文獻

汪文煌、陳怡敏、鄭貴真(2011)．聖馬爾定醫院推動電子病歷經驗分享與未來規劃．病歷資訊管理期刊，10(2)，12-23。

楊沛墩、陳彥臣、黃援傑(2011)．電子病歷推動現況及檢討建言．病歷資訊管理期刊，10(2)，1-11。

郭光明、余明玲、黃興進(2010)．如何成功導入電子病歷系統：醫院的觀點．病歷資訊管理期刊，9(2)，19-36。

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