提升整合醫學病房垂直轉銜收案率

Promoting the Acceptance Rate of Vertical Referrals in Integrated Medical Ward

林珮珊(Pei-Shan Lin) ； 楊芙菁(Fu-Ching Yang) ； 洪錦蕙(Jin-Hui Hong) ； 許桂菱(Kuei-Ling Hsu) ； 張秋華(Chou-Hua Chang)

《高雄護理雜誌》 41卷3期 (2024/12) Pp. 24-38

https://doi.org/10.6692/KJN.202412_41(3).0002

摘要

推動垂直轉銜業務主要是讓病人出院後有良好銜接照護，但同仁對流程不清楚、資料建置不完整、無個管師及收案率低等問題，引發成立専案動機。本研究目的為提升收案率，擬定對策：安排課程、業務重新分配、修定入住病房條件、制定流程圖、宣導海報、單張及醫病共享決策等。垂直轉銜符合收案條件率由42.9%提升至61.72%，完成收案率由8.6%提升至13.18%，雖未達目標值，但醫護團隊更投入垂直轉銜業務。全球邁入超高齡社會，面臨多重共病、多科看診及反覆住院逐年遽增，為優化病人的醫療便利性，冀望將垂直轉銜照護平行推展至全院，造福更多病人。

關鍵字

垂直轉銜 ； 整合醫學照護制度 ； 多重共病

並列摘要

The main purpose of promoting the vertical referrals process is to allow patients to have better transitional care after being discharged. Due to medical staffs were unfamiliar with the transfer process, incomplete data records, no case manager assigned, and low case acceptance rates, we established a study to analyze and improve the current situation. The goal of the study was to improve the acceptance rate by the following measurements: arrange instruction courses, redistribute the services, revise admission criteria to wards, create flow charts, construct posters and leaflets of Shared Decision Making. After this study, the rate of case that meets the criteria of vertical referrals increased from 42.9% to 61.72%, and the rate of complete acceptance increased from 8.6% to 13.18%. Although the target value was not reached, the medical teams got more involved in the vertical referrals process. While the global population was getting aging, we are facing more multiple comorbidities, multi-department visits, and an increase of repeated hospitalizations. To improve the convenience of medical service and help more patients, we hoped that the vertical referrals process could be implemented across all hospital departments.

並列關鍵字

Chemotherapy ； vertical referrals ； hospitalist ； multi-comorbidity

參考文獻

卜宜芝、陳強儀、周曉禎、黃俊達（2020）‧醫院整合醫學照護制度與專科護理師的角色‧護理導航，21（2），1-9。https://doi.org/10.29494/LN.202006_21(2).0001

汪秀玲、洪純隆（2018）‧醫院整合醫學照護制度（Hospitalist）對住院照護品質的影響，台灣文獻綜論‧台灣公共衛生雜誌，37（5），499-513。https://doi.org/10.6288/TJPH.201810_37(5).106140

何麗娟、詹惠雅、王怡人、詹其峰、余忠仁、曾家琳（2020）‧出院準備與轉銜照護之整合實務‧領導護理，21（2），10-20。https://doi.org/10.29494/LN.202006_21(2).0002

李婉菱、張慈惠、黃嗣棻（2021）‧醫病共享決策之概念與實務‧台大護理雜誌，17（1），5-13。https://doi.org/10.6740/NTUHJN.202101_17(1).0002

林婉如、杜姝莼、陳乃菁、黃惠滿（2022）‧提升急診護理人員執行ISBAR交、接班之完整率‧高雄護理雜誌，39（1），30–41。https://doi.org/10.6692/KJN.202204_39(1).0003