縮短病人入住VIP病房等候時間之專案

背景：病人等待入住時間過程延長會造成病人疾病不適及家屬焦慮不安。記錄2017年12月環衛人員開始清床至舖床完畢及通知新病人入住平均所需花費163分，病人無法立即接受醫療照護，對醫療處置不滿，導致醫病關係緊張，醫療服務品質受到負面影響。目的：縮短病人入住VIP病房等候時間。解決方案：制訂1.每日同時段出院大於3床，啟動環衛人員人力支援1人機制；2.跨單位制定清床標準流程及修改智能管理系統；3.重新規劃病房設備及清潔物品擺放動線、減少環衛人員撥補用品時間；4.推動「今辦明出｣醫囑，以利提早釋出床位運用。結果：達成出院清床至完成舖床時間及通知新病人入住時間由163分鐘，縮短目標值於96分鐘內完成，改善幅度達41.1%。結論：經由跨單位團隊合作，發現環衛人員的清床時機與流程是影響入住等候時間的最大因素，跨單位討論並共同制定解決方案，有效縮短出院清床時間，改善病人等候住院，建立優質醫療環境，進而提升醫療品質。

關鍵字

清床流程；今辦明出；等候床位

並列摘要

Background: The prolongation of the patient's waiting time for admission causes the discomfort of the patient and the anxiety of family members. It was recorded that in December 2017, it took 163 minutes from bed cleaning procedure to notification of new patients to move in. Patients were unable to receive medical care immediately and were dissatisfied with the medical treatment, resulting in a tense doctor-patient relationship. The quality of medical services were negatively affected. Objective: The purpose of this project is to reduce the waiting time for patients to admissions in VIP ward. Resolution: Project plans: (1) The sanitation manpower supporting mechanism was initiated, if more than 3 patients are discharged at the same time daily. (2) Establish a standard procedure for bed cleaning and modify the intelligent management system across units. (3) Re-design the ward equipment and cleaning items placement flow to reduce the time for replenishing supplies. (4) Promote "pre-opening MBD" procedure to facilitate early release of beds for use. Results: The results show that the time from patient's discharge to completion of bed making has been shortened from 163 minutes to the target value of 96 minutes. The improvement rate was 41.1%. Conclusion: Through cross-unit team cooperation, it is found that the timing and process of bed cleaning are the major factors affecting the waiting time for admission. Cross-unit discussions is beneficial in finding solutions to effectively shorten the time of bed cleaning at discharge, reduce patients' waiting time for hospitalization, establish high-quality medical environment, and improve the quality of medical care.

並列關鍵字

procedures for bed cleaning ； pre-issue MBD ； waiting time

參考文獻

王雅芳、劉永慶、黃玉文、鍾春花、王玉蘭、吳良儀、黃純婷、戴維荻、林文川(2017)．運用多元感染管制策略提升清潔人員環境清消成效．感染控制雜誌，27(2)，103-115。

江旺財、李衛華、廖芝倩(2015)．台灣急診室壅塞的初探．輔仁醫學期刊，13(4)，223-231。

李芳菁(2019)．病人滿意度調查之意見反應分析．彰化護理，26(2)，8-11。

李淑慧、高玉鳳、楊馨怡、郭怡君(2014)．縮短門診化療病人等候時間之改善方案．腫瘤護理雜誌，14(1)，49-61。

林玉菜、吳一金、林秀惠、陳芝文(2019)．縮短辦理出院等候時間之專案．高雄護理雜誌，30(1)，12-30。10.6692/KJN.201904_36(1).0002

主題瀏覽