運用團隊溝通整合－提升腦中風急性後期照護完整性之個案研究

The Team Communication Integration Program: Case Studies on the Integrity of Post-Acute Stroke Care

薛肇文(Chao-Wen Hsueh) ； 黃惠君(Hui-Chon Huang) ； 吳岱錚(Tai-Cheng Wu) ； 蔡光洋(Kwang-Yang Tsai) ； 杜國賢(Kuo-Hsien Tuo) ； 馬震中(Chen- Chung Ma)

《南臺灣醫學雜誌》 17卷1期 (2021/06) Pp. 39-49

https://doi.org/10.6726/MJST.202106_17(1).0005

摘要

目的：本研究以品質管理手法分析，探究如何強化團隊溝通整合能力養成，促進團隊溝通整合成效，以確保病人安全及提升腦中風急性後期照護（Post-Acute Care，PAC）品質。方法：本研究係以某醫療機構，PAC改善專案小組成員12人，PAC各職類工作人員24位及腦中風急性後期病人148例為對象，實施為期一年之訓練方案。藉由品管手法，組成團隊，運用現況把握檢視問題，進行解析及真因驗證，對策擬定、執行與查核；運用團隊資源管理（Team Resource Management，TRM）之工具實施團隊溝通訓練，作為新團隊整合依據。運用整體功能狀態及基本日常生活功能評估量表，測量腦中風病人失能及生活品質功能狀態。結果：PAC各職類工作人員於完成各階段訓練後，腦中風急性後期照護完整率由54.7％提升至91.1％。臨床PAC執行成效顯示，病人失能狀態、整體功能、及基本日常生活功能，呈現不同程度的進步與改善。結論：運用品管手法進行分析，以團隊溝通整合訓練，促進腦中風急性後期照護團隊溝通能力、專業素養，有效提升腦中風急性後期照護完整性，以確保病人安全及提升照護品質，期望本研究可作為其他類型急性後期照護團隊參考。

關鍵字

團隊溝通 ； 急性後期照護 ； 品質管理

並列摘要

Objective: This study analyzes using the quality control methods and explores the effectiveness of post-acute care (PAC) team communication and integration in stroke. Methods: This study was conducted for a period of one year, with a total 12 members of the PAC quality improvement teams, 24 staffs of the PAC teams, and 148 patients with post-acute stroke. We use quality control methods, including grasping current situation, setting goals, analyzing objective, countermeasure implementation and verification. With teamwork communication and ISBAR approach. We also held PAC and TRM educations for integrate and setting new PAC stroke team. Using the Modified Rankin Scale (MRS) and Barthel Activity Daily Living Index (B-ADL), for evaluate the functional state of disability and quality of life of pos-stroke patients. Results: Using the quality control and communication approach, the performance of standard procedure for the collection of acute post-stroke care was increased from 54.7% to 91.1%. The clinical effectiveness shows patients' disability status, the MRS, and the B-ADL index have varies degrees of improvement. Conclusion: This study concludes that the using tools of quality control and communication strategy improve integrated PAC team, professional accomplishment and healthcare quality in stroke.

並列關鍵字

communication ； post-acute stroke care ； quality control