導入資訊系統於醫院急診流程之效益評估研究

A Study on the Benefit of Implementing Clinical Information System for Intensive Care Unit in Hospital

劉軒伶(Shuan-Ling Liu)

指導教授 ： 黃崇興 ； 李吉仁

國立臺灣大學/管理學院/商學組/碩士(2014年)

https://doi.org/10.6342/NTU.2014.10795

摘要

有鑑於目前全球人口老化的趨勢，對於醫療資源的需求以及如何有效運用日趨迫切，而在所有醫療資領域中，又以急重症單位所面臨之挑戰最為嚴峻。其中牽涉到醫療資源的不足、醫護素質的參差不齊、醫病關係的不對等以及醫療網絡的整合不完全等等，都使得急重症醫療領域面臨挑戰，亟需導入臨床資訊系統來加以改善目前醫療環境所面臨之問題。

本研究希望探討臨床資訊系統之內涵以及導入臨床資訊系統於加護病房所帶來之效益。利用波特價值鏈模型為架構，探討目前急診流程所面臨之挑戰，以及在系統導入後，可以因流程改善而帶來之效益加以分析，並以針對相關人員做專案訪談，提供護理人員、病人、醫師之專業意見回饋。以質化及量化之數據，證實在臨床資訊系統導入後，分別在人力資源效能、醫療品質，病人滿意度以及流程簡化四部分，都有得到實質的效益提升。

最後，在本研究後續討論中，我們希望不管是在持續追蹤系統導入對流程改善與組織效益的發展狀況，或是未來將資訊系統擴大運用至所有臨床單位，甚至是結合資訊與通訊科技，將醫療服務延伸至居家照護等願景，都能達到打造超越國界與時空之雲端醫療環境的終極目標。

關鍵字

醫療資訊系統 ； 急重症 ； 臨床資訊系統 ； 遵從率 ； 組合式照護

並列摘要

Due to global trend of aging population, the demand for medical resources and how to effectively use it is getting increasingly urgent. Among all health care fields, critical care and ICU are two units facing the greatest challenges, including insufficiency of healthcare resources, uneven healthcare quality, unequal relationships between physicians and patients, and incomplete integration of the healthcare network and so on,. It therefore becomes urgent to evaluate the costs and benefits of implementing a clinical information system to improve and solve the problems in the healthcare environment.

The purposes of this research are to discuss the concept and reality of a clinical information system and to analyze the benefits of implementing clinical information systems in ICU. Guided by Porter's value chain model, this research is able to explore the current challenges in emergency procedures of ICU, and the differential benefits of ICU procedures after implementation. Moreover, for project-related members such as nurses, patients and physicians, their professional opinions and feedbacks are interviewed as well. Based on the qualitative and quantitative data, for parts respectively in the human resources efficiency, quality of healthcare, patient satisfaction, as well as procedure streamlined are found to be improved.

Future endeavor based on our initial findings can be made on examining the benefits of system implementation and the improvement of the organization, or expansion of the implementation of clinical information systems to other clinic units, even more applications of combination of informatics and telecommunication techniques in healthcare fields to extend the services to homecare, among others. We hope that an ultimate goal of being a cloud environment without boundary for healthcare can be realized soon.

並列關鍵字

Healthcare informatics system ； critical care & ICU ； Clinical informatics system ； Implementation ； Compliance ； Bundle care

參考文獻

白榮吉、李國光、曾文君、張鈺如，2007，從組織、科技與環境層面探討ERP系統導入之影響因素－台灣企業之多重個案研究，電子商務研究，5 卷 2 期：頁175-195。

李佩琳 呂欣茹，2005，加護病房之病人安全-以呼吸器相關肺炎(VAP)感染與Acinetobactor baumannii相關因素分析及護理措施為例，慈濟醫學雜誌，17卷4期：頁47-50。

邱韋欽、周明智，2008，APACHE II評估表對中部某醫學中心外科加護病房死亡率之估計與分析，中山醫學大學未出版之博士論文。

周翠蓉、張淑娟、林素玉、董怡君，2011，某加護病房呼吸器相關肺炎(VAP)照護改善專案，澄清醫護管理雜誌，7卷3期：頁63-71。

張敏、林璟淑、 張元玫、李亭亭，2008，護理資訊應用簡介－某醫院護理資訊系統推行之經驗分享，護理雜誌，55 卷3期：頁75 – 80。