轉型中醫院之醫工相關技術探討—以國軍某區域級醫院為例—

個案醫院因外在及內部多重因素，營運狀況並非理想，為改善經營困境並配合醫療政策，可能轉型成為社區型醫院或專科醫院，當前又立即面臨與醫院存息密切之醫院評鑑，本研究報告以「PACS品質改善」、「緊急災害應變」、「遠距居家照護」等三方面討論相關醫工技術，作為轉型前規劃及醫院評鑑準備之參考。建置「醫療影像儲傳系統(PACS)」已為目前各醫院有效管理大量醫學影像資料之最佳方案，個案醫院PACS屬委外建置、自行經營，對於品質管理及工作流程並無具體量化工具及數據。本技術報告建立PACS滿意度衡量及績效評估指標並擬訂問卷，規劃訪問對象為臨床醫師及放射技術人員，其統計結果可作為未來設備建置更新、品質管制提昇、工作效率改善之參考。「醫院緊急災害應變指揮體系(HICS IV)」已成為我國醫院緊急災害應變的標準作業程序，個案醫院未曾研討緊急災害應變時期醫療器材應如何管理，將極可能引發災害中的二次災害。本技術報告提供全新的應變組織及人員擬案提供參考，並建議立即成立編組並加強演習以熟悉其作業模式，對於醫療器材管理則建議立即引進國軍醫學中心的資訊管理系統以加強應變能力。為避免人口老化引發家庭及社會問題，政府提出各種長期照護政策，而居家護理為長期照護的基礎，亦為一般家庭最直接的照護模式，個案醫院附設居家護理所雖營運穩定成長，但宥於人力無法辦理突破性服務及發展。本技術報告建議參考其他醫院規劃建置「居家式遠距照護服務」，在轉型為社區型醫院後可有效提昇最佳的居家護理及社區醫療服務。

關鍵字

居家式遠距照護服務；滿意度；醫療影像儲傳系統(PACS) ；績效評估；醫院緊急應變指揮體系(HICS) ；老年化社會；醫療器材管理；居家照護；居家護理

並列摘要

The case hospital does not have a satisfactory operation due to multiple internal and external factors. In order to improve the operating difficulties and cooperate with the nation’s medical policies, it may be transformed into a Community-type hospital or a Specialists' one. Meanwhile, it is also taking a hospital accreditation which is closely related to the survival of the hospital. This report discusses the associated medical engineering methods by probing into three aspects: “PACS quality improvement, “emergency disaster response” and “remote home care service”. They will also be used as a reference for the pre-transforming planning and for hospital accreditation activities. The Establishment of a Picture Archiving and Communication System (PACS) has become the best solution for the efficient management of massive medical video data for hospitals. The case hospital runs a outsource-established and self-operated PACS whose quality control and task process has no concrete quantified tool and data. This technical report establishes the Satisfaction Evaluation Index and Performance Assessment Index and develops a questionnaire. The interviewees are clinicians and radiologists. The statistic result can be used as a reference for facility renewal, quality control enhancement and work efficiency improvement. Hospital Incident Command System (HICS IV) has become the standard operation procedure for this country’s emergency disaster response. The case hospital has never looked into that how medical equipment be managed during an emergency disaster, which will very likely to cause a secondary disaster in a disaster. This technical report provides a whole new response organization and personnel plan for reference and thus recommends organizations be set up and drills reinforced to help people familiar with the operating methods. As for the management of medical equipment, it is recommended that the information management systems from the MND’s medical center be introduced into to enhance its response capability. The government has instituted various long term care policies. Home nursing is the base of long-term care and the most direct mode of care for the general families. Though the case hospital’s affiliated care center develops steadily, it can not make any breakthrough service and development due to limited manpower. This technical report recommends that the hospital set up the “home-based remote care service”, which will provide the best home care and community medical service after the transformation.

並列關鍵字

PACS ； satisfactory level ； HICS ； performance assessment ； medical equipment management ； aging society ； home care ； home nursing ； remote home care service

參考文獻

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13.李孟儒、呂森永、陳克陽、陳淑君(2006)：醫院無片化管理之效益評估－衛生署新竹醫院之PACS導入經驗。健康管理學刊，第3卷第1期，頁35-39

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國際替代計量

轉型中醫院之醫工相關技術探討—以國軍某區域級醫院為例—

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