- 學位論文
改善門診等候時間服務品質之研究
Improving the Service Quality of Waiting Time on Outpatient Department
摘要
全民健保實施後民眾就醫性更方便了，也使得醫院門診量逐步上升，使得醫院須提供更多醫療設備作診斷及治療，且加重醫療工作人員的負擔，進而造成病人的等候時間增加，實際看診時間卻縮短之情形發生。本研究以專家學者的文獻佐證及3間國內醫院之門診流程作為基礎，彙整出門診等候時間之因素。並在KJ法的使用下，建立影響等侯時間架構雛形，再透過在焦點團體訪談與德爾菲等方法下，進行架構出各類別之合理且適切性檢測，完成影響門診等候架構終案。最後，在層級分析法(AHP)下，使本研究對於門診等候時間因素架構能夠建立出程度上的差異。 本研究發現影響門診等候因素以「醫師診間內做處置」、「診斷病情與解釋檢查報告過久」、「未能主動告知相關知識，引起病人擔憂與不必要詢問」、「醫師與病人雙向溝通不佳」、「疾病輕重導致看診時間落差」、「不清楚報到規則」、「等待檢驗報告」及「各科室之間的協調不足」等八個項目所佔權重較高，主要都與看診構面有關，可見病人就醫過程中最常在「看診過程」中等候最久。相信院方主管若能參照本研究成果，且予以支持改善，投入更多的資訊服務及足夠的人員配置，達到以「病人為中心」之優質就醫環境，將成為病人信賴之醫院；同時，也能藉此研究期能做為醫院管理者對服務品質提升之參考。
並列摘要
After the implementation of the national health insurance system, more patients seek medical service. The increased number of outpatients resulted in longer waiting time for patients, shortening the time of interaction between doctors and patients, and higher workload for the medical staffs. This study was aim to analyze the key factors associated with outpatients waiting time.This research study was conducted using information and data collected from three hospitals and literature review. We used Kawakita Jiro (KJ) technique to identify the key factors related to the waiting time of outpatients. Focus group method and Delphi method were used to check the accuracy of these factors. Analytic Hierarchy Process (AHP) was used to prioritize these factors. From the information and data of the three hospitals we studied, eight conditions were identified that led to prolonged outpatients waiting time. First, doctors performed intervention for outpatients during the same visit. Second, doctors spent much time to diagnose and explain the examination reports to patients. Third, doctors did not have enough time to perform disease teaching that resulted in patients’ worries and asked more questions. Fourth, patients and doctors had poor communication. Fifth, difference of the diseases severity of patients had impact on their visit time. Sixth, patients did not realized the registration and check in processes. Seventh, patients had to wait for the results of examination in the same visit. Eighth, different departments of hospital did not have good cooperation. By modifying the visiting and examination processes for outpatients and establishing doctor-patient relationship, we hope to reduce the waiting time for outpatients. Suggestions for the hospital administrators were made based on the findings to improve the service quality of waiting time on outparient department. At the same time, it can be able to provide better “patient-centered” health care service.