使用緊急傷病患電子轉診系統對醫護人員的衝擊-以嘉義地區醫院為例

Using the emergency electronic referral system impact on the medical staff- A Case Study in Chiayi area hospitals

尹賢琪(YIN-HSIEN-CHI)

指導教授 ： 張怡秋

國立中正大學/管理學院/資訊管理學系/碩士(2015年)

摘要

為了提升急診轉診品質，衛生福利部於民國102年制定「提升急診暨轉診品質計畫」，該計畫其中之一為運用緊急傷病患電子轉診系統Mars來進行轉診資料的傳輸。該系統施行成效如何?尚無定論，因此以此研究進行了解。
本研究使用質性研究中的個別深度訪談法，以半結構式問卷進行，訪談對象為嘉義地區基地及網絡共九家醫院擔任急診業務三年以上及實際操作「緊急傷病患電子轉診系統」或負責該系統推動業務之醫師、護理師或専科護理師。探討醫護人員在使用「緊急傷病患轉診電子作業系統」後成效，包含是否讓急診轉診的業務順暢及對醫護人員在作業上所造成的衝擊。綜合統整發現，在電子轉診的登錄率及回覆率皆達目標值，對提昇醫療品質是有用的，但對醫護人員產生了以下的衝擊：系統不穩定、未能提昇轉診效率(系統資訊提供不足、找不到可轉診病床、增加額外的工作)、影響工作人員士氣。研究依結論提出建議，希望能改善急診轉診的效率及降低轉診時使用該系統對醫護人員的衝擊。
另外建議政府未來應：加強消防機關了解各醫院急救能力的能量、衛教民眾就醫分級制度、Mars系統與HIS的橋接、緊急傷病患之次専科科別的透明、EOC協助緊急傷病患病床的調度。

關鍵字

衝擊 ； 緊急傷病患電子轉診系統 ； 急診

並列摘要

To improve the quality of emergency and referral medical services, the ministry of health and welfare had formulated “The project of improving the quality of emergency and referral medical services” since 2013. This project requires transferring the referral data by using the urgent patients electronic referral system ”Mars “. There is still no conclusion about the effect of this system, and this research aims to explore it.
In this research, we use semi-structured questionnaire to conduct in depth Interview of qualitative research method. The interviewee were doctors, registered nurses and nurse practitioners of nine hospital based at Chiayi and its network who had emergency medical services for at least three years and practical use of Mars, or was responsible for promoting the project. To investigate the effect of medical care personnel using “Mars”, data including whether the system made the emergency and referral medical services smoothly or not and the impact on medical care personnel were collected.
The results showed that the rate of registration and reply reach the goal in electronic referral system which is useful for improving the medical quality. The impacts on medical care personnel including unstable system, can not raise the referral service (system information insufficient, could not find bed, increase the work load), affect the morale of personnel. The suggestion based on the results of research is to improve the efficiency of the emergency and referral medical service and decrease the system impact on medical care personnel while referral. Meanwhile, the government should enhance the fire station on knowing the emergency ability of every hospital, teach people the medical grading of hospitals, connect Mars and HIS system, clarify the sub specialist of urgent patients, and help dispatch the bed form the EOC.

並列關鍵字

Mars ； Emergency ； Impact

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