醫療人員對評鑑特色與問題之看法

A Comparative Study on Hospital Accreditations

賴姵君(la pei chun)

指導教授 ： 楊漢湶

亞洲大學/健康學院/健康管理研究所/碩士(2009年)

摘要

本研究目的比較我國新舊醫院評鑑及JCI評鑑在制度面、作業面與結果面的差異與所面臨之問題，瞭解評鑑制度之實施達到評鑑目的的程度，以供醫界在檢討評鑑制度之參考。透過面對面的深度訪談方式，以參加過新舊制醫院評鑑及JCI國際評鑑之醫院人員為主要對象，訪談人數為3家醫學中心、10家區域醫院、10家地區醫院，共55位，其中8人為參加過JCI國際評鑑。研究發現舊制與JCI評鑑有別於新制評鑑以條列式規範並要求備有具體事證，其中包括評鑑準備作業、評鑑委員遴聘制度、評鑑費用、評鑑結果分級、排序等。本研究訪談結果，多數受訪者贊同分組簡化、醫院自評及評鑑結果與健保給付結合，也一致認同新舊制與JCI評鑑對醫療品質均有正面之影響，但JCI係以病人安全及就醫流程的角度來進行評鑑，值得我國醫院評鑑改革之參考。因此，主管機關應加強評鑑委員共識以達評核之公正性，並宣導評鑑是以輔導性為主要目的。

關鍵字

評鑑 ； 醫院評鑑 ； 醫療品質

並列摘要

The purpose of this study is to compare the past and current hospital accreditation in Taiwan and JCI in regards of difficulties introduced by differences in policy, operation and consequences. This research serves a valuable reference in administering medical evaluation and helps to understand accreditation practices and evaluation goals. The purpose of this study is to analyze the past and current hospital accreditation in Taiwan and foreign countries in regards of difficulties introduced by differences in policy, operation and consequences.The study was carried out through in-depth face-to-face interviews and the interviewees include vice president, medical director, nursing supervisor, management supervisor and personnel in charged of accreditation from 3 medical centers, 10 regional hospitals and 10 district hospitals. Overall, there are 55 participants (with 8 of them participated in JCI before).The result shows that both legacy system and JCI accreditation are different from the new assessment in such that standards and physical evidences are required. The differences can also be found in assessment pre-procedure, member selection, evaluation charge, result classification, ranking and etc,. The result shows that majority of the interviewees agree in simplifying classification, self-assessment and government should allocate national health insurance budget in accords to the results. Opinions also reveal the fact that assessment standards are beneficial in advancing our medical care system. Nevertheless, accreditation in Taiwan can further be improved by referencing JCI in aspect of patient-centered design. Therefore, government should enforce impartial standards and motivate accreditation in promoting a better medical quality.

並列關鍵字

Accreditation ； hospital accreditation ； medical quality

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