運用智慧流程化管理於跨單位交班之成效

目的：運用流程化管理設計智能之跨單位交班系統以強化團隊間即時正確與有效溝通。方法：本研究是以北部某區域教學醫院為對象，透過流程管理模式進行各類檢查處置盤點，以病人為核心並歸納與整合以做為系統流程設計之依據。並以Apache Cordova為跨平台開發工具，2018年5至11月共半年期間依階段進行跨單位交班與高危運送兩大功能。透過醫囑啟動交班、自動辨識與警示高危運送，並結合生理量測數據拋轉與整合院內相關系統資料，依據交班關卡追蹤病人動向，並比較導入前後之成效。結果：1.導入後縮短團隊交班時間383.4小時／月；2.檢查處置交接班執行完整率達93.9%；3.提升手術室周轉率（97.5%提高至103.4%）與減少手術室護理師加班費30萬／年；節省交班單印刷成本4萬／年。結論：全面性導入流程化管理，透過智能化運用提升工作效能與團隊溝通以提供病人更完整持續性的照護與確保病人安全。

關鍵字

流程化管理；跨單位交班；病人安全；溝通；跨團隊

並列摘要

Objectives: The purpose of this study was to examine the effectiveness of intelligent process management design in the cross-unit handover (CUH) system. Methods: First, an original cross-unit handover (CUH) process was systematically reviewed. Subsequently, cross-platform tools were developed using Apache Cordova. Next, consensus on the standardized and structured format of handover from a patient preparation (delivery site) department to an execution department was obtained. Subsequently, data were automatically transformed to this system from systems such as a structured physician ordering system, nursing information system, and laboratory information system. After system execution by the clinical unit, data regarding the outcome were collected. Results: Implementing the intelligent process management design engendered the following: (1) It improved work efficiency by reducing personnel cost and saving working hours (383.4 h/month). (2) It increased the turnover rate of the operating room from 97.5% to 103.4%. (3) Moreover, it reduced overtime pay (TWD$ 300,000 /per year). (4) Finally, it reduced printing material cost (TWD$ 40,000 /per year). Conclusions: The study results demonstrate the effectiveness of the innovative design in enhancing patient safety.

並列關鍵字

Process management ； cross-unit handover ； patient safety ； communication ； inter-professional

參考文獻

呂執中（2015）。醫療品質系統與流程管理。品質月刊，51(9)，41-47。doi: 10.29999/QM

戴秀霞、黃美瓊、莊若梅、陳玉青、童意婷、韓慧美（2013）。提升血液透析前病人跨部門交班完整性專案。臺灣腎臟護理學會雜誌，12(3)，49-62。d o i : 10.3966/172674042013091203005

Jenelle, M., Patricia, M. D. & Yenna, S. (2010). Review: bringing patient safety to the forefront through structured computerisation during clinical handover. Journal of Clinical Nursing, 20, 187-189. doi: 10.1111/j.1365-2702.2010.03242.x

Leon, D. S., David, T. C., Larry, N., Steve, H., Richard, E. W., Mark, L. Z., ...Yang, J. J. (2017). A Model For Electronic Handoff Between The Emergency Department and Inpatient Units. The Journal of Emergency Medicine, 53(1), 142-150. doi: 10.1016/j.jemermed.2017.03.027

Pucher, P. H., Johnston, M. J., Aggarwal, R., Arora, S. & Darzi, A. (2015). Effectiveness of interventions to improve patient handover in surgery: A systematic review. Surgery, 158(1), 85-95. doi: 10.1016/j.surg.2015.02.017

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運用智慧流程化管理於跨單位交班之成效

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