結合商業智慧系統與品管圈手法提升住院病人治療餐搭伙率

Increasing the Dining Rate of Therapeutic Meals Through the Combination of Business Intelligence and Quality Control Circle

陳盈汝(Ying-Ru Chen) ； 徐欽鵬(Chin-Peng Hsu) ； 謝梨君(Li-Chun Hsieh) ； 林杏純(Hsing-Chun Lin)

《臺灣膳食營養學雜誌》 12卷2期 (2020/12) Pp. 49-64

https://doi.org/10.6709/TJD.202012_12(2).0005

摘要

營養治療（medical nutrition therapy, MNT），近年來已是醫療的重要一環。治療飲食需配合各種疾病的營養需求進行菜單規劃，以期能對這些病人的臨床醫療結果有助益，若能提升住院病人治療餐搭伙率，對於整體醫療有正面輔助的效果。基於醫院營養照護服務品質之提升與監測，應持續檢討並改善住院病人之搭伙率，因此，本專案目的為結合商業智慧軟體（business intelligence, BI），用於支持業務訊息的蒐集、分析、呈現和傳播的技術，與透過品管圈手法，監測及改善住院病人治療餐搭伙率，以進一步提升營養照護品質。本科以問卷方式瞭解病人未訂餐原因，再進行統計分析，並以中部同儕醫院做標竿以訂定目標。品管圈活動期間於2018年5月～11月，成果維持追蹤期間為2018年10月～2019年12月；品管圈成員將要因依據相似性質或接近的作業時間點合併，共執行三項對策分別為菜單設計與供膳品質之提升、提升病人訂餐意願及營養知識、提升醫護人員推廣餐點意願及營養知識。執行成果：全院搭伙率由41.4%上升至48.9%，治療餐平均搭伙率由6.2%提升至17.4%；訂餐正確性、飲食遵從度及營養知識行為，營養介入後皆有提升，期間供膳滿意度維持95.0%以上，附加效益為收入逐年增加。本科運用品管圈手法改善治療餐搭伙率，提升院內供餐品質，對整體醫療營養照護品質亦有加成效益，故本科將持續藉由品管圈手法與擴大BI之應用提升MNT以及供膳品質。

關鍵字

營養治療 ； 商業智慧軟體 ； 品管圈 ； 供膳品質

並列摘要

Medical nutrition therapy (MNT) has become an important part of medical care in recent years. Therapeutic meals are designed by dietitians to improve health and provide diet therapy for various disease. Increasing the dining rate of therapeutic meals has positive auxiliary effects on overall medical treatment. In the hospital setting, continuous improvements in and monitoring of the quality of dietetic service are necessary. The aim of this quality improvement project was to apply business intelligence (BI) to support the data collection, analysis, presentation, and dissemination of business information and quality control circle (QCC) to monitor and improve the dining rate of therapeutic meals and the quality of nutritional care. We used questionnaires and conducted statistical analyses to determine the reasons why patients do not dine meals, and then set goals based on the benchmarks of other hospitals. The study period was from May to November 2018, and outcomes were followed from October 2018 to December 2019. We merged countermeasures with similar properties and operating times. Our quality improvement strategies included redesigning cycle menu, monitoring dietetic serving quality, and improving the willingness to order meals and nutrition knowledge of patients, and enhancing medical staff to promote meals and their nutrition knowledge. Results: The hospital dining rate of meals increased from 41.4% to 48.9% and the dining rate of therapeutic meals increased from 6.2% to 17.4%. Accuracy of therapeutic meal prescription, and dietary compliance and nutritional knowledge of patients were all improved after implementation of this quality improvement project, and the overall satisfaction level went up to 95%. An additional benefit has been the continued increases in yearly incomes. Thus, it appears that BI and QCC can be used in combination to enhance nutritional care and the quality of dietetic service.

並列關鍵字

medical nutrition therapy (MNT) ； business intelligence (BI) ； quality control circle (QCC) ； quality of dietetic service