結合模糊德菲法與詮釋結構模式探討國際醫院評鑑之關鍵指標

Applying Fuzzy Delphi Method and Interpretive Structural Modeling to Determinethe Key Indicators of Joint Commission International

葉子明(Tsu-Ming Yeh) ； 鍾允怡(Yun-Yi Chung)

《寶建醫護與管理雜誌》 12卷2期 (2014/12) Pp. 23-44

https://doi.org/10.29681/PCJHM.201412_12(2).0003

摘要

國內醫院自2006年開始參與JCI國際醫療評鑑。在病人不斷追求更好的醫療品質下，國內陸續有醫院都積極去參與JCI評鑑，但JCI評鑑有著比國內醫院評鑑還繁瑣與詳細的指標。本研究先應用模糊德菲法（FDM），從131項JCI國際醫院評鑑標準中，篩選出醫院推行JCI評鑑前的關鍵性指標項目；接著運用詮釋結構模式（ISM）來探討不同醫院層級對篩選後之指標關聯性。研究結果發現，不同醫院層級在推行JCI評鑑指標項目的關聯性上大致相同，但區域醫院比醫學中心多5項指標項目。而在JCI評鑑指標重要程度的排序方面，「確保手術部位正確、流程正確、病人正確（IPSG4）」、「醫療團隊對病人評估診療能有整合照護的流程（COP2）」位居醫學中心與區域醫院前兩名。未來國內有意參加JCI評鑑之醫院可依據本研究結果做為推行前之教育訓練準備，一方面可提升醫院有規劃性進行JCI評鑑的相關準備效率，再者可減輕醫院臨床人員的工作負擔。

關鍵字

醫院評鑑 ； 國際醫療評鑑 ； 模糊德菲法 ； 詮釋結構模式

並列摘要

There are already some domestic hospitals starting participating in Joint Commission International (JCI) since 2006. While patients remain in the tendency for increasingly better medical service quality, more and more domestic hospitals have already prepared aggressively to participate the rating of JCI. However, the JCI features fare more complicated and detailed indicators for making evaluations than the domestic counterparts. The Fuzzy Delphi Method (FDM) was applied in this research firstly for screening out the critical indicator criteria from the 131 rating criteria currently used by JCI; Secondly, the Interpretive Structural Modeling (ISM) was applied in exploring the relevancy between the importance of each indicator and the level of the hospitals being rated. The research analysis indicates that although the rating criteria of JCI are generally the same for the hospitals in different levels, regional hospitals have 5 more indicators than medical centers. Among all rating criteria of the JCI, ＂The organization develops an approach to ensuring correct-site, correct-procedure, and correct-patient surgery (IPSG4)＂ and ＂There is a process to integrate and to coordinate the care provided to each patient (COP2)＂ rank the two most important rating criteria among medical centers and regional hospitals. Hopefully, the research results can be adopted by the domestic hospitals which have the intention to participate in the JCI evaluation as the basis for the preparation of education. It can not only enhance hospitals working efficiency for planning the relevant preparation for participating in JCI rating but also reducing the burdens on the clinical staff.

並列關鍵字

Hospital Accreditation ； Joint Commission International ； Fuzzy Delphi Method (FDM) ； Interpretive Structural Modeling (ISM)