以DMAIC方法於門診智慧系統導入前後之探討 —以A醫學中心為例

Abstract

隨著網路媒體的普及和就醫意識逐漸抬頭等威脅，病患對於醫療服務品質的要求日益提升，再加上台灣健保醫療政策的不斷改變，已使得醫療體系產生劇烈的變化，因此醫療院所為了在競爭市場存活，不斷增強自身優勢，建立良好形象與口碑而努力。本研究之個案醫院位於新北市，平均每日門診服務量超過5,000人次、每日急診服務量近400人次，已是全國第二大量，從這些數據可想見其門診擁擠程度，就醫民眾往往花費過長的時間在排隊掛號、等候門診、批價、等候領藥等等程序，因而降低其對醫療的滿意度。在醫療產業競爭白熱化現象之下，未來的醫療產業勢必也要提供更完善的服務，有鑑於此，隨著個案醫院將進行新大樓的擴建，期望引進全面品質管理之理念及改善手法，思考醫院動線與空間規劃。基於此緣由，運用六個標準差的DMAIC (Define, Measure, Analyze, Improve, Control)模式進行流程檢視之基礎，進一步了解現行門診就醫流程程序缺陷，提出解決方案與門診智慧化系統以提升流程的效率與就醫民眾的滿意度，解決門診大廳人滿為患與壅塞的窘境。 整體而言，門診智慧化系統導入後，個案醫院在檢驗、領藥、影像與掛號/批價之等候時間滿意程度皆有所提升。門診病患滿意度調查結果顯示，民眾感覺院內硬體、設備有進步，但仍反應整合效率須再加強。

The rise of patient-centered awareness and the widespread comments on treatment quality that can be found on social media have led to a higher quality expectation of treatment quality by patients. Continuous changes in health insurance policies have dramatically impacted the health care system in Taiwan, and hospitals have had to increase their competitive strengths through the reputation building and word-of-mouth marketing. Our case study focuses on a hospital located in New Taipei City, ranked second in the country in terms of patient numbers, treating more than 5000 patients on a daily basis, with its emergency department seeing treating nearly 400 patients per day. We used the DMAIC model to study solutions for reducing overcrowding, enhancing clinical experiences, and increasing patient satisfaction through the use of an intelligent clinical system. As the healthcare industry is highly competitive, it is necessary for hospitals to implement a standardized service process integrating methodologies of total quality management. Patient satisfaction is greatly influenced by waiting times during the treatment process. Overall satisfaction improved after implementation of the intelligent clinical system, particularly in the areas of examination, medical imaging, the pharmacy, and the payment process. The results of patient surveys show that patients recognize efforts put into the facility and related equipment, but feel that there is a lack of efficient integration. Moreover, patients are troubled by unclear spatial instructions within the hospital grounds.