護理品質監測系統之精實資訊流策略與成效

Strategies and Effectiveness of Lean Information Management in a Nursing Quality Monitoring System

10.6142/VGHN.34.3.289

張麗銀(Li-Yin Chang)；張瑛瑛(Ying-Ying Chang)；彭素貞(Su-Chen Pong)；尤琇慧(Hsiu-Hui Yu)

精實 ； 資訊管理 ； 護理品質監測系統 ； lean ； information management ； nursing quality monitoring system

榮總護理

34卷3期（2017 / 09 / 01）

289 - 298

繁體中文

本研究以精實研究方法分析護理品質監測系統所應用之精實策略及其成效。經由精實研究之五項原則分析價值、價值流、流動、拉式、持續改進等，精實策略之應用包括：確認有價值的流程，避免浪費，以監測單位較多且申報外部機構頻率高之指標為主，目前已建置13項次系統，功能涵蓋資料輸入、查詢修改、統計繪圖、檢討改進分析與流程版、匯出等，並加入多元之創新、整合、管理等加值功能包括：品質監測資料與紀錄、交班、通報、PDCA、實證、資訊之整合；品質監測與管理結合涵蓋：統計製程管制（Statistical process control, SPC）、警示燈號管理、流程版等。整合過程應用多元資料輸入裝置及資料庫間資料自動擷取，以簡化護理人員花費之時間及強化各創新加值功能之應用。結果顯示平均花費時間減少69.82%，護理人員接受度95%以上。附加效益包括：線上簽核文件可以簡化交付時間和人力、降低紙張成本、節省存儲空間；另外上傳傷口影像可提供團隊溝通。經由精實方法檢視護理品質監測系統，將可持續改善流程及提供護理品質監測。

This study focused on the lean analysis of a nursing quality monitoring system (NQMS) and its effectiveness. Lean methodology was implemented based on five principles: valuation, value stream, one piece flow, a pull system, and continuous improvement. We built 13 subsystems, the functions of which covered data input, query modification, statistics and figures, evaluation, and workflow procedures. In addition, we incorporated multiple innovative value-added functions and applications, including the automatic import of handover records, patient safety reports, and evidence-based collaborations. Management systems including statistical process control, warning signal management, and workflow procedures were integrated. For the integration process, a multivariate data entry device was employed, and the interdatabase data were automatically retrieved to reduce the amount of time spent for collecting patient information from caregivers. The results showed that the mean time spent was reduced to 69.82%. The rate of acceptance of nurses was 95% or higher in the NQMS. The online registration function reduced fi le delivery time, manpower, and paper cost and saved storage space. Furthermore, uploads incorporated images to facilitate team communication. The fi ndings showed that by applying lean methodology, we can efficiently reduce time spent on various processes and improve NQMS processes.

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