門診跟診人力派班改善專案

Improvement Project for Nursing Shift Manpower Arrangement in Outpatient Department

10.29494/LN.202009_21(3).0009

李佩潔(Pei-Chieh Lee)；陳雅伶(Ya-Ling Chen)；張念瑜(Nien-Yu Chang)；蔡惠珠(Hui-Chu Tsai)；胡瑞桃(Shui-Tao Hu)

門診 ； 跟診人力 ； 派班 ； outpatient department ； outpatient nurses ； shift arrangement

領導護理

21卷3期（2020 / 09 / 01）

107 - 123

繁體中文

本專案旨在改善門診跟診人力派班，2018年4－6月份陸續收到醫護人員抱怨2－3件／月，主要抱怨派班人力與配置不一致及未派足人力等原因。鑑此，2018年07月成立本專案小組，進行門診跟診人力派班問題分析及檢討改善。現況分析派班不符問題，包括：（1）流程方面：門診看診當天仍派班。（2）政策方面：2001年門診派班配置標準與現況人力需求不符、上午診及下午診開診比率不符現況派班需求、教學診不定時開診，未依規定提出申請。（3）人員方面：延診比率高。擬訂相關措施，包括：（1）流程方面：調整門診一週前截止派班。（2）政策方面：調整門診人力派班配置標準、門診開診比率重新分配、宣導教學診依規定提出申請。（3）人員方面：延診監控。專案實施後：（1）流程方面：開診前一週截止派班，當日看診派班，由平均7.5診下降至1診／天。（2）政策方面：重新調整門診人力派班配置標準後，無收到抱怨案件、上午診及下午診開診比率，各由47.1%及37.2%調整至44.0%及38.8%、教學診未依規定申請，由12.3診／月改善至0診／月。（3）人員方面：延診率，由39.0%下降至33.6%。結果顯示著實達此專案改善目的。

The purpose of this project is to improve the dispatch of outpatient department follow-up human resources. From April to June 2018, 2 to 3 complains per month were received from medical staff, mainly due to the inconsistency of dispatch manpower and configuration as well as lack of sufficient manpower. Therefore, the project team was established on July 2018 to analyze, review and improve the outpatient follow-up manpower dispatch issue. The problems identified from inconsistency of dispatching including: (1) Process Aspect: the dispatched scheduling is still on the day of the outpatient visit. (2) Policy Aspect: The staff manpower allocation guideline set in 2001 was inconsistent with the current manpower requirements. The ratio of morning and afternoon outpatient consultations did not match the current dispatch needs, and the teaching clinic operates irregularly, and no application was submitted in accordance with the regulations. (3) Personnel Aspect: the rate of post-diagnosis is high. Formulate relevant measures including: (1) Process Aspect: The staff roster scheduled at least a week before the clinic. (2) Policy Aspect: Adjust the allocation standards of outpatient manpower dispatching, redistribution of clinical opening ratios. The teaching clinic should be applied according to the regulations. (3) Personnel Aspect: post-diagnosis monitoring. After the intervention, the results were as follows: (1) Process Aspect: Staff allocation roster was finalized a week before clinic, dispatched staff on the day from 7.5 to 1.0 clinic/day. (2) Policy Aspect: After the adjustment to current standard of staff manpower allocation, no complaints were received. The morning and afternoon clinics proportion were adjusted respectively from 47.1% and 37.2% to 44.0% and 38.8 %. The application of teaching clinics was reduced from 12.3 to 0 clinics / month. (3) Personnel Aspect: The proportion of the clinic overtime was reduced from 39.0% to 33.6%. The results clearly demonstrated the aim of this project.

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