導入資訊系統減少出院準備服務個案管理文書作業

Reducing Case Managers' Documentation Burden Through the Implementation of the Case Management Information System for Discharge Planning

10.6317/LTC.202406_27(1).0004

謝佳穎(Chia-Ying Hsieh)；徐則彬(Tse-Pin Hsu)；高秀娥(Hsiu-O Kao)；林宜陵(Yi-Ling Lin)；詹惠雅(Hui-Ya Chan)

工作流程 ； 出院準備 ； 個案管理 ； 資訊系統 ； workflow ； discharge planning ； case management ； information system

長期照護雜誌

27卷1期（2024 / 06 / 01）

59 - 75

繁體中文;英文

因應國家發展多元醫療及長照政策，出院規劃專責團隊業務量明顯提升，造成高達52.45%工作超時紀錄。通盤檢討工作流程及工時分布後發現，個案管理文書作業占用3.98小時／日／人，其導因有：表單無法自動帶入個案資料、平板電腦無法連接衛福部長照系統、記錄時需開啟多種工作表單、無專責行政人力、合併報表易誤蓋檔案，需費時校對、表單資料填入不完整。本專案目標為降低個案管理文書作業工時至2.67小時／日／人以下。本專案導入可自動帶入病歷資料的個案管理資訊系統、長照評估平板電腦與軟體。個案管理資訊系統整合了過往需要填寫的數張表單，並且可以匯出成報表，系統也針對容易遺漏的欄位增設防呆警示。專案實施後，個案管理文書作業工時降低至2.44小時／日／人，使用者滿意度達4.33分，達成專案目標。建置良好的個案管理資訊系統、簡化工作流程並使硬體設備完善，可以有效改善繁複的個案管理文書作業及工作超時問題，也可避免人力資源耗用。

In response to the need for diversified medical care and long-term care, the discharge planning team has experienced a significant increase in workload, resulting in a high overtime rate of up to 52.45%. Tedious paperwork takes up 3.98 daily working hours per case manager of discharge planning. The major reasons for long hours of documentation work were unable to automatically bring in personal data from Hospital Information System (HIS); lacking tablet computers to connect to the Governmental Information System; the unintegrated forms and files; easily accidentally overwriting the file, and the recording form was un-easily completed. This project aimed to reduce daily documentation tasks and paperwork below 2.67 person-hour. A Case Management Information System (CMIS) for discharge planning was established by automatically bringing in the patients' data from HIS. Case managers can use tablet computers to access the nationwide long-term care system directly. In addition, CMIS was designed to provide integrated reporting forms, build step-by-step instructions for generating reports, and set the warning response for missing data. The daily working hours on documentation tasks and paperwork dropped to 2.44 person-hour. The overall user satisfaction score was 4.33 on a 5-point scale. Establishing a well-designed CMIS, streamlining workflows, and ensuring sufficient hardware can effectively improve the complex case management documentation process, alleviate the excessive workload, and avoid the consumption of human resources.