頁籤選單縮合
題名 | 利用六標準差手法改善手術同意書簽署完整性=Improvement in Completion of Obtaining Preoperative Informed Consent Using the 6-Sigma Technique |
---|---|
作者 | 劉惠琴; 張嘉晃; 王拔群; 古雪鈴; | 書刊名 | 輔仁醫學期刊 |
卷期 | 6:2 2008.06[民97.06] |
頁次 | 頁79-86 |
分類號 | 419.38 |
關鍵詞 | 六標準差; 手術同意書; 簽署完整性; 6-sigma; Informed consent; Completion rate; |
語文 | 中文(Chinese) |
中文摘要 | 背景及目的:手術同意書簽署不完整,醫護人員須花費額外時間處理簽署手續,以致延遲病人進入手術室的時間,進而影響手術室作業的順利。故導入六標準差手法提升手術同意書簽署完整性。方法:運用『DMAIC 』流程改善的五大步驟,以病歷回溯方式及魚骨圖的製作,調查及探討簽署不完整原因。自 2006 年10 月至2007 年4 月導入改善措施。結果:手術同意書共分為七部份,簽署完整率依序為:『簽署完整後第二聯給病人』:18%~29% (0.6~1.0)、『醫師聲明完整』:68%~85% (2.0~2.6)、『病人聲明完整』:73%~82% (2.2~2.5)、『擬實施手術說明完整』:85%~94% (2.6~3.2)、『手術醫師簽名完整』:88%~97% (2.7~3.4)、『立同意書簽名完整』:91%~95% (2.9~3.2) 及『病人基本資料完整』:91%~97% (2.9 ~3.4)。介入六標準差管理後,每部份簽署完整率皆達90%以上,尤其在『病人基本資料』及『立同意書簽名』完整率達100%。結論:運用六標準差改善手法,不但有效降低手術同意書簽署的不完整率,同時也降低手術病人安全照護流程中,術前溝通不完善發生的機率,且減少病人進入手術房時間的延遲,對手術室的業務運轉績效更是有加分的效果。 |
英文摘要 | Background and Purpose: Incompletion of obtaining informed consent can lead to operation delays and can incur additional management loading. The aims of this study were to use the 6-sigma method to improve the preoperative completion of informed consent for better communication between patients and healthcare workers. Methods: Following the DMAIC 6 sigma standard procedures, we retrospectively reviewed medical records and used a "fishbone chart" to investigate the causes of incompletely obtaining informed consent. Prospective interventions were introduced during the period from October 2006 to April 2007. Results: There are 7 items which need to be completed prior to surgery. Before the intervention, the [intervention/completion?] rates were 18%~29% (0.6~1.0) for a 2nd copy to the patient, 68%~85% (2.0~2.6) for the doctor's claim, 73%~82% (2.2~2.5) for the patient's claim, 85%~94% (2.9~3.2)for the type of operation, 88%~97% (2.7~3.4) for the physician's signature, 91%~95% (2.9~3.2) for the patient's signature, and 91%~97% (2.9~3.4)for the patient's demographics. After the intervention, the completion rates rose to > 90% (2.9~3.8 )for all items. Conclusions: Introduction of the 6-sigma method proved to be effective in improving completion of obtaining informed consent and improving doctor-patient communication. At the same time, operation delays and management loading were successfully reduced. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。