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研究生:廖志融
研究生(外文):Chin-Jung Liao
論文名稱:放射科高風險警示系統用於門診病患之初步評估以某醫學中心為例
論文名稱(外文):Preliminary Evaluation of High Risk Reminding System in Outpatient Section Concerning Radiology Alerts in A Medical Center
指導教授:黃崇謙黃崇謙引用關係
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:醫務管理學研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:107
中文關鍵詞:警示系統放射電腦警示滿意度
外文關鍵詞:Reminder SystemRadiologyComputer AlertSatisfaction.
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本研究利用個案醫院之病人安全中心放射科 HRR 門診病患通報資訊資料庫,統計某一時期之門診病患通報數量,以及常發生在門診之警示值檢查項目、種類,常發生警示值之臨床科別進行分析,並輔以 QUIS Model 人機介面使用滿意度之問卷來評量各臨床科醫師對使用HRR 系統的滿意度。
研究結果顯示,放射科 HRR 資料庫共 489 筆,問卷回收總數 103 份,有效回收問卷為 94 份,個案醫院放射科高風險警示系統的使用滿意度頗受臨床醫師肯定,平均滿意度為 3.91。門診病患 HRR 通報多集中於:胸腔內科、神經內外科以及一般外科,醫師透過 HRR 系統協助,可清楚瞭解病人狀況及臨床處置的優先順序;門診病患超出臨床醫師預判的潛在危急疾病,藉由放射科 HRR 通報,病患在檢查後3日內回診佔總資料人數近6成。受訪之臨床科醫師在接受通報方式以「手機簡訊」得到較高的使用滿意度;年齡層 41-50歲及51歲以上的主治醫師,對於警示訊息的及處理病患安全的經驗較其他年齡層顯著;職務別結果呈現與年齡層相似,收到 HRR 通報之主治醫師,對 HRR 的感受性較不常收到及從沒收到訊息的醫師來的顯著。不同服務科別的臨床醫師皆會檢視來自放射科通報之警示訊息,且多數醫師能在30分鐘以內聯絡危急病人回診做進一步處理。
根據本研究的結果,我們可瞭解個案醫院 HRR 系統使用狀況,及提供未來改善方向,期許藉由利用資訊科技來提升病人安全。
This research is based on the Patient Safety Center HRR database of outpatient of Radiology in single-cased hospitals. It estimates the number of the announcedoutpatients during a period and frequently happen reminding Exam item and Exam type. It also analyzes clinical department with a user satisfied questionnaire of QUISModel to evaluate physicians using HRR system。
The research shows that 489 are distributed from the Radiology of HRR database. The sample of 120 physicians, total responses of satisfaction questionnairesare 103, and 94 (78.33%) are deemed effective. Most physicians at Radiologyapprove the use of HRR system with a satisfactory rate of 3.91. Most outpatient HRRannouncements are in Chest Medical Department, Neurology Medicine, and GeneralSurgery. With the aid of HRR system, physicians can clearly understand the priorityof patient situation and clinical take care. By Radiology HRR announced, when theoutpatient goes beyond the physician’s expecting potentially hazard disease, nearly60% of the patients will return within 3 days.
By mobile news-letter, we get more satisfaction among interviewed physicians. In addition, the physicians that are between 41 to 50 age as well as above 51 age have more experience of remind message and deal with patient safety than other ages. Similar to the above comparison, the sensitivity of the physicians that have everreceived HRR announcements is more remarkable than those who have never or seldom received HRR announcements. All physicians survey the warning information from Radiology HRR, and most of them will contact exigent patients to come back tothe hospital within 30 minutes to do further treatment.
According to the result of this research, we can learn how hospitals use HRR system and provide future improvements. We hope to promote the patient safety byinformation technology.
目錄
表目錄 i
圖目錄 iii
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究重要性 5
第三節 研究目的 6
第四節 研究範圍 7
第五節 研究流程 8
第二章 文獻探討 9
第一節 放射科資訊系統 9
第二節 資訊系統協助改善醫療品質 14
第三節 高風險警示系統 16
第四節 國內外HRR使用情形 18
第五節 醫師使用HRR系統的滿意度 22
第三章 研究方法 25
第一節 研究架構與研究假設 25
第二節 問卷設計 28
第三節 抽樣設計與方法 31
第四節 資料處理及分析方法 32
第五節 研究變項之操作型定義 33
第四章 結果 39
第一節 描述性結果 39
第二節 推論性資料結果 61
第五章 討論 81
第一節 研究結果討論 81
第二節 研究限制 88
第六章 結論與建議 90
第一節 結論 90
第二節 建議 92
參考文獻 94
附錄(一) 問卷調查表 98
附錄(二) 專家內容效度之專家名單………………………………………………...102
附錄(三) 專家效度量表 104
中文文獻
1. 林逸(2003)。醫療機構 PACS 系統架構程度相關因素探討—以台灣中部醫
院為例。國立交通大學管理科學研究所。
2. 孫漣(1998)。臨床即時警示系統--以腎臟科為例。國立陽明大學公共衛生學研究所。
3. 趙嘉成(2005)。運用無線通訊科技提昇病人安全之研究以高風險通報為例。國立政治大學資訊管理研究所
4. 劉世南(譯)(2004)。只想買條牛仔褲:選擇的弔詭 。台北:天下雜誌出版。(Schwartz Barry, 2004)
5. 何信穎 (2004)。台灣行動通信產業之競爭策略分析---以大眾電信 PHS 為例。東海大學管理碩士學程。
英文文獻
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Customer Satisfaction. Journal of Marketing Research, 19, 491-504.
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Control, 9th ed, Prentice Hall.
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