醫策會國家品質獎卓越中心:風濕免疫中心品質提升與成果分享

Abstract

鑒於風濕免疫中心照護的病人多為重大傷病及難治疾病，且易合併共病，如早發性心血管疾病、間質性肺病變及骨質疏鬆等，進而減低平均餘命及降低生活品質，因此亟需優質的跨領域團隊合作及持續的照護品質提升，方能達成全人照護目標。故風濕免疫中心參加第24屆醫策會國家醫療品質獎系統類卓越中心競賽，期待藉由外部評核來改善缺失及進行品質優化。 本中心自2016年成立以來，依據優質的醫療照護需求及嚴謹的全面品質要求，建置優質的跨領域醫療照護團隊及建立共同照護及轉介簡易流程，提供「病人至上」之創新與全方位醫療服務，並在選擇標靶藥物治療時，鼓勵病友參與醫療決策，因應2020年新冠疫情爆發，更著手建置醫療照護之雲端資訊系統，以達衛教無時限及醫病零距離。為能提升醫療照護品質，訂定具時效性的關鍵指標及優質照護相關的標準作業流程，並運用商業智慧進行品質監控及藉由PDCA手法進行改善。近五年來成效卓越，包括質量兼具的醫療照護品質、線上衛教高總數及高滿意度、提高風險藥物（標靶藥物）使用的安全性、及明顯提升病友的自我照護品質等。  Patients under the care of the Rheumatology and Immunology Center often experience severe and refractory diseases that are accompanied by comorbidities such as early-onset cardiovascular disease, interstitial lung disease, and osteoporosis, which reduce both life expectancy and quality of life. High-quality interdisciplinary teamwork and continuous improvement in care quality are required to achieve holistic patient care. Thus, the Rheumatology and Immunology Center participated in the 24th Joint Commission of Taiwan National Healthcare Quality Award for the Quality Improvement System category, aiming to use external evaluations to identify deficiencies and optimize quality. Since its establishment in 2016, the Rheumatology and Immunology Center has developed a high-quality interdisciplinary medical care team and established streamlined processes for collaborative care and referrals, meeting the demand for superior medical care and the rigorous requirements of total quality management. With a patient-first approach, the center provides innovative and comprehensive medical services and encourages patient participation in medical decisions, particularly in selecting targeted drug therapies. In response to the COVID-19 outbreak in 2020, the center also implemented a cloud-based medical care information system to achieve continuous health education and seamless doctor–patient communication. To enhance care quality, the center established timely key performance indicators and standard operating procedures related to high-quality care, using business intelligence for quality monitoring and the Plan-Do-Check-Act method for improvement. Over the past 5 years, the center has achieved remarkable results, including high-quality medical care, extensive online health education with high satisfaction rates, improved safety in the use of high-risk (targeted) medications, and significantly enhanced patient self-care quality.