Construct an evaluation and continuous improvement system to upgrade the quality and quantity of self-payment medical services– Evidence from post-operative pain control service in the hospital

• Main Authors: Li-Kuei Chen, 陳李魁
• Other Authors: Shu-Hsing Li
• Format: Others
• Language: zh-TW
• Published: 2011
• Online Access: http://ndltd.ncl.edu.tw/handle/67420577958679434160

碩士 === 國立臺灣大學 === 會計與管理決策組 === 99 === With the rapid progression of new technology, medical services have continuous changed and developed day by day. Different kinds of analgesic methods or packages for relieving postoperative pain are one of the items. At present, most of big hospitals, including NTUH (National Taiwan University Hospital) have provided patient controlled analgesia for postoperative pain management. Owing to the initial development stage of APS (Acute Pain Service) team in our hospital and the obstacle from traditional old concept, the applying percentage of APS for the clinical practice was beyond the expectation. At present, patients have to pay NT 7,300 for receiving APS and about 350 patients will apply APS per month. The overall gross income (patients have to pay by themselves and the health insurance does not cover) will be around NT 2,555,000 every month. If the case number could increase by improving the service quality and then around 500 patients (15% of total patients receiving operation) will apply APS per month, the overall gross income will increase to around NT 3,650,000 every month. Thus, how to popularize this service by upgrade the service quality and quantity, and then increase the willing of patient to adopt this service with increasing the self-payment income for hospital simultaneously should be an important issue for further study and investigation. This study was conducted to completely analyze, evaluate and propose the solution how to upgrade and improve the quality and quantity of APS in our hospital, since we have invested a lot of capital and manpower in setting up APS team. At first, we try to make sure and find out the target issues, problems and assumptions via BSC (Balanced Scorecard) analysis. Then, we will construct a dynamic modifying model from the APS systemic processing and try to dig out the key driver factor in the different wards and surgical departments through the cause & effect feedback diagram and the simulation results. At last, we will focus to make the modification and improvement for those key driver factors and by using the dynamic BSC and KPI value (Key Performance Index) to make the final evaluation and judgment of achievements. The main purpose or goal is tried to construct an evaluation and continuous improvement system model to upgrade the quality and quantity of acute pain service for different wards and surgical departments in our hospital. In the near future, we might popularize this APS system model to the other hospitals to upgrade the NTUH APS team as the leading index and role model in developing APS in Taiwan.