運用團隊資源管理提升大腸直腸癌首次化學治療病人出院服務滿意度

Patient satisfaction with discharge service is one of the indicators regarding quality of care. The score of satisfaction with discharge service was 2.9 (Likert scale 1-5) and the readmission rate was 14.7% among patients with colorectal cancer receiving first chemotherapy in the first six months of 2015. After investigation, the reasons of patient poor satisfaction included lack of emotional support, medication and diet consultations, and self-care ability regarding side effects. This demonstrated that a multidisciplinary team approach was needed during hospitalization. The aim of the project was to improve the satisfaction score of discharge service from 2.9 to 4 (Likert scale 1-5) among patients with colorectal cancer receiving first-time chemotherapy. Team resource management was applied to develop several strategies. These included the leader being responsible for telephone visits and consultations; the content of patient education was standardized; an e-consultation and early warning mechanism for pharmacists, psychologists and dietitians was set up; and patient education was established to monitor indicators of quality control. Results in 2017 showed that the nursing education rate was 95%; chemotherapy education rate was 99% and the teach-back rate of chemotherapy was 97%; readmission rate was 0%; and the score of satisfaction with discharge service improved from 2.9 to 4.2 among patients with colorectal cancer receiving first chemotherapy. The project indicated a multidisciplinary team approach could improve satisfaction with discharging services and then improve the quality of care.