| Summary: | 碩士 === 台北醫學院 === 公共衛生學研究所 === 88 === Medical quality has been a major subject of study in many social and economical fields. Yet, effective evaluation and improvement of medical quality must begin with establishment of legitimate indicators and practical evaluation process. Currently, Taiwan has not established an objective monitoring system with complete data result. This research intends to develop an objective system of medical indicators. A research of its feasibility is conducted through clinical applications in hospitals with goals to provide a model for policy making and to improve the medical quality in Taiwan.
This study includes three phases. First of all, 40 experts are asked to fill out a questionnaire to express their opinions on the application and feasibility of the medical indicator systems they currently use. Second, Delphi Method is utilized to conduct a symposium participated by representatives from 10 hospitals. The purpose is to build consensus of the definition of medical quality indicators and to discuss issues concerning their applications. Third, a survey on the feasibility of the “Taiwan Quality Indicators System” is conducted and opinions from 10 hospitals are collected.
Result findings show that 90% of the surveyed experts approved 80% of the 154 indicators currently used. After intensive discussions, it is concluded that there are three major problems about the definition of current medical quality indicators. Problems include that” the definition of an indicator can be unclear”, “what the definition was may vary from what it is now”, and “that the definition can be used inconsistently”. Possible solutions may gear toward “redefining indicators”, “referencing the definition of TQIP”, and “borrowing the definition used by the Hospital Accreditation here in Taiwan”. After two rounds of discussion, 10 tested hospitals have reached the agreement that TQIS has positive impacts on the establishment of a standardized system of quality control, a numeric evaluation system of quality control, and an indigenous culture of quality control. On the other hand, negative impacts may result in the increase of human resource expenses and workload. Over all, all the tested hospitals fully support the feasibility of the TQIS and believe that it will improve the reliability of future medical quality evaluation.
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