부산대학교 도서관

Emergency room (ER) overcrowding and prolonged length of stay in ER have resulted in a noisy and less satisfactory environment for ER patients, and therefore a decline in patients' satisfaction. We have investigated the most frequent negative comments toward an emergency department of a tertiary medical care center in Taipei, Taiwan and are as the follows: prolonged ER stay before admission, crowdedness and noisiness in ER, etc. In order to reduce the waiting time in ER, we establish a program of patient diversion and referral to help improve patients' satisfaction. We aim to reduce the length of ER stay by a patient transfer program in cooperation with Taipei City Hospital. Patients are transferred directly towards Taipei City Hospital to receive well medical care if shared decisions are made. After the analysis of the selection matrix, we performed the following interventions:(1) a coordinator in charge of the referral and transfer process;(2) posters and videos to promote transfer;(3) tools to help with shared decision making (SDM);(4) establishing transfer protocol and standardization;(5) inter-hospital network and cooperation program;(6) definition of minor and less complex diseases that could be managed in local hospitals;(7) outsourcing for patient transportation. The intervention was conducted from March to August in 2020. The pre-test satisfaction score was 54 points and was raised to 91.85 points after the intervention. A total of 92.3% of patients were satisfied with and positive about the program and 92% of patients believed that the program is sustainable. The program has successfully and effectively simplified the transfer process and improved patients' satisfaction. To expand the hospital network in both Taipei and New Taipei City can be the next goal to promote quality of medical care.