The Causes Analysis for the Number of Patients Waiting in General X-ray Room (Focus on Utilization of Quality Improvement (QI))

일반촬영실의 환자대기건수에 대한 원인별 분석 - QI 활용을 중심으로 -

A questionaire survey was conducted for patients who had been examined at the Department of Radiology to investigate the items that need to be improved. Brainstorming was also conducted by team members to suggest the tactics that can efficiently perform the QI activity by selecting the most frequently answered topics for the reduction of waiting time of x-ray examination. From September 2006 to November 2007, number of patients before and after conducting QI was compared for 3 months by each category differentiated by types of detailed causes. A patient case was set as one shooting for one patient. After conducting QI, the waiting cases before conducting QI were evaluated for the method of improvement for 3 month through the QI team discussion and conducted by following the improvement method for the next 1 month and the waiting cases were measured and the difference before and after the QI activity was compared in percentage. 1. When patient waiting cases were compared before and after conducting QI activity against the causes of repetition, it resulted in 3.9% of reduction effect. 2. When patient waiting cases were compared before and after conducting QI activity against the causes for the lack of guiding, it resulted in 1.1% of reduction effect. 3. When patient waiting cases were compared before and after conducting QI activity against the causes of miss-inputting prescription, it resulted in 1.1% of reduction effect. 4. When patient waiting cases were compared before and after conducting QI activity against the causes for emergency patients, patients with acute pain and discomfort patients, it resulted in 12.0% of reduction effect. 5. When patient waiting cases were compared before and after conducting QI activity against the causes for shooting overlapping of outpatients and hospitalized patients, it resulted in 4.7% of reduction effect. There are many factors to reduce the patient waiting cases in radiography. The first step is for radiology department to find these factors through QI, to improve them, which is the reason why the QI team is organized to perform the QI activities.

영상의학과에서 검사한 환자들의 불편사항을 사전설문조사를 통해 개선사항을 조사하고 팀원과 Brain storming을 실시하여 가장 많은 답변인 촬영대기시간단축을 주제로 선정하여 QI활동을 효율적으로 수행할 수 있는 방안을 제시하고자 한다. 2006년 9월부터 2007년 11월까지 세부원인 분류에 따라 각 항목별로 3개월간 QI 실행전과 후의 환자건수를 비교하였다. 환자건수는 환자 한 명 당 촬영한 검사 한 건으로 하였으며 QI실행 후는 QI실행 전 대기건수를 QI팀 회의를 걸쳐 1개월간 개선방안을 모색한 후 개선방안에 따라 시행 하면서 같은 방법으로 1개월간 측정하여 QI활동 전후의 차이를 각각 백분율로 비교하였다. 1. 재촬영원인에 대한 QI활동 전 후 환자촬영 대기건수 비교하였을 때 3.9%의 감소효과 2. 안내부족 원인에 대한 QI활동 전 후 환자촬영 대기건수 비교하였을 때 1.1%의 감소효과 3. 처방착오입력 원인에 대한 QI활동 전 후 환자촬영 대기건수 비교하였을 때 1.1%의 감소효과 4. 응급환자, 통증이 심한 환자, 몸이 불편한 환자 등의 원인에 대한 QI활동 전 후 환자촬영 대기건수 비교하였을 때 12.0%의 감소효과 5. 외래와 병동환자의 촬영중복시간 원인에 대한 QI활동 전 후 환자촬영 대기건수 비교하였을 때 4.7%의 감소효과 환자의 촬영대기건수를 단축하기 위해서는 많은 요인들이 존재한다. 이 요인들을 QI를 통해 영상의학과의 많은 문제점을 찾아내 수정하고 개선하는 것이 QI의 첫걸음이며 영상의학과 QI팀이 결성되어 QI활동을 실행하는 이유라고 할 수 있다.