應用史哈特循環：計畫－執行－檢查－行動模式於臨床復健醫療服務等待時間之改善

The Shewhart cycle ”Plan-Do-Check-Act” (PDCA) can be applied by organizations as a model for designing, checking, evaluating, improving, or re-designing plans to improve the quality of service. We applied the PDCA model to clinical rehabilitation services in Taiwan and discussed its effects on the improvement in waiting time. Three issues facing current clinical rehabilitation services were proposed by the Department of Physical Medicine and Rehabilitation in a medical center to which PDCA was applied: (1) arranging occupational therapy for in-patients within 3 days after consultation, (2) shortening the waiting time for therapy in children with developmental delays, and (3) shortening the waiting time for psychological evaluation experienced by children with developmental delays. The results showed that (1) the rate of scheduling occupational therapy within 3 days after consultation improved from 76% to the threshold of 90%, (2) the waiting time for occupational therapy, speech therapy, and physical therapy among children with developmental delays improved from 6 months to 25 days, 3 months to 14 days, and 2 weeks to 1 week, respectively, and (3) the waiting time for psychological evaluation was shortened from 18 days to 5 days. The PedsQL-Health Satisfaction score given by caregivers of the children with developmental delays improved 4% after the application of PDCA. Our study proved that the application of the PDCA model could improve the waiting time and quality in clinical rehabilitation services.