臺灣醫療照護品質指標系列(THIS)之介紹

品質指標並非玩數字遊，而是將無形的品質以人類可理解的文字、數字或圖表來解釋說明對品質之感覺，另一方面為藉由文字或數字的表達來評定品質的好壞，而各類項的群組可謂稱之系統，其項次內容我們則可稱為指標。指標的意函，可分為正反向指標，也有人說是哨兵事件指標…等眾說紛紜，但不可否認的它可提醒錯誤行為及改善空間，繼而提昇既定水準，若適用在醫療行業上則整體稱為醫療品質指標系統。 面對國內外醫療環境的變遷，為早日釐定醫療品質指標測量標準，並建立全國性的品質指標蒐集系統，衛生署1999年委託醫管學會且結合產官學進行本土化醫療指標系統的研究開發，爾後藉由初步成果擴大廣邀醫界共同參與，此階段我們則以「臺灣醫療照護品質指標系列（Taiwan Healthcare Indicator Series, THIS）」稱之。 THIS自2001年7月1日始至2005年3月31日，經由原先參與的45家醫院曾加為3231家。近四年努力成果，已初步建立國內本土資料庫，未來則應透過多元化手法強化資料的一致性及正確性，建構更完備完善的指標系統。透過定其/不定期的會議活動過程方可了解醫院在推動THIS指標的現況、經驗與實際面臨的困境，相互提供醫院改善方案或建言，以完備規畫及維護全國性的醫療品質指標系統資料庫，並期許得預延續完成最終目標通過ORYX的認証。 Quality indicators are not just games of numbers. It is a process to transform the formless quality into statistical numbers, graphs and understandable phrases, and to explain one’s feeling about quality. On the other hand, through the presentation of numbers and words, we may be able to judge quality. Each item is called an indicator and the aggregates of indicators will form system. Indicators can be classified in a variety of ways, for instance, negative and positive indicators, sentinel event indicators, etc. it is undeniable that indicators can be sued as reminders of what go wrong and whether there is room for improvement. Healthcare quality indicator systems are the application of this framework. Facing domestic and international changes, in order to define the performance standards of healthcare quality and establish a national quality indicator collection system as soon as possible, the Department of Health (DOH) funded a research project led by the Taiwan College of Healthcare Executive (TCHE) to develop a local healthcare quality indicator system in 1999. Before long, TCHE launched the indicator system nationwide and named it Taiwan Healthcare Indicator Series (THIS). From July 1st, 2001 to March 31st, 2005, the participating hospitals have increased from 45 to 231 hospitals. After nearly four years’ development, the localized domestic database has been established. Through user group meetings, participating hospitals are able to share experiences and advise each other on how to overcome barriers in practice and to initiate quality improvement actions. The objectives for the future are to increase the reliability of data collection and reporting, and to expand into a more comprehensive system. And the final goal is to be listed in the U.S. Joint Commission on Accreditation of Healthcare Organization (JCAHO) ORYX initiative.