目的:副木製作後因故需修改為職能治療師臨床工作常見的問題，本文欲探討可否藉 由品管圈活動作為解決臨床問題的方法，並驗證其效果。方法:分析本科 2014 年 1 月至6 月統計數據後，發現經由他科轉介之副木修改率達 18.4%，故成立品管圈欲降低修改率。 檢視修改原因，將其歸類為:醫囑單資訊不足、使用或保管不當、肢端腫脹、病程改變、 有壓迫點。以柏拉圖驗證「醫囑單資訊不足」、「使用或保管不當」為問題要因，據此 擬定以設計副木、製作肢體印章及將副木衛教單圖像化作為對策措施，並利用 Plan-Do- Check-Action 手法進行三項對策檢討和效果確認。以線性趨勢及 Wilcoxon Ranks-Sum Test 分析改善效果。結果:2014 年 1 月至 6 月的修改率為 17.9% 至 22.2%，其趨勢並無 統計上的顯著差異 (p = .468)，然而 2014 年 7 月至 12 月的修改率由 25% 逐月下降至 0%， 其趨勢呈現統計上的顯著差異 (p = .013)。此外，2014 年 1 月至 6 月與 2014 年 7 月至12 月兩區間的修改率趨勢亦呈現統計上的顯著差異 (p = .005)。延伸性效益方面，他科醫 師對副木單和肢體印章皆感到滿意以上;而治療師使用圖式衛教單時，對於衛教時間、民 眾接受度與整體執行程度上均有小程度至中等程度改善。據此修訂轉介副木製作流程並制 定轉介副木作業標準書以建立標準化作業流程。結論:本品管圈成功的利用圖文方式促進 醫療跨團隊溝通，所建立之標準作業流程可做為新進人員訓練及實習生教學。品管圈手法 可使用於改善臨床問題，並據此標準化以持續改善效果。

Objectives: Splint modi cation is a common problem in the routine clinical practice ofoccupational therapists. This study investigated the efficacy of implementation of a qualitycontrol circle(QCC) to decrease the rate of splint modi cation. Methods: Data collected from January to June 2014 were analyzed, and the results revealed that up to 18.4% of splints referred from other departments underwent adjustment because of insufficient informationin the physicians’ prescriptions, inadequate use or storage, extremity swelling, changes in disease course, or pressure points. A QCC was established to reduce the modi cation rate and improve the quality of splints. Through Pareto analysis, the QCC identi ed that “insuf cient information in physicians’ orders” and “inadequate use or storage” were the root causesof poor quality splints Accordingly, the QCC formulated three solutions, namely designingsplint introduction lea ets, using body stamps in prescriptions, and creating graphical healtheducation leaflets on appropriate splint usage, which were subsequently verified by the Plan–Do–Check–Action. The linear trend test and the Wilcoxon Ranks-Sum Test were useto estimate the difference of modi cation rate. Results: The modi cation rate from January2014 to June 2014 was 17.9% to 22.2% (p = .468), but the modi cation rate presented the signi cant decreased from 25% to 0% (p = .013) between July 2014 to December 2014. The trend of those two time periods indicated a significant difference (p = .005). Furthermore, physicians rated the splint introduction leaflets and the design of the body stamps as satisfactory or above. Moreover, therapists recognized small to medium improvements in instruction time, patient acceptance, and overall performance because of the graphic health education leaflets. Finally, to standardize related procedures, the fabrication process of referred splints was revised, and a standard operation procedure (SOP) for splint referral was formulated. Conclusion: The QCC successfully facilitated interdisciplinary communication with a graphic approach. The resulting SOP is useful for training new staff and interns. The QCC method proved to be capable of providing solutions for clinical problems and resulting SOP to continue the improvement.