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  • 學位論文

藥劑部門內部服務品質之缺口分析:以台灣某教學醫院為例

Gaps Analysis for Internal Service Quality of the Pharmacy Department:An Example from a Teaching Hospital in Taiwan

指導教授 : 郭乃文
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摘要


醫院藥師是醫院裡的專業團體之一,藥師本身所擁有對於藥品的知識與調劑權,理應是醫院病患在用藥安全及品質上把關的最佳人選。以醫院的藥物管理系統而言,病人是藥劑部門的外部顧客,直接或間接接受藥劑部的服務,而臨床醫師及護理人員則是藥劑部門的內部顧客,直接接受藥劑部門服務的顧客。如同外部行銷中,服務品質為決定顧客滿意度的重要因素;內部服務品質同樣影響著員工滿意度,進而影響其工作成果。本研究將外部行銷的概念運用於內部服務品質之衡量,以PZB服務品質模式驗證其在醫院藥劑部門內部服務品質的適用性,由分析結果顯示,內部服務品質缺口及各缺口影響因素確實可解釋藥劑部門現況與面臨的問題。 本研究以自填式結構性問卷為研究工具,內部服務品質問卷主要以SERVQUAL量表作為基礎,再參考藥劑部門各項藥事服務之特性,最後發展為五個構面20題問項的服務品質量表;內部缺口影響因素量表則參考PZB所設計的影響因素構面,共35題問項。研究對象為台灣北部某教學醫院的臨床醫護人員及藥劑部人員,分填A、B不同問卷。醫護人員共發放923份問卷,有效問卷回收率為78.5%;藥劑部門共發出52份問卷,有效問卷回收率為88.5%。研究結果顯示: 一、目前藥劑部門內部服務品質中有三個顯著缺口存在,包含缺口五、缺口二及缺口三,缺口五是「醫護人員」對「藥劑部門」服務的期望與實際知覺的落差;缺口二是「藥劑部人員認知醫護人員的服務期望」與「藥劑部門設定的服務品質標準」兩者之間的落差;缺口三是「藥劑部門設定的服務品質標準」與「藥事人員實際提供醫護人員的服務」兩者之間的落差。綜合三個缺口主要差距構面出現在「可靠性」及「系統性」。 二、缺口一的影響因素構面與缺口一服務品質無顯著相關。缺口二的影響因素構面與缺口二服務品質呈中度正相關,且對「系統性」構面解釋力最高。缺口三的影響因素構面與缺口三服務品質呈中度正相關,對「可靠性」構面解釋力最高。 三、不同屬性的受訪醫護人員對藥劑部門期望與實際知覺的服務品質確實存在差異,包含「教育程度」、「所屬單位」、「職務別」、「職位別」、「服務年資」、「疑議處方接受建議情形」等屬性。 四、醫護人員對藥劑部門服務品質的滿意度為中上程度。僅有「所屬單位」及「疑議處方接受建議情形」兩變項與整體滿意度有顯著差異,顯示不同屬性的醫護人員對藥劑部門服務品質的整體滿意度趨近一致。 五、醫護人員「實際知覺服務品質」與整體滿意度呈高度正相關,「期望與實際知覺服務品質差異」與整體滿意度成中度負相關,而所得之迴歸模式,以知覺水準(P)對內部顧客整體滿意度的解釋力高於知覺與期望水準之差距(P-E)。 最後,根據研究發現與結論提出相關建議,作為藥劑部門提升內部服務品質之參考。

並列摘要


Pharmacist is one of the largest professional groups in hospital. Pharmacists possess professional knowledge in medication and the right of dispensing. They play the most important role in ensuring medication safety and quality. As far as a hospital medication management system is concerned, patients are external customers, directly or indirectly receiving services from the pharmacy department; clinical physicians and nurses are internal customers, directly receiving services from the pharmacy department. As in external marketing, service quality is an important determinant of customer satisfaction; internal service quality affects employee satisfaction, which may further affects employee job performance. This study applied external marketing concepts to measure internal service quality and used PZB gap model to examine the internal service quality of hospital pharmacy department. Results showed that internal service quality gaps and factors affecting the gaps could explain the current status of and problems faced by the pharmacy department. The research tools were two self-report structured questionnaires. Based on the SERVQUAL score and the service characteristics of the pharmacy department, the internal service quality questionnaire consisting of 20 items in five dimensions was developed. The questionnaire on factors of internal service quality gaps was designed according to the dimensions proposed by PZB and consisted of 35 items. The two questionnaires (A and B) were respectively administered to clinical medical staffs and pharmacists of a teaching hospital in northern Taiwan. A total of 923 questionnaires were distributed among the medical staffs of this hospital, and the valid response rate was 78.5%; 52 questionnaires were distributed among the staffs of the pharmacy department of this hospital, and the valid response rate was 88.5%. The main findings were as follows: 1. There were three significant gaps in the internal service quality of the pharmacy department, including Gap 5, Gap 2, and Gap 3. Gap 5 refers to the difference between “medical staff’s expectation” and “their perception of pharmacy service quality”; Gap 2 refers to the difference between “pharmacists’ perception of medical staffs’ expectation” and “translation of perceptions into pharmacy service quality specifications”; Gap 3 refers to the difference between “translation of perceptions into pharmacy service quality specifications” and “the service delivery”. The three gaps suggested that the service quality gaps existed mainly in the “reliability” and “systems” dimensions. 2. The dimension of factors causing Gap 1 is not significantly related to the service quality in Gap 1. The dimension of factors causing Gap 2 is moderately and positively related to the service quality in Gap 2, providing relatively more explanation of the “systems” dimension. The dimension of factors causing Gap 2 is also moderately and positively related to the service quality in Gap 3, providing relatively more explanation of the “reliability” dimension. 3. Medical staffs’ expectation and perception of the pharmacy department’s service quality varied by several attributes, including “education degree”, “department”, “position”, “job ranking”, “duration of service”, and “acceptance of the amendment of their inappropriate prescriptions”. 4. Generally, the medical staffs showed an intermediate-high level of satisfaction with the pharmacy department’s service quality. Their overall satisfaction significantly differed on only two variables, namely “department” and “acceptance of the amendment of their inappropriate prescriptions”, showing that medical staffs across different attributes had almost consistent overall satisfaction with the pharmacy service quality. 5. Medical staffs’ “perception of pharmacy service quality” was highly and positively correlated with their overall satisfaction, and the “difference between expectation and perception of pharmacy service quality” was moderately and negatively correlated with their overall satisfaction. In the regression model, perception level (P) provided higher explanatory power for internal customer satisfaction than the difference between the perception and expectation levels (P-E). Finally, based on research findings and conclusions, some suggestions were proposed as a reference for the pharmacy department in the improvement of internal service quality.

參考文獻


韓揆(1994)。醫療品質管理及門診服務品質定性指標。中華公共衛生雜誌,3(6),7-13。
傅鍾仁、張錫惠(2002)。我國醫療服務品質滿意度之實證研究。臺灣管理學刊,1(2),317-340。
林公孚(2007)。醫療品質之最佳實務運作模式。品質月刊,43(8),25-32。
詹前彥(2002)。現行醫療體制下醫療人員對重症加護藥事服務認知與滿意度之研究。碩士論文,台北醫學大學藥學研究所,台北。
Gronroos, C. (1981). Internal Marketing—Theory and Practice. In American Marketing Association Services Marketing Conference Proceedings, 41-7.

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