醫療服務機構中主管領導風格與組織文化對員工工作績效與組織承諾影響之研究－以動態能耐為中介變項

The Impact on Employees’ Performance and Organizational Commitment by Leadership Style and Organizational Culture in Medical Service Institults – Using Dynamic Capabilities as a Mediator

謝惠婷(Hui-Ting Hsieh)

指導教授 ： 洪英正

共同指導教授 ： 李芸蕙

淡江大學/商管學院/企業管理學系碩士在職專班/碩士(2013年)

https://doi.org/10.6846/TKU.2013.00810

摘要

隨著全球化與健康意識抬頭，人口結構、生活習慣與疾病型態的改變，醫療費用支出增加與服務成本相對提高，加上全民健保制度改革之不確定性，使醫療產業近十年來面臨經營型態重大挑戰。根據學者研究指出，動態能耐較高之企業透過整合、學習、重整能力能快速因應外在環境變化(Wang & Ahmed,2007)。因此本研究藉由管理觀點探討領導風格與組織文化對動態能耐之影響，同時分析動態能耐對工作績效與組織承諾之影響。
本研究使用Bass(1985)交易型、轉換型領導作為領導風格構面，並依據Wallach(1983)提出之官僚型、創新型、支持型作為組織文化構面，同時以Teece, Pisano, & Shuen(1997)整合、學習及重整作為動態能耐構面，在工作績效中則採用Borman & Motowidlo(1993)任務與脈絡績效兩種作為工作績效構面，在組織承諾係依據Meyer & Alien(1991)提出之情感性、持續性與規範性承諾作為構面。
本研究以醫療服務機構人員為研究對象，以紙本、線上問卷填答對象涵蓋十三家醫療院所，回收有效樣本共計397份，以SPSS 20分析，研究假設如下：H1：領導風格對動態能耐有顯著影響。H2：組織文化對動態能耐有顯著影響。H3：動態能耐對工作績效有顯著影響。H4：動態能耐對組織承諾有顯著影響。H5：動態能耐在領導風格對工作績效與組織承諾之影響上有顯著中介效果。H6：動態能耐在組織文化對工作績效與組織承諾之影響上有顯著中介效果。H7：不同人口統計變項之醫療機構員工在領導風格、組織文化、動態能耐、工作績效及組織承諾上有顯著差異。
經研究結果顯示：一、主管領導風格及組織文化兩者對醫療服務機構動態能耐有顯著影響；其中集權性文化不利動態能耐形成。二、機構動態能耐對員工工作績效及組織承諾兩者有顯著影響。三、動態能耐在領導風格與工作績效間具完全中介效果，在領導風格與組織承諾間具部分中介效果，動態能耐在組織文化與工作績效間及在組織文化與組織承諾間均具部分中介效果。四、人口統計變項中婚姻、年齡、職務層級、職務性質、現職醫療服務機構規模在領導風格、組織文化、動態能耐、工作績效及組織承諾上有顯著差異。
綜上所述，組織經營績效達成與機構優勢建立在良好的機構動態能耐，管理者應以制度管理建立學習型組織文化，運用知識管理使團隊自發性學習，透過充分授權培養員工當責精神，透過訂定明確工作目標及所屬權責達到分層負責、專業分工運作，同時凝聚團隊共識強化員工組織承諾，建構透明、公開之升遷與績效衡量標準。

關鍵字

醫療機構 ； 領導風格 ； 組織文化 ； 動態能耐 ； 工作績效 ； 組織承諾

並列摘要

With the globalization and the awakening of health consciousness, as well as the change of population structure, life habits and disease types, the medical expenses and service costs have been continuously increasing. Moreover, the reforming of National Health Insurance remains uncertain. All these factors have put the medical industry facing a challenge from operating in the latest decade. According to a study, enterprises with higher dynamic capabilities rapidly adjust themselves to external changes through the ability to integrate, build and reconfigure (Wang & Ahmed, 2007). This study will discuss how leadership style and organizational culture influence dynamic capabilities from the aspect of management. The influence from dynamic capabilities to job performance and organization commitment will also be analyzed.

This study uses “transactional and transformational leadership” as the leadership style aspect (Bass, 1985), and “bureaucratic”, “innovative” and “supportive” culture proposed by Wallach (1983) as the organizational culture aspect. For dynamic capability aspect, integrating, building and reconfiguring by Teece, Pisano & Shuen (1983) is adopted. “Task and contextual performance” for job performance aspect is inspired by Borman & Motowidlo (1983). Finally, the “affective, continuance and normative commitments” suggested by Meyer & Alien (1991) is used for organization commitment aspect.

Through paper and on-line questionnaires, this study interviews personnel from 13 medical service institutions. The effective samples are 397 and analyzed with SPSS 20. The assumptions are as following: H1 – leadership style has a significant influence on dynamic capabilities. H2 – organizational culture has a significant influence on dynamic capabilities. H3–dynamic capabilities have a significant influence on job performance. H4–dynamic capabilities have a significant influence on organization commitment. H5–dynamic capabilities play a role of mediator in the influence from leadership style on job performance and organization commitment. H6–dynamic capabilities play a role of mediator in the influence from organizational culture on job performance and organization commitment. H7 – interviewees from different medical service institutions show significant differences in leadership style, organizational culture, dynamic capabilities, job performance and organization commitment.

As a result, managers’ leadership style and organizational culture significantly affect dynamic capabilities. Centralization is unfavorable to forming dynamic capabilities. This study suggests that:
1. Dynamic capabilities in an organization significantly affect job performance and organization commitment.
2. Dynamic capabilities play as a complete mediator between leadership style and job performance, whilst only partial in leadership style and organization commitment.
3. Dynamic capabilities play as a partial mediator between organizational culture and job performance, as well as organizational culture and organization commitment.
4. Marriage status, age, job level, job content and the scale of the organization show significant differences in leadership style, organizational culture, dynamic capabilities, job performance and organization commitment.

In summary, the achievement of goals and superiority of an organization depend on good dynamic capabilities. Managers should build a learning organizational culture, and use knowledge management to have the team learn spontaneously. Employees will be responsible with thorough authorization. Setting clear targets and identifying responsibilities can enhance a harmonious cooperation from different parties. At last, a clear standard of promotion and evaluation will help the team cohere and emphasize the organization commitment.

並列關鍵字

Medical service institution ； Leadership style ； Organizational culture ； Dynamic capabilities ； Job performance ； Organization commitment

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