轉型之領導與策略－以台北醫學大學為例

Turnaround Leadership and Strategy ─the Case of Taipei Medical University

朱子斌(Tu-Bin Chu)

指導教授 ： 江炯聰

國立臺灣大學/管理學院/商學研究所/博士(2014年)

https://doi.org/10.6342/NTU.2014.10410

摘要

經濟社會環境快速變化，企業組織爲達到永續經營之競爭力，組織變革已成為一個企業生存的必然趨勢。同樣地，醫療機構也為了降低因內外部環境變化所帶來的衝擊，與避免組織因內部管理不當所造成的危機，而開始採取組織重整、改善作業流程、重新設計制度、並落實組織文化的核心理念以強化組織內部管理與面對外部環境的挑戰。
根據組織生態理論可得知，任何組織在不同的發展階段，必然會產生不同的現象與問題。組織應根據不同的發展階段採取適當之管理策略，調整組織功能與管理模式，面對並解決各階段當下可能產生的組織問題與危機。然而，董事會運作績效與機構營運興衰息息相關，乃由於董事會具有監察與督導機構願景、策略規畫、財務制度、醫療品質、資源運用、社區發展、危機處理等職責。因此，當組織面臨存亡危機時，董事會如能審時度勢進行組織變革，制定可維持其成長與重生的關鍵策略，便可領導組織度過變革期所面臨的複雜挑戰。
有鑑於此，本研究採用個案研究分析法(case study analysis)，以組織生態循環理論的觀點探討個案機構-台北醫學大學從創校到組織變革成功間之重整過程。分析個案機構在重整的過程中，組織所面臨危及存亡的危機、領導者轉型與魅力領導效能的展現與變革決策制定與執行的過程。並輔以國內外企業組織變革案例作一比較以歸納出其變革過程與個案機構之異同。期以本研究可作為未來國內外企業機構於組織變革時之重要參考典範。研究結果發現，根據組織生態循環理論的觀點，北醫醫療體系組織變革之關鍵成功因素如下：
一、再生期(1995~2002)：(1)轉型與魅力領導：治理者的轉型領導與管理者魅力領導效能之展現，建立「成為國際一流之大學醫院」之新組織願景。(2)爭取萬芳OT經營權：以萬芳醫院另闢改革戰場的作法，全面推行品質管理策略，藉由鼓勵員工持續品質改善(CQI)的組織文化，凝聚品質提升的共識、激勵全員參與的熱忱，促使組織內部學習。(3)啟動附醫改革：於2002年啟動附醫改革，全面複製萬芳醫院成功之經營模式。

二、開採期-興業行動(2004~2013)：(1)爭取雙和BOT案：除了萬芳醫院之外，北醫董事會另闢一個可以支持北醫附醫繼續成長的據點，於2004年爭取經營雙和醫院。由於萬芳醫院以卓越領導、顧客導向、持續改善、全員參與等全面品質管理(TQM)之四大支柱執行品質管理政策，獲得相當的經營成效。因此，北醫董事會在雙和醫院的管理上，便決定全力複製萬芳成功之經營策略。(2)推展國際醫療：為了讓北醫醫療體系成為國際醫療領導品牌，北醫董事會大力推展國際醫療之發展業務。於是在2009年至2010年承接駐史瓦濟蘭王國及聖多美普林西比共和國醫療團，讓北醫醫療體系高品質的醫療服務能揚名國際。
三、開採期-策略管理(2009~2013)：(1)董事會的治理變革：修訂新版之董事會規範章程，以強化董事會功能，內容包括：董事長只能連任一屆；董事會有行事準則，正面表列董事行使職權的規範；董事會有榮退條例，成員能有適當的換血機會。(2)一校三院整合：「建立管理發展中心」可以作為一校三院營運資訊整合與分析之單一窗口。「整合資訊系統」滿足與提升北醫目前一校三院營運資訊提供的即時性，具體衡量出三院之績效表現，透過資訊管理找出績效數據的差異化，以便領導者與其管理團隊能夠根據明確的數據資料做出正確且適時的決策規劃。(3)治理者之治理策略規劃重點：推薦人才、蔚為國用；人才接班、開創新局；參與政策、國際醫療；投入社會、推動生醫；柔性變革、校院整合；建立制度、樹立典範。
以病人為中心的角度出發，北醫在萬芳醫院建立了新的組織文化，以「品質作為標竿」的萬芳經驗，之後才能有北醫體系全面的改革。本文探討個案機構之組織變革管理模式，同時對照國內醫療機構與國外企業之組織變革案例，進而衍生出許多管理意涵與對未來相關研究之建議。期以醫院董事會決策與領導對機構轉型績效影響之研究，作為未來國內外醫療機構於組織變革時之一重要參考典範。

關鍵字

醫院變革管理 ； 組織生態 ； 危機管理 ； 轉型領導 ； 決策模式

並列摘要

Social economic environment changing rapidly, organizations need to sustainable the business competitiveness. Organizational change has become an inevitable trend of business survival. Similarly, medical institutions in order to reduce the environmental changed impact and internal mismanagement crisis begins to restructuring organization, improve processes, redesign the system and implementation the organization core culture concept value to strengthen internal management and facing the challenges of the external environment.
According to the organizational ecocycle theory can learned any organization at different stages has different phenomena and problems. Organization should take appropriate management strategies in adjusting organizational functions and management mode depend on different develop stages to cope with problems and possible crisis that may arise. However the Board has closely relationship with organization raise and fall performance due to it play the role in monitoring and supervision vision, strategic planning, financial systems, health care quality, way to use the resources, development community, crisis management and others. Therefore when the organization is facing a crisis, the Board can assess and develop the strategies are the renewal key factors in the organization then can lead the organization through the complex challenges.
Use the Case Study Analysis and organizational ecocycle theory to study the case, Taipei Medical University, restructuring process from the founding to the successful. By analysis the case faces a threatening crisis how to use the transformational and charismatic leadership effectiveness to implementation in the organization turnaround process to survival. Compare the domestic and international will knowing cases as supplemented then induction the turnaround process the same and differences. Hope the study can as an important reference model for domestic and internaiotnal enterprise transformation. Point of view in organizational ecocycle theory, the key successful turnaround factors of Taipei Medical University as follows:
1. Renewal Period (1995 to 2002): (1) Transformational and charismatic leadership: governance demonstrates the transformational and charismatic leadership effectiveness to build up “World-Class University Hospital” as new organizational vision. (2) Fight for the Wang-Fang Operate Transfer (OT) right: used the Wang-Fang to open the new turnaround battle field to implementation the quality management strategy, through the organizational culture of Continuous Quality Improvement (CQI) to cohesion quality improvement consensus, encourage full participation and promote learning within the organization. (3) Start to reform the Taipei Medical University Hospital: duplicate fully Wan-Fang Hospital successful business model to reform Taipei Medical University Hospital in 2002.
2. Exploitation period - Entrepreneurial action (2004 to 2013): (1) fight for the Shang-Ho Hospital Build-Operate-Transfer (BOT) operation project: others than Wang-Fang Hospital, Board of Taipei Medical University open up an additional spot that can support Taipei Medical University to grow continuance. In 2004 got the Shang-Ho Hospital operation right. Since Wang-Fang Hospital used the Total Quality Management (TQM) to implementation four fields of quality management in excellent leadership, customer orientation, continuous improvement and full participation to access the considerable operating results. Therefore, the Board decide fully replicate the Wan-Fang Hospital successful business strategy management to Shang-Ho Hospital. (2) Promote Medical to Internation: in order to allow the Taipei Medical University system becomes the leading brand in the internation, Taipei Medical University Board energetically in develop the international medical business. In 2009 to 2010 undertake the Medical Mission in Kingdom of Swaziland and São Tomé and Príncipe to let Taipei Medical University health care system can be well known in global.
3. Exploitation period - Strategy Management (2009 to 2013): (1) The Board changes the goverance: amend a new version of the board’s Specification Prospectus to strengthen the Board’s functions. Including: Chairman can renewable once only, acted the Board power standards by positive list, have regulations emeritus that make Board have proper turnover opportunities. (2) Integrate School and Hospitals: set up “the Management Development Centre” as a single-window to analysis integration operational information. Through "Integrated Information System" to enhance the Taipei Medical University Hospitals have real time operational information and specifically Hospitals performance measure data. The leader and their management team can timely to identify and clarify differentiated performance information then make the right decision. (3) Governed Strategic focused on: recommends talent to be country use, talent succession to open the innovation, involves in policy and promote the international medical, devotes into society and promotes biomedical, flexible changes and integrates the University and Hospitals to establish a system as model.
Using Patient-centered perspective, Taipei Medical University established a new organizational culture in Wan-Fang Hospital. Use Wan Fang experience as "quality benchmark" to comprehensive reform in TMU system. This study examines the case organizational change management model and compare with domestic medical institutions and international enterprises, and thus derive a number of management implications and recommendations for future research. Looking the research on the impact of the transition to the performance of the hospital Board decision-making and leadership can be one of the important reference models for domestic and foreign medical institutions need to turnaround.

並列關鍵字

Hospital turnaround management ； organizational ecocycle ； crisis management ； transformational leadership ； decision-making model

參考文獻

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