署立醫院廚房實施HACCP制度影響因素之研究

The Influence Factors of Implementing HACCP in Kitchens of Affiliated Hospitals of Department of Health, Executive Yuan, R. O. C. (Taiwan).

施桂梅(Kuei-Mei Shih)

指導教授 ： 王維康

元智大學/管理學院/管理研究所/碩士(2008年)

https://doi.org/10.6838/YZU.2008.00003

摘要

「危害分析重要管制點」(Hazard Analysis and Critical Control Points, HACCP)係由農場到餐桌之完整食物供應鏈管理，此制度是一套強調事先分析明瞭食品從原料經製造、加工、調配、包裝、運送、儲存、販賣過程中可能出現之危害，並於這些過程中尋找重要管制點，在管制點即予以適當控制，使危害不致發生於最後成品內的預防系統，亦即藉由預防控制確保成品的安全，對於膳食的衛生品質更具有保障。
我國於民國87年導入HACCP制度，乃為防範食品中毒之嚴重後果，並於民國89年經衛生署修正食品衛生管理法，正式將HACCP制度管理納入食品衛生管理法第二十條中（稱之為食品安全管制系統）。衛生署為提昇所屬醫院膳食衛生品質，自民國90年起，推動署立醫院廚房實施餐飲食品安全管制系統(餐飲HACCP制度)之認證。根據民國96年10月調查結果，署立醫院共有29所，通過衛生署食品安全管制系統先期輔導認證之署立醫院共12所，而17所未實施HACCP制度署立醫院中有6所採用外購便當。
署立醫院首開我國醫院廚房實施HACCP之先例，惟其認證相關經驗至今尚無深入之研究，因此本研究將23所署立醫院納入調查範圍。本研究主要目的即在於探討已實施HACCP制度署立醫院，對該制度的認知與推展期間面臨的執行困難，以及獲得認證後的實質受益，且以假設性的相同問項對未實施之署立醫院施測，經由比對分析，找出醫院廚房推展HACCP制度的具體影響因素，並分析人員屬性與工作特性對實施後滿意度，以及提高未實施者實施意願之影響因素。以問卷調查法於民國96年11月至12月共蒐集已實施之署立醫院105份樣本、未實施之署立醫院85份樣本進行實證研究。
實證結果顯示，已實施者對於實施此制度感到困難程度之所有指標均顯著低於未實施者、對於此制度之認知程度有3項指標顯著高於未實施者、對於認證效益也有1項指標顯著高於未實施者；人員屬性與工作特性對於實施後滿意度與提高實施意願有部份指標呈現顯著差異。根據實證結果，本文提出因應對策，供全國尚未實施該制度之醫院是否願意推展HACCP制度認證之參考。

關鍵字

危害分析重要管制點；HACCP；供應鏈；醫院；食品安全管制系統

並列摘要

Hazard Analysis and Critical Control Points (HACCP) system is a supply chain's management to the entire food which is from farm to table. The system is based on the identification of potential hazards and critical control points at which these hazards may be prevented or eliminated. The process is intended to review each step from the procurement of raw materials to the point of consumption. If the hospital kitchen can implement the HACCP system, hospital catering will have the safeguard regarding of hygienic quality.
Taiwan introduced the HACCP system since 1998 for preventing the large-scale of food poisoning. In 2000, the Department of Health (DOH) amended the Act Governing Food Sanitation, which integrated the HACCP in No.20 of Act Governing Food Sanitation. To promote food hygiene and sanitation of hospital catering, the DOH impelled many hospitals to set up the authentication of the HACCP system since 2001. According to the result of investigation in October, 2007, there were 29 affiliated hospitals belong to the DOH., only 12 affiliated hospitals which passed the authentication of HACCP system. The other 17 affiliated hospitals did not implement the HACCP system; including 6 hospitals used to buy lunch from outside.
The DOH set a precedent for the affiliated hospitals to implement the HACCP system in hospital catering. Up till now, deep research is not done. Therefore, this research subsumed 23 hospitals for investigation including the cognition, points of view, difficulties, and benefits of HACCP implementation in DOH-affiliated hospitals as HACCP-recognized hospitals. On the other hand, DOH-affiliated hospitals that are NOT implemented HACCP were also investigated with questionnaire to the assumptive questions. After using cross analysis, we identified the factors which influenced the satisfaction level and incentive of HACCP implementation. In comparison with HACCP-recognized hospitals, the levels of difficulty indicators were significantly higher in hospitals without HACCP implementation. The result implied that the real difficulty of implementation is lower than we had expected. We propose looking at the research results and using the related strategies for the hospitals that are considering HACCP implementation.

並列關鍵字

Hazard Analysis and Critical Control Points ；HACCP； supply chain； hospital； hospital catering

參考文獻

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