醫院檢驗科經營策略型態與績效管理之現況及相關性研究

Association of Strategic Typology and Performance Management of Clinical Laboratories in Taiwan

翁本才(Pen-Tsai Weng)

指導教授 ： 毛莉雯

高雄醫學大學/健康科學院/公共衛生學研究所碩士在職專班/碩士(2005年)

摘要

在國內外對績效管理應用於醫院經營或醫院內部單位管理的理論與建構方法已相當成熟。但應用於醫學檢驗單位（檢驗科）的研究則付諸闕如；所以本研究希望能針對以下幾個方向做探討與貢獻：（1）瞭解台灣各層級醫院檢驗科主管之策略型態；（2）探討醫院特質與主管屬性是否會影響其所採取之策略型態；（3）分析檢驗科主管對績效評估指標重要性與可行性之看法；（4）分析檢驗科主管的策略型態與績效評估指標之關聯性；（5）期望提供檢驗科管理者擇取適合績效衡量指標來進行管理策略之參考。
本研究採問卷調查法，結合Miles & Snow（1978）對策略型態之定義所發表之健康維護組織（HMO）的經營策略量表與Kaplan & Norton（1990）平衡計分卡（Balanced Score Card ）概念，透過相關文獻探討，以結構式問卷進行資料搜集工具，對於針對台灣地區120家地區教學層級以上醫院檢驗部門主管所採取的策略型態及績效評估指標認知態度的關聯性做分析探討，並藉此暸解醫院檢驗部門實施績效評估現況做分析。有效回收問卷64份，回收率52.03％。利用SPSS for Windows 10.0版軟體進行統計運算分析，統計方法包括T 檢定、卡方檢定、Pearson Correlation、單因子變異數分析、Scheffe與Tuky事後檢定。爰利用因素分析求出績效指標認知量表上的建構效度，期望能夠達到以較少的因素層面含括所有的觀察變項。
研究結果顯示，樣本醫院檢驗部門主管採用分析型策略佔最多數（79.7％），其次是反應型策略（9.4％）、前瞻型策略（7.8％）、防禦型策略（3.1％）。對績效指標重視程度在顧客構面是最高，也認為最容易實施。檢驗部門主管所採取的策略型態與績效評估指標重要性與可行性之認知無顯著性的影響。不同策略型態之檢驗科主管僅在平均年齡達顯著差異水準。樣本醫院檢驗科主管對績效評估指標重視程度與實施難易度的認知對績效制度實施現況會有影響。
研究結果顯示，檢驗科主管所採取的策略型態並不會影響其對績效評估指標重要性的看法，亦即不論檢驗科主管所採取的策略不同，對各項績效評估指標的重視程度都相當高。
本研究提出以下建議：1、當檢驗科主管考慮引進平衡計分卡的績效評估方法時，經過因素分析後的績效指標（KPI）可提供選擇參考。惟平衡計分卡績效管理成功之關鍵在於是否能將績效指標配合本身的策略與組織願景，並結合員工的認同與支持，否則績效管理將失去方向。2、建議未來的研究者可以利用此研究架構將其他科別納入研究，探討不同部門間是否有差異。

關鍵字

關鍵性績效指標 ； 策略型態 ； 績效評估 ； 平衡計分卡

並列摘要

The theory and methodology of applying performance management on hospital operation and internal administration has been well-known all over the world. However, there is rare study discussing managing clinical laboratory performance. The aim of this study was (1) to understand the strategic typology of Taiwan clinical laboratory administrators based on different hospital scales; (2) to investigate whether the hospital property and the clinical laboratory administrator’s characteristic may have influence on organizational strategic type or not; (3) to analyze how clinical laboratory administrators thinking about the importance and feasibility of performance index; (4) to study the correlation between the strategic typologies of clinical laboratory administrators and the performance evaluation ; (5) to be as a reference for clinical laboratory administrators selecting a suitable performance evaluation index for strategic management.

The study was based on the concepts of the “Strategic typology” raised by Miles & Snow in1978, and of the “Balanced Scorecard” (BSC) by Kaplan & Norton in1990; and applied questionnaire as the research material. With constructed questions designed referring to former papers, the study analyzed and discussed the relevance between clinical laboratory administrator strategic types and how they think about performance evaluation index, and also investigated the current situation of those clinical labs that implementing performance evaluation. There were total 126 clinical laboratory administrators of medical centers, regional hospitals, and district teaching hospitals in Taiwan within the study survey group. Overall, there were 64 questionnaires retrieved effectively, and the recovery rate was 52.03%. The study applied SPSS for Windows 10.0 editions for compiling statistics. The statistical techniques including T-test, Chi-square Test, Pearson Correlation, One-way ANOVA, Scheffe and Tuky afterwards assay. In order to explain all aspects of performance index with fewer factors, this study obtained construction validity based on factor analysis.

According to this study, most of the clinical lab supervisors in the sample group were analyzers (79.7%). 9.4% supervisors in the group were reactors, and 7.8% were prospectors. Only 3.1% of those administrators were defenders. The performance index was the most important for customer perspective in BSC, and it was thought to be the easiest part to bring into practice. There was no obvious relevance between the strategic types of clinical laboratory managers and how they take the importance and feasibility of performance indicator into consideration. The study only showed apparent variations while analyzing the correlation between strategic typologies and average ages. And, how those clinical lab supervisors valued performance index and how they thought the way to apply performance index will influence adaptation situation. The study also revealed that no matter what kind of strategic type that the clinical lab managers adopt, those administrators highly take account of performance indicator.

The study provides the following suggestions: (1) clinical laboratory supervisors can refer to Key Performance Indicator (KPI) while applying balanced scorecard for performance evaluation. Nevertheless, to apply BSC successfully, one should incorporate performance index with the organization strategy and goal, and also tie in employees’ identification and support, or performance management will lose control; (2) researchers in the future can applied the construction of this study to analyze other departments, for understanding if there are diversities among different departments.

並列關鍵字

Key Performance Indicators ； Balanced scorecard ； Strategic typology ； Performance evaluation

參考文獻

中文參考文獻（按姓氏筆劃順序排列）

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