- 學位論文
人力資源管理對照護績效的影響―以全面品質管理及全面關係管理為中介因子
The Influence of Human Resource Management on Healthcare Performance – Using Total Quality Management and Total Relationship Management as Mediators
摘要
由於健保給付制度及醫療政策的更迭全民健康保險政策之實施，加上醫療環境的競爭激烈，致使醫療機構的經營越來越困難，面對此嚴峻的挑戰與衝擊，促使台灣醫療機構營運環境面臨重大的改變，面對此環境與制度的變革，醫療機構的營運績效遂成為醫療機構亟需重視的課題。醫療機構唯有增進經營效率，提升醫療服務品質，建構組織及員工的核心能力，方能取得競爭優勢、建立形象與口碑。機構最重要的資產是員工，其中護理人員亦是佔最多比率，醫療機構要如何有效的進行人力資源管理，提高護理人員工作意願，提升高品質之照護績效，以達到最有效率的護理人力運用以因應環境及政策的變化，遂成為醫療組織中所要重視的議題。本研究為了解醫療機構進行人力資源管理對照護績效影響程度，以及探討醫療機構在全面品質管理與全面關係管理之中介關係及影響程度，根據研究結果提供醫療機構經營管理者參考，以提升護理人員照護績效。 本研究以長庚醫療財團法人機構之護理人員為研究對象，透過問卷調查方式獲致483份有效問卷，有效回收率達80.5%，在結構方程模型分析下，主要研究發現有：(一)研究構念間人力資源管理正向影響照護績效；(二)人力資源管理在全面關係管理或全面品質管理與照護績效間各具中介效果; (三)人力資源管理對照護績效影響受全面品質管理與全面關係管理中介因子之序列中介影響。 研究發現除提供未來對醫療機構相關議題有興趣者引文參考外，並就不同程度醫療環境，醫療機構管理者以運用人力資源管理提升照護績效並取得護理競爭優勢之實務參考，於未來執行實務時建立持久服務競爭品管優勢模式有更明確的方向。
並列摘要
Since the change of policy of the National Health Insurance system of reimbursement and medical policies, coupled with competitive health care environment, resulting in operating medical institutions increasingly difficult to face this challenge and impact. There are facing major changes in prompting Taiwanese medical institutions operating environment, however, changing in this challenge environment and system with the operating performance of medical institutions became urgent medical issue attention. However, medical institutions only enhance operational efficiency, and improve the quality of medical services. In order to obtain a competitive advantage, image and reputation, the most important asset will be the staff agency. They need the ability to organize and construct major staffs. Which also accounted for nursing ratios, medical institutions, how effective in human resources management, improving nurses' willingness to work to improve the performance of the high quality of healthcare. Therefore, health care organizations should pay more attention to achieve the most efficient use of nursing human in response to environmental and policy changes. This study was to understand the medical institutions for protecting human resource management control performance impact, and explore the relationship between these three factors: medical institutions in the mediation and influence total quality management and overall management. Findings of this research would be useful and provide elaboration measures to enhance the effectiveness of the work of nurses, care and thus enhance performance to medical institutions upper management. The survey was conducted in “Chang Gung Medical Foundation nursing institutions” amount 483 completed questionnaires received for analysis. The effective recovery rate of 80.5%, in the structural equation model (SEM), the major three research finding are: (1) positive impact of healthcare performance between the construct in addition to human resources management; (2) human resources management in a Total relationship between the management or total quality management and performance with Mediation Effect; (3) impact of human resources management also controls in protection performance and Total quality management with full sequence of Mediation Effect in total relationship management. The findings of this study would benefit medical institutions operators in better understand the preferences interested in these issues and for further researchers’ references. Also, in different level of medical environment, medical institutions managers will improve human resources management in nursing healthcare performance and achieve competitive advantage substantive reference to implementation of practice QC in the future.