- 學位論文
門診醫師看診遲到的代價
The Cost of A Doctor's Being Late for Patients' Visit in Outpatient Department
摘要
醫師看診遲到造成病人等候，影響醫療服務品質及病人滿意度甚巨。本研究以態度問卷調查高高屏地區四家區域教學醫院的病人、跟診護理人員與醫療主管等相關人員，面對醫師看診遲到時，可能產生的負面態度與反應行動，來探討醫師看診遲到所要付出的代價。以警惕醫師避免遲到，減少病人的等候，提升醫療服務品質。 本研究運用基本敘述統計、T檢定、單因子及二因子變異數分析等方法，探討相關人員的負面態度與反應行動之表現程度與差異。研究發現，相關人員對醫師看診遲到的可容忍時間大部份在15分鐘以內。相關人員的負面態度以負面情感影響為主，也會顯著影響對醫師的服務品質認知與個人觀感，而且女性病人比較希望被告知醫師遲到原因。病人與護理人員比較會隱藏內心不滿，但醫療主管為了醫院形象比較會想要告誡遲到醫師。反應行動方面，病人與護理人員同樣比較會隱藏內心不滿而不採取任何行動，若採取行動，則以言語抱怨為主；女性病人若有被告知醫師遲到原因，比較不會有負面反應行動。醫療主管則不會坐視不理，尤其是男性主管，多數會採取私下的勸誡行動。 病人為醫師的外部顧客，跟診護理人員及醫療主管為內部顧客，當醫師看診遲到時，相關人員的負面態度如成本冰山理論的內隱成本，反應行動為外顯成本。本研究針對內、外部顧客及內隱與外顯成本，發展管理策略矩陣，對外部顧客內隱成本提出等候品質管理、對外部外顯成本提出服務失誤補救、對內部內隱成本提出應變能力管理及對內部外顯成本提出人際關係管理等策略，作為醫師及醫院管理階層面對醫師遲到成本的處理方針。
並列摘要
A doctor’s being late for patients’ visit in outpatient department results in patients’ waiting, and affects the service quality and patients’ satisfaction. The research utilized the attitude questionnaire to investigate the possible negative attitude and responsive behavior of patients, nursing staff that attended, and medical directors of four regional hospitals in Kaohsiung and Pingtung when they faced the situation of the doctor’s being late for patients’ visit in outpatient department to explore the cost of the physician would pay for being late to make the phyxician be vigilant and avoid being late, decrease the patient’s time of waiting, and elevate the quality of medical service. The research made use of the basic descriptive statistics, T-test, and Two-way ANOVA analysis to probe into the expression extent and difference of relevant people’s negative attitude and responsive behavior. The research found that most of relevant people’s tolerant time for the physician’s being late for patient visits was within 15 minutes. The relevant people’s negative attitude was chiefly negative emotional influence; moreover, it would affect their cognition for the doctor’s service quality, as well as the personal impressions, and comparing to male patients, female patients were more wishing to be informed of the doctor’s reason of being late. The patients and nursing staff would tend to hide their mental discontent; however, for the hospital image, the medical director would tend to exhort the doctor that was late. At the part of responsive behavior, similarly, the patients and nursing staff would tend to hide their dissatisfaction at heart, and adopt no action; the behavior they adopted was mainly complaint if they adopted any one, and female patients would have less negative responsive behavior if they were informed of the doctor’s reason of being late. On the other hand, the medical director would not sit by idly and remain indifferent, especially, most of the male directors would adopt the exhortation action privately. When the doctor is late for patients’ visit in the outpatient department, the relevant people’s negative attitude is just as the implicit cost in cost iceberg theory, and negative responsive behavior is just like the explicit cost. As the proverb, “A feather shows the way the wind blows,” which means that from one small clue, one can see what is coming, the doctor should understand clearly the considerable price of being late for patients’ visit when seeing the relevant people’s responsive behavior. Aiming at all kinds of cost, the research proposed the management strategic matrix to be the doctor’s and the medical director’s management tool of boosting the hospital’s service quality. The management strategic matrix includes the waiting quarlity management, the service recovery management, the responsive ability management and the interpersonal relationship management.