醫師對醫療知識流機制及其對醫療知識管理效益認知之探討

Exploring Physicians' Perceptions of Medical Knowledge Flow Mechanisms and the Effectiveness Toward Medical Knowledge Management

張碩芳(Sho-Fang Chang) ； 蔡雅米(Ya-Mi Tsai) ； 楊千霈(Chian-Pei Yang)

《醫務管理期刊》 7卷1期 (2006/03) Pp. 17-39

https://doi.org/10.6174/JHM2006.7(1).17

摘要

醫療業是一個高度知識密集的產業，透過適當的機制鼓勵醫師分享知識，有助於推動醫療知識管理，降低醫療服務的不確定性與提高醫療品質。由於醫療產業對於導入醫療知識管理的相關研究仍未臻成熟，因此本研究欲探索醫師間醫療知識流機制的使用現況，以及認知上此類機制對於知識管理的效益。研究結果期待對於實務界推動醫療知識管理提供－初步及具體的建議。
本研究以半結構式間卷分層立意取樣四十名醫師進行深度訪談，在資料分析階段，採用內容分析法與敘述性統計分別進行質性與量性資料的整理與分析，並進一步採用「多研究者三角印證」方法提昇研究的信效度。
研究結果得知，知識流機制可依知識流單位的不同，分為同院同科、同院跨科及跨院同科三類；另可依照知識流承載介面的不同，分為面談交流，書面交流，以及資訊科技交流三類。本研究除了將現行醫療知識流管道依照上述兩類機制做一完整之分類外，在各類機制對於知識管理的效益方面，發現書面交流及面談交流貢獻較大，而資訊科技等相關機制在現階段不論是使用率或是對於知識管理的認知貢獻度都偏低。此結果提示管理階層若欲推動醫療知識管理，首要之務即需致力於克服醫師對於資訊科技使用的障礙。

關鍵字

醫師 ； 醫療知識流機制 ； 醫療知識管理 ； 深度訪談 ； 內容分析 ； 資訊科技醫師

並列摘要

Healthcare industry is a knowledge-intensive industry. Hence, encouraging knowledge sharing among physicians through adequate mechanisms facilitates medical knowledge management, so as to reduce the uncertainty of medical service and enhance medical quality. Since the relevant studies concerning how healthcare industry introduces knowledge management are rare, this study aims to explore the current use of medical knowledge flow mechanisms and their perceived efficiency. The result is expected to provide suggestions for the managers when practicing knowledge management in healthcare industry.
Semi-structured questionnaires are used for in-depth interviews with forty physicians selected by purposively stratified sampling. Content analysis and descriptive statistical methods are performed for qualitative and quantitative data analysis respectively. Researchers' triangulation is used to increase the reliability and validity of the study.
The result shows that medical knowledge flow mechanisms can be categorized by various knowledge flow units as within the division, among the divisions in a hospital, and among various hospitals of the same specialties. They can also be categorized by various knowledge flow interfaces as face-to-face communication, documental platforms, and information technology platforms. As for their contributions to knowledge management, it is found that face-to-face communication and documental platforms are perceived as more efficient; information technology platforms are otherwise less efficient. The result implicates that healthcare managers' most important task before practicing knowledge management is to conquer the use of information technology among physicians.

並列關鍵字

Physician ； Medical Knowledge Flow Mechanism ； Medical Knowledge Management ； In-Depth interview ； Content Analysis ； Information Technology

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