緊急醫療服務流程改善與績效評估之機制研究 —以新北市緊急救護服務為例

A Study on Framework of Process Improvement and Performance Measurement for Emergency Medical Service — A Case Study of New Taipei City

張軒齊(Hsuan-Chyi Chang)

指導教授 ： 余峻瑜

國立臺灣大學/管理學院/商學研究所/碩士(2012年)

https://doi.org/10.6342/NTU.2012.02796

摘要

本研究之目的為建構一套適用於緊急救護服務、以平衡計分卡呈現之績效評估系統。而過去在緊急救護服務之績效評估工具之建立上，作業指標缺乏一有系統的輔助分析架構來協助建立之。故本研究首先選擇服務藍圖來了解服務流程之現況，並據之進一步討論該如何進行改善。同時配合服務利潤鏈之架構，以在流程分析與改善的基礎之上，配合針對前台與後台服務提供者之能力培訓、內部工作環境改善，來進而達到提高外部顧客滿意度之效果。最後，再以平衡計分卡之形式，將由流程分析及服務品質觀點發展而來的改善建議，發展為能夠衡量之指標及基準值。具體、清楚地呈現出一套發展緊急救護服務績效評估系統之過程。

本研究接著應用此一分析架構於新北市緊急救護服務流程，並對實務執行提出兩點建議：一、 濫用空跑案件數之降低在EMSS品質改善過程中扮演了關鍵的樞紐角色。而促進EMD與EMT間之交流合作、促進EMT與醫院急診醫護人員之交流、以及促進對民眾之正確觀念之教育，皆可達到降低濫用空跑案件之效果。二、無論是落實來自急診醫護人員之教育訓練，或是對EMT-P之培訓，在長期之下皆可達降低EMSS總成本之成效。但若未能在EMT工時上配套執行管理控制措施，則會在達到由教育訓練形成之成本降低效果之前，就因為將EMT人員當下之精力耗損殆盡，而造成服務系統之崩潰。

最後，本研究須強調此一程序應該要持續、定期地重複執行，因為特定之績效評估系統之設計，很難長期下一體適用。

關鍵字

績效評估 ； 平衡計分卡 ； 服務藍圖 ； 服務品質 ； 服務利潤鏈 ； 緊急救護

並列摘要

This study aims to develop a performance evaluation system for emergency medical service (EMS) and present it in the Balanced Scorecard (BSC) fashion. There is no systematic structure for development of EMS operational performance indicators. Therefore, this study deployed Service Blueprint to analyze service process of EMS and identify the potential failure points. In the meantime, Service Profit Chain is utilized to link the internal quality improvement to external service quality and customer satisfaction. Eventually, this study translates analysis results above-mentioned into measureable indicators of BSC.

Based on validation of research structure above-mentioned with EMS process of New Taipei City, this study concluded two recommendations: 1). Reduction in misuse cases plays essential role in quality improvement of EMS and can be achieved via collaboration between key stakeholders of EMS system. 2). With precondition of regular working hours of emergency medical technician (EMT), long-term training of EMT can lower total cost of EMS.

The last but not the least, results of this study focused on a framework of developing performance evaluation system of EMS, rather than specifics indicators. This framework should be conducted repeatedly and regularly to measure performance and improve process efficiently and effectively.

並列關鍵字

Performance evaluation ； balanced scorecard ； service blueprint ； service quality ； service profit chain ； emergency medical service

參考文獻

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