醫院之學習型組織構面與醫療服務效率之相關性研究

Relationship Between Learning Organization Dimensions and Healthcare Service Efficiency

劉智能(Chih-Neng Liu)

指導教授 ： 許怡欣 ； 黃國哲

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2005年)

摘要

全民健康保險的實施，為競爭的醫療環境開啟了一個嶄新的紀元。如何在競爭的環境下生存，成為醫療機構生存與否的重要議題。「學習得比競爭對手快」是維持組織競爭優勢的唯一方法。 本研究之主要目的為瞭解國內各級教學醫院鼓勵學習方案的推動情形，及探討醫院之學習型組織層次及構面與醫療服務效率之相關性。 本研究以國內124家地區級以上教學醫院為母群體，採用郵寄問卷方式進行調查，有效問卷回收75份，回收率60.48％。研究之重要結果如下： 一、非公立醫院比公立醫院對醫院短期內（今年相較於去年）醫療服務效率，因鼓勵學習而進步的贊成程度來得高，認為醫院今年的醫療服務效率比去年好。二、 不同評鑑等級之醫院，對於鼓勵學習能提升醫療服務效率的贊成程度無統計上之顯著差異。三、醫院過去之醫療服務效率表現不影響其對於鼓勵學習能提升醫療服務效率的看法及贊成程度。四、 實施「新進員工辦理職前訓練」、「互動式網頁學習環境」及「送訓或培訓制度」的醫院今年的醫療服務效率比去年好。實施「讀書會」的醫院認為未來數年的醫療服務效率將會提升。五、外在環境因子（市場競爭程度）不影響醫院對於鼓勵學習能提升醫療服務效率之贊成程度。六、醫院之系統連結構面數值越高，越認同鼓勵學習能提升醫療服務效率。 綜合來說，教學醫院所具有之學習型組織構面平均值普遍很高，是推動成為學習型組織的絕佳對象，且醫院普遍認同鼓勵學習能提升醫療服務效率。因此建議政府機關能持續推動醫院成為學習型組織專案及提供相關經費，以增加誘因。另建議醫院管理者能設置教學、研究或推廣學習之專責單位，有系統的鼓勵學習。讓醫院成為真正優質的學習型組織，員工素質提升，良好的醫療品質及經營效率自然而來。

關鍵字

學習型組織 ； 醫療服務效率

並列摘要

Healthcare environment in Taiwan has become more competitive due to the implementation of the National Health Insurance program in 1995. How to survive is the most important issue encountering by hospital administrators. Learning more and faster than your competitors is inevitable to sustain a competitive advantage. The main purposes of the study are to explore how hospitals encourage the formation of a learning organization and to investigate the relationship between the dimensions and healthcare service efficiency. This study collected empirical data from the 124 population hospitals in Taiwan. The number of the valid respondents was 75, the response rate by 60.48%. Several key findings are as the following: 1.The performance of the healthcare service efficiency by reinforcing learning in the private hospitals is more effective than the public ones during the short period (this year compared with last year).2.There is no significance of the degree in agreement of encouraging learning to improve healthcare service efficiency among the various accredited degree hospitals.3.The past performance of the healthcare service had no effect upon encouraging learning of hospitals.4.The hospitals who implement the “the training before job for new staff program”, “internet learning program” and “training system program” currently have more efficient of healthcare service. Then Implementing the “organizing the study groups program” will have more efficient healthcare service in the future.5.There is no significance of the degree in agreement of encouraging learning to improve healthcare service efficiency under different HHI.6.The higher system connection dimensions, the more recognition the contribution of encouraging learning to improve healthcare service efficiency. In conclusion, teaching hospitals have high level learning organization dimensions. In addition, they recognize encouraging learning to enhance efficiency. Based on the findings, it is suggested that the government should establish some incentive programs to encourage teaching hospitals to upgrade into learning organizations. Moreover, it is recommended that the upper-level management of hospitals should establish an ad hoc committee to implement the learning programs to enable the learning systematically. In the end, high quality healthcare services and excellent operation performance could be achieved through the learning organization program.

並列關鍵字

learning organization ； healthcare service efficiency

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