應用模糊層級分析法建構與驗證醫務管理職能之研究

臺灣醫療產業中之醫院經營，因近代醫療環境改變與社會保險制度的施行、醫策會醫院評鑑、民眾普遍教育水準提升及其就醫意識抬頭等因素，逐漸面臨如何排除困境因素，達到永續經營。因此，醫療產業也開始著重於經營管理人才之培育，因為產業別與其他商業組織有所不同，故所需之管理人員亦有所差異。種種因素之下，醫務管理愈來愈受到醫療產業的重視，甚至大專院校開始有相關學位課程開設，期待從學界結合產業界，共同培育醫務管理人才，茁壯醫療產業。再者，基於面對複雜且多變的外在環境，現階段組織管理不僅重於醫院內部營運及外部醫療環境市場的因應對策，同時也必須肩負起社會服務及責任等多重角色。管理人才需要有其對應之職能，方能讓人員與工作職務適得其所，對於醫務管理亦然。因此，培育醫務管理人才之餘，更需要建立相關職能機制。如此一來，不但可以讓組織更容易快捷找到所需人才；也能讓人員知道自己的職能取向，認知本身的優劣勢，進而獲取與能力相匹配的工作職位。所以，顯示出醫務管理職能的研究有其必要性及重要性。本研究藉由修正式德爾菲法專家問卷分析，將醫務管理人員之管理職能分成五大群組：「概念技能」、「領導技能」、「規劃技能」、「人際技能」與「專業技能」。而在五大群組下經由專家調查意見後，彙整20個管理職能要素：問題解決、邏輯思考、認真負責、創新能力；組織層面、資源分配、團隊合作、執行能力；目標訂定、分析思考、工作管理、自我學習；溝通協調、人際互動、衝突管理、主動積極；專案管理、品質導向、風險意識、危機管理。並進一步運用模糊層級分析法，醫務管理人員之管理職能分析結果領導技能(0.13)>規劃技能(0.12)>概念技能(0.11)>專業技能(0.10)>人際技能(0.05)；以上述構面進行驗證醫務管理人員的職能分析，建構出一套客觀且具有公信力之指標。經研究驗證後得知，四位評核者測出所具備的職能與其實際擔任職務所需之職能兩者之間有相當程度的符合。研究中所建構之醫務管理人員職能之指標，管理職能需具備之專業素養期待轉為量化的權重比例，藉此建立系統化及科學化之醫務管理人員管理職能之指標體系，可提早作為內部儲備主管計畫之基礎資料與管理職能發展計畫之參考，落實達成醫務管理人員之管理職能之目的，亦可使個人與組織內部晉升達到連動性發展促使雙贏。

關鍵字

醫務管理；管理職能；修正式德爾菲法；模糊層級分析法

並列摘要

Hospitals need to develop solutions to managerial problems and achieve sustainable operation in the face of changes within the modern health care environment, including the implementation of the social insurance system, hospital accreditation conducted by the Joint Commission of Taiwan, the increasingly high educational level of the public, and public awareness of health care services. Therefore, the health care industry has begun to focus on training health care administrators. The managerial administrators required by the health care industry are different from those in other business organizations. For many reasons, the health care industry is payingincreasing attention to healthcare management; universities and colleges have begun to offer programs and degrees to train healthcare administrators in cooperation with other industries, thereby benefitting the health care industry. Moreover, facing a complex and changeable external environment, the current organizational management of hospitals not only focuses on strategies for hospital operation (internal environment) and health caremarkets (externalenvironment) but also provides social services and assumes social responsibilities. Health care administrators and management personnel require corresponding competenciesto arrange personnel suitable for the assigned jobs. Therefore, relevant mechanisms need to be established in addition to the training of administrators for healthcare management. These measures not only make it easier for an organization to find administrators but also enable administrators to be aware of their competencies. Knowledgeof their strengths and weaknesses could assist administrators in findingthe best jobsto match theirabilities. Therefore, the competenciesrequired for healthcare management are worthy of investigation. This study dividedthe managerial competencies of healthcareadministrators into five dimensions by using the modified Delphi method and a questionnaire survey.The five dimensions were conceptual skills, leadership skills, planning skills, interpersonal skills, and professional skills. Twenty managerial competencies were synthesized under the aforementioned five dimensions through expert opinions. They wereproblem-solving,logical thinking, seriousness and responsibility,innovation capability,organization,distribution of resources, teamwork, executive ability, goal setting, analytical thinking, job management, self-learning, communication and negotiation,interpersonal interaction, conflict management, being active, project management, qualityorientation, risk awareness, and crisis management. These competencies were further analyzed using thefuzzy analytic hierarchy process. The results for the five dimensions were as follows: leadership skills (0.13) >planning skills (0.12) > conceptual skills (0.11) > professional skills (0.10) > interpersonal skills (0.05). This study verifiedthe managerial competencies of healthcareadministratorsbased onthesefive dimensions to construct objective and reliable indicators. After verification, four raters found a considerable degree of conformity between the 20 aforementioned competencies and those required for actual professional duties. This study proposed indicators regarding the managerial competencies of healthcareadministrators.The levels of professional quality required for managerial competencies are expected to be quantified into weight ratios. The establishment of such systematic and scientific indicators can serve as reference for basic information regarding internal management trainees and managerial competency development. In addition, these indicatorsserve the purpose of managing the competencies of healthcareadministrators and achieve linkage development through the promotion of individuals and the internal organization, thereby constituting a win-win situation.