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題名：應用多準則決策法以改善台灣老年病患門診服務
作者：吳永宏
作者(外文)：Yung-hung Wu
校院名稱：國立臺灣科技大學
系所名稱：工業管理系
指導教授：郭人介
許總欣
學位類別：博士
出版日期：2012
主題關鍵詞：高齡化社會；品質機能展開；醫療照護失效模式與效應分析；二維品質模式；模糊理論；多準則決策方法；Aged society；QFD (Quality Function Deployment)；HFMEA (Healthcare Failure Mode and Effects Analy；Kano’s model；Fuzzy theory；MCDM (Multi-Criteria Decision-Making)
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人口老化已是全球關注的一個焦點，而台灣地區老年人口所佔的比例已超過10%，早已達聯合國世界衛生組織所以定義的高齡化社會，若以老年人口的成長速度來看，高居世界第二位。人口老化的比率及速度快速成長，相對的也反映出老年病患醫療的重要性和急迫性與日俱增，醫療院所必須重新思考如何提供符合老人需求的門診需求品質項目，以營造友善的就醫環境。品質機能展開，經過四十多年的開發與應用，已被證明為一有效縮短研發時間、降低成本及掌握顧客需求的工具，而醫療照護失效模式與效應分析為美國國家病人安全中心發展出來做為有效改善病患就醫流程的方法，這兩種方法有其優點，但也有其不足之處。因此，本研究嘗試應用二維品質模式、模糊理論，並結合多準則決策方法來加以改善。研究發現，老年病患重視的門診需求品質項目前三項依序為「有符合病患使用的醫療機器設備」、「提供迅速的服務解決病患問題」、「主動為病患提供服務」，而必須改善的門診作業失效模式依序為「看診時間太短」、「未告知檢查或治療可能產生的併發症」、「及未尊重病患和家屬的想法和感覺」。本研究除針對上述失效模式提出改善建議外，其發展出的改善老年病患門診服務作業模式也可擴展至其他醫療的作業流程，並提供給所有醫療院所參考。
Population aging has become one of the major global health issues (WHO, 1999). The overall senior population in Taiwan has surpassed 10%, meeting the WHO definition of an aged society. In terms of aging rate, Taiwan ranks second among societies worldwide. This significant growth in elderly population also reflects the importance of the emergence and development of geriatric medical care. Given these demographic trends, hospitals should reconsider how to provide suitable outpatient service for elderly patients and create an aging-friendly environment. Through more than 40 years of application, QFD (Quality Function Deployment) has been proven to be an effective tool to shorten research-and-development cycles, reduce costs, and meet customer’s needs. HFMEA (Healthcare Failure Mode and Effects Analysis), first introduced by NCPS, is a method to improve medical care processes. There are pros and cons with each of these two methods, so an optimized modified version will be deployed by applying Kano’s model, Fuzzy theory and MCDM (Multi-Criteria Decision-Making). The research found that the key QRs (Quality Requirements) in order of importance were ‘Proper medical equipment for patients’, ‘Providing fast services to solve patients’ problems’, and ‘patient-centered service’. Also, the modes needing improvement were “The clinical examination is too brief,” “insufficient disclosure of possible complications from the treatment” and “Opinions and feelings of the patient and relatives are not respected.” Based on these findings, we conclude by recommending an operational model for geriatric outpatient service that we hope can also serve as a useful clinical reference.
Ahmet, C. K., Mehmet, E., 2012. Fuzzy failure modes and effects analysis by using fuzzy TOPSIS-based fuzzy AHP. Expert Systems with Applications 39(1), 61-67.
Akao, Y., 1990. Quality Function Deployment, Cambridge, MA: Productivity Press.
Alexander, A., Liou, Y.H.A., 1998. Improving Customer Satisfaction in an R&D Environment. National Aeronautics and Space Administration Lewis Research Center.
Armacost, R.L., Componation, P.J., Mullens, M.A., Swart, W.W., 1994. An AHP Framework for Prioritizing Customer Requirements in QFD. An Industrialized Housing Application. IIE Transactions 26 (4), 72-79.
Arash, S., Mehd,i P., 2011. Facility Layout Simulation and Optimization: an Integration of Advanced Quality and Decision Making tools and Techniques. Modern Applied Science 5(4), 95-111.
Buckley J.J., 1985. Fuzzy Hierarchical Analysis. Fuzzy Sets and Systems 17(3), 233-247.
Burnette, D., Mui, A.C., 1999. Physician utilization by Hispanic elderly persons. Medical Care 27(4), 362-374.
Chan, L.K., Wu, M.L., 2002. Quality Function Deployment: A Literature Review. European Journal of Operational Research 143, 463-497.
Charles, P., 1984. Normal Accidents: Living with High-Risk Technologies. Basic Books, NY.
Chen, S.J., Hwang, C.L., 1992. Fuzzy Multiple Attribute Decision Marketing-Method and Application. A State-of-the-Art Survey 66, 33-55.

Cheng, C. C., Chou, C. J., Wang, P. C., Lin, H. Y., Kao, C. L., Su, C. T., 2012. Applying HFMEA to Prevent Chemotherapy Errors. Journal of Medical Systems 36, 1543-1551.
Cristano, J. J., Liker, J.K., White III, C.C., 2000. Customer-driven Product Development through Quality Function Deployment in the U.S. and Japan. Journal of Product Innovation Management 17, 286-308.
DeVellis, R. F., 1991. Scale Development Theory and Applications. London: SAGE.
Donabedian, A., 1978. The Quality of Medical Care. Science, 200:856-864, 26.
Donabedian, A., 1980. The Definition of Quality and Approaches to Its Assessment. Ann Arbor, MI: Health Administration Press.
Donabedian, A., 1988. The Quality of Care- How Can It Be Assessed? Journal of American Medical Association 260 (12), 1743-1748.
Fisher, A.W., 1971. Patients' Evaluation of Outpatient Medical Care. Journal of Medical Evaluation 46, 238-244.
Gay, L. R., 1992. Educational Research Competencies for Analysis and Application. New York: Macmillan.
Ghobadian, A., Terry, A. J., 1995. How Alitalia improves service quality through quality function deployment. Managing service Quality 5(5), 25-30.
Gilchrist, W., 1993. Modeling “Failure Modes and Effects Analysis”. International Journal of Quality & Reliability Management 10(5), 16-23.
Govers, C.M.P., 1996. What and how of quality function deployment (QFD).Proceedings of the eighth International Working Seminar on Production Economics 46(7), 275-285.
Graessel, B., Zeidler, P., 1993. Using quality Function deployment to improve customer service. Quality Progress 26(11), 59-63.
Matzler, K., Hinterhuber, H.H., 1998. How to make product development projects more successful by integrating Kano’s model of customer satisfaction into quality function deployment. Technovation 18(1), 25-38.
Hansell, S., Sherman, G., Mechanic, D., 1991. Body Awareness and Medical Care Utilization Among Older Adults in an HMO. Journal of Gerontology 46(3), 151-159.
Hauser, J. R., Clausing, D., 1988. The House of Quality. Harvard Business Review, May-June: 63-73.
Hwang, C.L., Yoon, K., 1981. Multiple Attribute Decision Making: Methods and Application. Springer-Verlag, NY.
John, G. R., Barbara, L.K., Mike, S., 2003. FMEA-the Cure For Medical Errors. Quality Progress 36(8), 67-71.
Joseph, D.R., Erik, S., James, P., Tina, N., 2002. Using Health Care Failure Mode and Effect Analysis: The VA National Center for Patient Safety’s Prospective Risk Analysis System. Joint Commission on Accreditation of Healthcare Organizations 28 (5), 248-265.
Kano, N., Seraku, T.F., Tsuji, S., 1984. Attractive quality and must-be quality. The Journal of the Japanese Society for Quality Control, 39-48.
Lazzaro R., Pierluca P., Mimma R., Carola L., 2009. Communicating cancer diagnosis and prognosis: When the target is the elderly patient-a GIOGer study. European Journal of Cancer, 374-383.
Leclere, F.B., Jensen, L., Biddlecom, A.E., 1994. Health Care Utilization, Family an Text, and Adaptation among Immigrants to the United States. Journal of Health and Social Behavior 35, 370-384.

Markides, K.J., Levin, J.S., Ray, L.A., 1985. Determinants of Physician Utilization Among Mexican- Americans: A Three-Generations Study. Medical Care 23(3), 237-245.
Meagher, K., Teo, E.G.S., 2005. Two-Part Tariffs in the Online Gaming Industry: the Role of Creative Destruction and Network Externalities. Information Economics and Policy 17, 457-470.
Mutran, E., Ferraro, K. F., 1988. Medical need and use of services among older men and women. Journal of Gerontology 43, 162-171.
Partovi, F.Y., Corredoira, R.A., 2002. Quality Function Deployment for the Good of Soccer. European Journal of Operational Research 137, 642-656.
Patrice, L.S., 2003. Using failure mode and effects analysis to improve patient safety. AORN Journal 78(1), 16-37.
Pullman, M. E., Moore, W. L., Wardell, D. G., 2002. A comparison of quality function deployment and conjoint analysis in new product design. Journal of Product Innovation Management 19, 354-364.
Radharamanan, R., Godoy, L.P., 1996. Quality Function Deployment as Applied to A Health Care system. Computers and Industrial Engineering 31(1-2), 443-446.
San, M., 2003. Function Deployment (IQFD) for Discrete Assembly Environment. Computers & Industrial Engineering 45, 269-283.
Saaty, T.L., 2001. Decision making with dependence and feedback: The analytic network process. 2nd, RWS Publications, Pittsburgh, USA.
Saaty, T. L., 2003. Decision making in complex environments. Super Decisions.
Saaty, T.L., 1996. Decision making with dependence and feedback—the analytic network process. RWS Publication.

Saaty, T.L., Vargas, L.G., 1998. Diagnosis with dependent symptoms: Bayes theorem and the analytic hierarchy process. Operations Research 46, 491-502.
Sarkis, J., 1999. A methodological framework for evaluating environmentally conscious manufacturing programs. Computer and Industrial Engineering 36, 793-810.
Sarkis, J., 2003. Quantitative models for performance measurement systems-alternate considerations. International Journal of Production Economics 86(1), 81-90.
Sarkis, J., Talluri, S., 2002. A model for strategic supplier selection. Journal of Supply Chain Management, 18-28.
Sarkis, J., Nehman, G., Priest, J., 1996. A Systematic Evaluation Model for Environmentally Conscious Business Practices and Strategy. Proceedings of the IEEE International Symposium on Electronics and the Environment, 281-286.
Sarkis, J., 1997. Evaluating flexible manufacturing systems alternatives using data envelopment analysis. The Engineering Economist 43(1), 25-48.
Schvaneveldt, S. J., Enkawa, T., Miyakawa, M., 1991. Consumer Evaluation Perspectives of Service Quality: Evaluation Factors and Two-dimensional Model of Quality. Total Quality Management 2, 149-161.
Senders, J.W., Senders, S.J., 1999. Failure Mode and Effect Analysis in Medicine. In Michael, R.C. (Eds.), Medication Errors (3.1-3.8). American Pharmaceutical Association: Washington D.C.
Shieh, J. I., Wu, H. H., Huang, K. K., 2011. A DEMATEL method in identifying key success factors of hospital service quality. Knowledge-Based Systems 23(3), 277-282.
Tan, K. C., Shen, X.X., 2000. Integrating Kano’s model in the planning matrix of quality function deployment. Total Quality Management 11(8), 1141-1151.
Thomas E. R., George L. W., John C. H., 2006. Improving Communication With Older Patients: Tips From the Literature. Family Practice Management 13(8), 73-78.
Tontini, G., 2000. Identification of customer attractive and must-be requirements using a modified Kano’s method：Guidelines and case study. ASQ’s 54th Annual Quality Congress Proceedings, 728.
Tseng, T.Y., Klein, C.M., 1989. New Algorithm for the Ranking Procedure in Fuzzy Decision Making. IEEE Transaction on Systems, Man and Cybernetics 19, 1289-1296.
Wang, L.X., Mendel, J.M., 1992. Generating Fuzzy Rules by Learning form Examples. IEEE Transactions on Systems, Man and Cybernetics 22(6), 1414-1427.
Xu, K., Tang, L.C., Xie, M., Ho, S.L., Zhu, M.L., 2002. Fuzzy Assessment of FMEA for Engine Systems. Reliability Engineering and System Safety 75, 17-29.
Yan, W., Khoo, L.P., Chen, C.H., 2005. A QFD-Enabled Product Conceptualization Approach Via Design Knowledge Hierarchy and RCE Neural Network. Knowledge-Based Systems 18(6), 279-293.
Yanlai, L., Jiafu T., Xinggang, L., Jie, Xu., 2009. An integrated method of rough set, Kano’s model and AHP for rating customer requirements’final importance. Expert Systems with Applications 36(3), 7045-7053.
Yang, C. C., 2003. Establishment and Applications of the Integrated Model of Service Quality Measurement. Managing Service Quality 13(4), 310-324.
Zadeh, L. A., 1965. Fuzzy Sets. Information and Control 8, 338-353.
Zeleny, M.A., 1974. Concept of Compromise Solutions and the Method of the Displaced Ideal, Computers and Operations Research 1, 479-496.
Zhang, P., Dran, G., 2002. User Expectations and Rankings of Quality Factors in Different Web Site Domains. International Journal of Electronic Commerce 6, 2 9-33.
 
 
 
 
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