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題名:醫院推展精實革新關鍵成功因素之探討
作者:楊賢惠
校院名稱:逢甲大學
系所名稱:商學博士學位學程
指導教授:賴文祥
學位類別:博士
出版日期:2017
主題關鍵詞:醫療服務精實管理4P卓越模型層級分析法模糊層級分析法Healthcare deliveryLean Management4P Excellence ModelAHP MethodFuzzy AHP
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由於人口結構持續老化,慢性病增加,將激發額外的醫療保健需求,另隨著醫療技術進步,醫療成本急遽攀升,如何在降低成本同時亦維持醫療服務品質,將是全球醫療服務產業所面臨的重要挑戰。許多研究指出,精實管理是改善醫療服務成效的有效途徑,已成為近年來醫療產業變革不可或缺的角色。本研究旨在確立一項有效率衡量醫院在推展精實變革時的準則及架構,提供醫院在實施精益管理決策或策略時的參考。本研究採用4P精實管理模式,從領導力,人員管理,夥伴關係,工作流程和服務成效五個面向來評估和衡量醫療組織。為了探索主要因素和次要因素的範圍,使用層級分析法(AHP)和模糊理論計算每個因素的權重以確定資源分配之優先順序。本研究發現,當醫院推動精實改革首重於流程之優化,一所精實醫院必須落實以病人為中心的理念,作為醫療照護的核心準則,提供高價值的醫療照護系統,並能在服務量不斷增加的情況下,明確定義工作內容,使專業能力受到重視並能充分發揮,以避免服務傳遞過程中的失誤及延誤。醫療服務照護過程需仰賴各單位人員有效地發揮團隊合作,才能提升醫療品質及病人的預後與安全。藉由持續的改善與學習,不斷追求品質、效率、病患安全與服務的提升,維持機構的競爭力與合理盈餘以達永續發展與服務人群的目標。
The study explores key influential factors for successful Implementation Lean management in hospitals and propose a framework define the influential variables and sub-variables. It adopts the 4P Excellence Model in Lean management to assess and measure the healthcare organizations from the five perspectives: leadership, people, partnership, processes, and products. To explore the potential factors, the study employs the Analytic hierarchy process (AHP) method and Fuzzy inference system judgment to prioritize the significance of each factor. The study has led to a number of useful insights. Processes are crucial when hospitals advocate lean management. Among the 18 sub-factors in the five criteria, the most significant factors include patient-centered care, clearly defined work content, rewarding teamwork effort, continual learning and upgrading, and Escalating the clinic quality. To satisfactorily carry out Lean management, a hospital should continuously strive for improvement, pursue perfection, engender organizational culture, strengthen teamwork, and create mutual trust among team members. Moreover, patient-centered care beliefs should be actively implemented. To provide seamless care, patients and their families should be the main focus. The results could be used by hospital managers to improve their skills and knowledge when implementing Lean management. In addition, the framework developed herein could potentially lend itself to many practical applications.
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