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題名:從中榮智慧創新模式和組織慣性 探討應用創新流程與科技輔助建構
作者:李萬國
作者(外文):LEE, WAN-KUO
校院名稱:國立中正大學
系所名稱:企業管理系研究所
指導教授:曾光華
學位類別:博士
出版日期:2021
主題關鍵詞:服務品質虛實整合系統創新流程組織變革service qualitycyber physical systeminnovation processorganizational changeorganizational inertia
原始連結:連回原系統網址new window
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臺灣實施健康保險制度後,醫院產業因應市場競爭,不斷提升醫療品質與病人安全服務。二十年前公立醫院(包含台中榮總)因應環境變化將醫療業務區分為核心醫療與非核心醫療業務,並將非核心醫療業務(後勤勞務)服務外包給廠商執行,以利專注醫療本業,提升組織競爭力適應環境變遷。但是隨著社會經濟環境改變,台中榮總整體服務品質卻因為外包廠商所提供的服務品質不佳產生落差,無法達成內、外部顧客滿意,亟需改善。
本研究綜整四家學界、實務界之創新流程模式,歸納為四個創新步驟,做為本研究之架構以利研究外包制度存在公立醫院的歷史與優劣,以及應如何組織變革之目的。創新步驟與研究結果分別如下:透過「因果脈絡」階段發現台中榮總後勤勞務生產發展過程,二十年前因外包制度引進讓組織變革獲得成功經驗並延續複製多年。但近年來低成本策略導致外包廠商管理停滯不前,無法跟隨中榮智慧化模式服務提供對等服務品質,因此「智慧化」導入,是組織變革之新途徑。再經過「觀察釐清」步驟,用科學工具進行調查分析與歸納統計,確認智慧化是組織技術變革的方向。在「輔助建模」階段研究以虛實整合系統應用模型,導入三個中榮個案,驗證對服務落差問題解決之可行性與有效性,發現個案導入科技有其成效。但是其中一個個案卻停止執行,因此透過「堅持執行」階段,將三個個案再次比較分析,發現決策者受到「認知感受」與「組織慣性」的影響限制,無法有效理性決策。
藉由個案現象與命題假設進行科學推理辯證,獲得由外而內進行智慧化組織變革成功途徑有二。一為決策者具備機會感知,逕行劇烈變革跳脫組織慣性束縛;二為決策者具備威脅感知,採用漸進變革運用組織慣性推動智慧化變革。兩途徑之目的皆是醫院決策者願意透過虛實整合系統讓外包商提供精準服務,順利銜接高品質醫療服務,達成醫院精準醫療與績效之目標。
After implementing the Health Insurance, the first priority of healthcare industry in Taiwan is to improve medical quality and patient safety in order to respond to market competition. Public hospitals, including Taichung Veterans General Hospital, have differentiated medical services into core medical services and non-core medical services. Non-core medical services, such as logistic management, are outsourced so that the management of the hospitals can focus on the medical professions, and enhance the quality of medical competitiveness.
After several years of implementation, however, there is a significant gap between the quality of outsourcing services and expectations in Taichung Veterans General Hospital. The outsourcing services can’t satisfy both internal and external customers, as a result, it needs to be improved.
The purpose of the study is to examine how public hospitals improve the quality of Non-core medical services through intelligent technology so as to reduce the gap of service quality between core and non-core medical services. In addition, another aim was to find out in which condition can the organizational change from the outside in succeed easily because of importing intelligent technology.
The causes of success and failure are being observed and analyzed in the study with importing cyber physical system into three outsourcing services, which are service delivery, parking lot administration and the integration of healthcare information system in branch hospitals. Among these three services, it is successful to import parking lot administration and the integration of healthcare information system in branch hospitals. Nevertheless, organizational inertia leads to the failure of service delivery. The study puts forward five factors, which are spontaneous inducement, system kernelization, inertial idealization, executive power integration, and transforming threat into chances. Decision makers will prefer to import clicks-and-mortar system into outsourcing services so that they can have high quality core medical services. Consequently, precision medicine and performance targets will be achieved.
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