自全民健保開辦以來，造福了廣大的台灣民眾，幾乎人人得以享有健康保險與適當的醫療照護，但隨著人口加速老化、經濟持續成長、疾病型態的改變以及民眾對醫療品質要求的提升，導致醫療保健支出不斷上漲，也促成健保支付制度的改變，其結果則是衝擊了醫療院所的經營型態，醫療院所面臨營運額度的限制、持續加入的競爭者及醫療集團化的趨勢，必需不斷檢視調整其經營策略以保持其經營彈性與競爭力，也因此國內已有多所醫療院所導入平衡計分卡之績效衡量系統，期望藉此建立組織短中長期之策略目標及確保策略之達成。
本研究乃針對國內某家區域教學醫院為研究對象，藉由問卷調查及焦點訪談等研究方法探討1.個案醫院人員對於推動平衡計分卡之認知與認同度;2.導入平衡計分卡後對機構的影響;3. 導入平衡計分卡後對單位及人員工作型態的影響;4.個案醫院面臨的主要問題;5.個案醫院未來應採行的改善措施;及6.提供其他已導入或欲導入計分卡之機構相關建議。
本研究採用問卷調查法，針對個案醫院之內部四部門進行抽樣調查，後依據問卷調查結果進行問卷信度、效度測試，其後針對各構面進行調查結果分析，了解各構面問項平均分數的差異與其意義，同時採用T-test檢定各問項與所屬構面是否具顯著差異，其次，依序依基本資料之部門別、職級別、教育背景、年資及性別等進行對應不同構面之ANOVA分析，再針對基本資料對問項達顯著性者進行事後分析，綜合分析結果可得知不同類別人員針對單一問項之確實反應。而焦點訪談部分則是依四部門隨機各選取兩人進行深度訪談。
研究結果有以下發現:(1)以認知與認同度而言，員工最認同平衡計分卡可將醫院願景與經營策略結合及可促使醫院檢視經營策略及修正營運方向，其中行政部門較護理與醫務部門的認同感較高，學歷高者亦較學歷低者認同感高。(2)對於企業的影響方面，員工普遍認同推動平衡計分卡可促使組織有效策略聚焦及促進經營目標的達成，其中又以行政部門較為認同，高階與高學歷人員亦較認同推動平衡計分卡可為企業帶來正面的效應。(3)對單位及個人的影響方面，研究顯示單位主管普遍重視單位目標的執行，但單位目標與個人工作未做適當連結，而行政部門主管於單位內推行與宣導最落實，高學歷人員及資深人員皆較清楚單位目標與組織目標的連結度，清楚單位目標與個人工作的關連性。(4)主要面臨的問題則是資源提供與教育訓練不足，且醫務部門面臨的困難最高。(5)對未來採取行動的建議主要為提供基層人員充足的教育訓練、確保組織目標與單位行動方案的連結及規劃績效考核聯結機制。
綜合研究結果本研究對個案醫院的建議為: 1.加強高階主管承諾與支持; 2.全面導入平衡計分卡架構; 3.加強教育訓練與落實輔導員制度; 4. 組織內外策略整合連結; 5.單位主管落實宣導與推行; 6.建置平衡計分卡管理平台; 7.鼓勵每人將策略落實於日常工作中; 8.連結計分卡與績效考核制度; 9.確保策略成為持續性的改善流程。 / Taiwanese residents are highly benefited by the implementation of National Health Insurance System since 1995. Nearly 98 percent of the residents are covered under NHI and are able to access any medical service in need. However, due to the high growth rate of the elderly, economic growth and higher requirement over the quality of care, the growth rate of health expense has risen dramatically. Which lead to the reform to NHI system and thereafter highly impact the operation of healthcare organizations. The implementation of the global budget and highly competitive healthcare environment drive healthcare leaders to pursue for new management tools to maintain its competitiveness. Balanced scorecard is now widely applied by healthcare organizations in Taiwan to align organizational strategies with performance measurement and management.
This dissertation conducts a case study for a Regional Teaching Hospital in Taiwan. Based on questionnaire survey and focus group interviews, this research study intends to find: (1)How do the staff comprehend and support the adoption of BSC; (2) How does the implementation of BSC impact the organization; (3) How does the implementation of BSC impacts the daily operation of business units and personnel; (4) The main hindrance the hospital encounter; (5) Future actions recommended to the hospital; (6) General issues and advices the healthcare organizations which intend to or had applied BSC should consider.
Finding of the research concludes that (1) The personnel agree that applying BSC framework had assisted on aligning organizational mission, strategies and objectives; (2) Referring to the effects to the organization, personnel agree that applying BSC framework had provided benefit on facilitating the achievement of strategic objectives; (3) Considering the effects to Business Units and personnel, it is agreed that leaders of business units pay most attention to the performance of scorecard. However, personnel’s daily activities were not completed aligned with the strategies. Leaders of Administrative Department are most supportive on executing the balance scorecard; (4) The major problem encountered are insufficient supportive system and lacking of training. The Department of Medicine had the most obstacles to implement the balance scorecard; (5) Recommendations of future actions are to provide sufficient education and training for staff; to ensure the alignment among organizational strategies and action plans; and to develop a motivation system.
The recommendations for the Regional Teaching Hospital are: (1) Enhancing the commitment and support of the leadership; (2) Applying the balanced scorecard in every business unit; (3) Providing sufficient education, training programs and well managed coaching system; (4) Ensuring strategic alignment among business units and supporting units, and also among hospital and allied partners; (5) Assuring the involvement of director of each unit; (6) Establishment of the webbased platform of (7) Ensuring alignment between strategies and daily job (8) Applying a motivation system; (9) Making strategy a continual process.
| Identifer | oai:union.ndltd.org:CHENGCHI/G0094932030 |
| Creators | 黃靖雅 |
| Publisher | 國立政治大學 |
| Source Sets | National Chengchi University Libraries |
| Language | 中文 |
| Detected Language | English |
| Type | text |
| Rights | Copyright © nccu library on behalf of the copyright holders |
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