以變革管理及網際網路提高醫院營運績效及民眾滿意度---署立新竹醫院個案研究

Abstract

以變革管理及網際網路提高醫院營運績效及民眾滿意度 ---------署立新竹醫院個案研究 學生:張景年 指導教授:朱博湧博士 許祿寶教授 國立交通大學 高階主管管理學碩士班 摘 要 我國自民國84年3月1日開始實行全民健保後，醫療生態產生巨變，而健保局由於財務上的困難，提出一連串新的措施，例如：合理門診量及總額預算，來壓抑健保費用的成長，醫療界的競爭要比從前更為劇烈地去爭食越來越小的餅，加上馬偕、國泰、台大紛紛要在新竹設立分院，對於身在新竹的新竹醫院而言是一個極大的挑戰。 新竹醫院在民國85年發生巨變之後，形象跌至谷底，加上民國87年初小兒科醫師陸續離職，造成新竹地區沒有醫院可以看小兒科急診的報導又喧騰一時，新竹醫院在此時從事變革管理，期以內部管理的改善，來提高醫療品質，其做法在行政人員及醫技人員方面有：推行禮貌運動（顧客構面）、實行TQM制度、ISO-9000（企業內部流程構面），而在學習與成長構面上則推動標竿學習及異常事件報告；在醫師方面則推動獎勵金制度的改革，鼓勵學術發表（財務構面），醫療品質制度之推動（顧客構面）、大力推動人事制度之改革（企業內部流程構面），而在學習與成長構面方面則加入TQIP計畫及舉辦醫師共識營，在這些措施之後，可以發現醫院的業績各項指標（門診人次、住院人日、急診人次及營運收入）都有不斷提升，同時醫療品質的各項指標的滿意度（醫療品質滿意度、服務滿意度、時效上滿意度、環境滿意度）也都有平行的上升。在創新構面，則從事一連串網業的改革，期以網際網路做到優質的顧客關係管理。 關鍵字：醫院營運績效、民眾滿意度、變革管理、網際網路

Improve the Hospital Performance and Customer Satisfaction by Change Management and Internet ------A Case Study of Hsin-Chu General Hospital student: Ching-Nien Chang Advisors: Dr. Po-Young Chu Professor Lu-Pao Hsu Master Program of Management for Executives National Chiao Tung University Key words: Hospital Performance, Customer Satisfaction, Change Management, Internet ABSTRACT There has been a tremendous impact on health care industry ever since the start of national health insurance in Taiwan on March1,1995. Dealing with the financial problems, however, there will be more new policies offered by the national health insurance bureau, such as appropriate outpatient number and global budget. In other words, health care industry will become more and more competitive to share the fewer resources. Hsin-Chu is a high-tech city. The needs for better health care by its high-tech people is more intense. In addition, the establishment of branches of Mackay General Hospital, Cathay General Hospital and National Taiwan University Hospital will pose a new big challenge to Hsin-Chu General Hospital, an established hospital at Hsin-Chu for years. After the catastrophe in 1996, the image of Hsin-Chu Hospital fell to the ground, the flow of pediatricians, leave from Hsin-Chu Hospital in early 1998 made it worse. It therefore started implementing change management to improve the quality of medical care, which included good-manner contest（customer aspect）, implementing TQM, ISO-9000（internal process aspect）, benchmarketing, reports for accidents（learning and growth aspect）. For the physicians, the revolutionary change of physician bonus system, academic achievements award（financial aspect）, medical quality improvement（customer aspect）, change of human resources system（internal process aspect）, joining TQIP project and shared vision campaign for physicians（learning and growth aspect）were implemented. The results were the followings: all the achievement indicators （outpatient number, inpatient number, emergency patient number and revenue ）were rising, the satisfaction criteria of various indicators for medical quality were improving at the mean time（satisfaction for medical care, medical service, hospital efficiency and facilities）. Hsin-Chu Hospital also enforced its marketing to increase its visibility by mass media, to improve the communications with scienced-base industrial park community and to select a presented monthly marketing subject to the public. Besides, by the use of internet, a series of reforms on the web site to implement better customer relationship management as an innovation for health care industry are in progress. As quality improvement is a constant process, all the reforms are therefore still in process, hence the evaluation for the future result will be more effectively assessed by the balanced scorecard approach.