不同層級醫院推行品管圈對醫療品質成效影響之研究

Impact of the Quality Control Circle Effect on Health Care Quality in Different Levels' Hospitals

本研究探討台灣醫策會所舉辦第八屆至第十二屆醫品圈競賽的參賽機構及參賽圈或該機構其他品管國在不同醫院層級中各醫院品管國推行成效對醫療品質成效之影響。以台灣地區醫院、區域醫院與醫學中心之參加醫策會第八屆至第十二醫品圈競賽之參賽囡囡長及國員為研究對象。採自陳式問卷方式調查，發出問卷900份，回收有效問卷共453份，有效回收率為50.3%。採用描述性統計與結構方程模型進行資料分析。依據結構方程模式分析品管國成效與醫療品質關係，結果證明下列四點：（1）醫院品管圈的組織推動成效、國活動成效對醫療品質成效之過程面有顯著正向影響、（2）醫院品管圈活動成效對醫療品質成效之結果面有顯著正向影響、（3）在醫學中心與區域醫院樣本中，圈活動成效對醫療品質成效之過程面與結果面有顯著正向影響、（4）在地區醫院樣本中，組織推展成效對醫療品質成效之過程面有顯著正向影響。醫院品管圈組織推展成效及圈活動成效能預測醫療品質成效之過程面與結果面，研究結果將有助於未來醫療相關機構在施行晶管圈或實務應用及研究上的參考依據。

This study probes the effects of promoting Healthcare Quality Improvement Circles (HQICs) through the contests of the HQICs among different service levels of hospitals. The contests were held by Institute for Biotechnology and Medicine Industry in Taiwan. The surveyed subjects were the leaders and members of HQICs from the district hospitals, regional hospitals, and medical centers who participated in the 8th to 12th annual HQIC contest. 900 self-descriptive survey questionnaires were distributed, and 453 were returned with a response rate of 50.3%. The collected data were analyzed using descriptive statistics and a structural equation model. The analysis results indicated that (1) the promotion of HQIC structures and activities had significantly positive effects on the process of healthcare quality improvement; (2) HQIC activities had significantly positive effects on the outcomes of healthcare quality improvement; (3) the effects of HQIC activities were significantly positive in the process and the outcome of healthcare quality improvement in the regional hospitals and the medical centers; and (4) the promotion of HQIC structures in district hospitals had significantly positive effects on the process of healthcare quality improvement. This study suggests that the effects of promoting HQIC structures and activities may predict the processes and the outcomes of healthcare quality improvement. Therefore, the research results may serve as a reference for healthcare-related institutions in the implementation of HQIC or application and research of healthcare quality improvement.