「社區好醫院」：醫院組織再造與社區健康促進創新模式

“Community-Friendly Hospital”: An Innovative Model for Hospital Restructuring to Promote Community Healthcare

由於公共衛生的推行、醫療科技的進步及衛生教育水準的提昇，使人民平均壽命延長，相對於健康促進及醫療照護的需求也與日俱增。「渥太華憲章」提出強化社區行動的重要性是在促進居民健康，但為達到增進健康的目標，透過社區組織的推動是最具成效。目前台灣推動社區健康促進有二種模式：一為醫療衛生機構，成立單一社區健康部門；另一為民間團體或政府機構在社區成立關懷據點，此二種模式雖然皆為推動社區健康促進來提升民眾身心健康，但亦各有優缺點。本院經由組織再造，締造出創新健康促進模式─「社區好醫院」，以社區醫學三大構面設立22組社區服務小組，全院專任員工依個人志願及專長，加入其中一組為組員，員工除了本身醫療、醫事或行政之專業外，另從事一部分的社區服務工作，再由主管會議督導小組之工作進度與成效，這種全院員工與社區結合的模式，讓社區健康促進不再是醫院內某部門或某些人的事，而成為全院所有同仁的責任。本研究在探討推行「社區好醫院」五年間，社區服務小組參與社區健康促進的執行成效，以及員工參與社區服務的滿意程度，結果顯示多數社區服務小組在持續督導及獎優制度下，皆有明顯的成效；問卷調查亦顯示「社區好醫院」獲得員工極高的評價。有鑑於健康促進服務應為持續性的過程，因此依據問卷分析，重新規劃同質性高的組別，重整為15組，並應社區居民需求，結合本院中醫特色增加「中醫藥養生組」，期望此種創新模式能持續改善社區服務品質，達成促進民眾自我健康管理，進而形成健康社區之最終目標。

With the help of the improved public health, advanced medical technology, and a betterrounded public health education, the expectancy of human lives has dramatically increased. As the result, the demand and importance of advanced health care and the betterment of health education is getting higher and larger day after day. According to “Ottawa Charter”, the importance of community action is to promote the health of all residents; however, in order to achieve the goal, the most effective method would be through the promotion of community-based organizations. At the moment, Taiwan is promoting community health in the following two models: first, setting up medical and health institutions, the establishment of a single community health sector; second, forming non-governmental organizations or government agencies in the community to provide help and care in general. Although both of these two models are set out to promote community health in order to improve physical and mental health of residents nearby, each of them has its own advantages and disadvantages. “Community-Friendly Hospital” is the result of our reorganization and restructuring within to further improve our services and rebuild our relationship with communities around us. “Community-Friendly Hospital,” is composed with three dimensions of 22 groups of community service groups, with individual volunteers who are equipped with specialized expertise, to take initiatives on providing health care services. Community health promotion is no longer the responsibility that belongs to a certain department or a certain group of people, but a shared responsibility of everyone who works in the hospital. This study is to discuss the result and the improvement that has been brought about from the implementation of “Community-Friendly Hospital.” The result shows that most of the community service group experienced dramatic improvement with proper and constant supervision and a fair reward system. A survey among our staffs also reveals that “Community-Friendly Hospital” is highly satisfactory and rewarding. For the reason that the promoting of public health service should be a continuous process, we have reconstructed the teams based on the result of our survey. First of all, we have recomposed our personnel into 15 groups in order to have a coherent game plan. Secondly, the innovated “Chinese Medicine Health Group” is formed due to the high demand from residents within the community in the hope for a new and improved quality of community health care service. We hope the combination of these two plans will help us in achieving better quality, encouraging residents in the community to pay more attention to public health, and lastly, accomplishing our ultimate goal of a healthy community.