學習型組織與組織績效影響之研究－－以醫院為例

The Influence of Learning Organization on Organization Performance — A Case study of Hospitals in Taiwan

自全民健康保險開辦，促進就醫的地域性與公平性，相對地提升醫療產業的競 爭。隨著消費者對服務品質及醫療技術的重視，醫院的經營與型態，應伴隨著政策、 人口結構與市場需求改變；因此，醫療機構如何在激烈的競爭環境中生存、轉型與經 營發展，實為重要之課題；而透過學習型組織可持續不斷的學習發展與轉化，不僅能 改變組織成員的心智及行為模式，也是組織創新與成長的致勝關鍵，更能迅速適應環 境的變遷。本研究期能探討醫院層級、職別對學習型組織與組織績效的認知是否有差 異、學習型組織與組織績效的相關性及影響程度，並依據研究結果提供醫療院所之經 營管理者參考。 本研究針對 家台灣醫院協會人力資源委員會區域級以上之教學醫院發出320份問 卷，樣本有效回收率為72.5%，運用獨立樣本t檢定（Independent Sample t-test）、皮爾 森（Pearson）相關分析、迴歸分析（Multiple Regression Analysis）進行統計分析，結 果發現：醫學中心的學習型組織傾向顯著高於區域醫院之平均值。在不同職務別中， 主管在學習型組織構面中的「共同願景」、「團隊學習」之平均值顯著高於非主管 之平均值；但在「系統思考」、「自我超越」、「心智模式」並無顯著差異。不同的 醫院規模、職務別在其組織績效認知上亦具有顯著差異性，其中醫學中心高於區域醫 院、主管高於非主管。學習型組織各構面與組織績效之間具有顯著正相關，高學習組 織傾向的醫院，對於組織績效的認知感受程度也越高。同時，學習型組織之「自我超 越」、「團隊學習」、「系統思考」對組織績效呈顯著正向影響力，顯示醫療機構的 組織績效與學習型組織息息相關。因此，為求醫療機構組織績效的發展，經營管理者 必須以形塑學習型組織為重要的策略之一，並鼓勵工作人員應朝「自我超越」、「團 隊學習」及「系統思考」方面努力，以期能創造更好的整體組織績效。

Since National Health Insurance launched, it has promoted the fairness of medical services, and has stimulated the competitiveness of medical industry. With the emphasis the consumers pay more on service quality and medical technology, the management and operation type of hospitals should be changed with its policy, demographic structure and market demand. Consequently, how medical constitutions survive, reform and develop in the competitive environment is an important issue. Through the operation of learning organization, hospitals can not only reform and develop continuously, but also change its members’ minds and behavioral patterns; in other words, the operation of learning organization can help hospitals to adapt the changing environment rapidly, which is the key to success of organization innovation and growth. The study is to explore the relationship between organization performance and learning organization, and the conception of staffs in the hospital toward this. 32 0 questionnaires were issued to 16 district teaching hospitals and medical centers of Taiwan Hospital Association, and valid return rate is 72.5%. Samples are analyzed by Independent Sample t-test, Pearson and Multiple Regression analysis, and result shows: the medical centers got higher average score than teaching hospitals in tendency of learning organization; the executive got higher average score than the non-executive in “Shared Vision”, “Team Learning”; nevertheless, there is no obvious difference in “Systematic Thinking”, “Personal Mastery” and “Improving Mental Models.” Different scales and positions show significant difference in conception of organization performance as well; therefore, the learning organization is positive related to organization performance, and “Personal Mastery”, “Team Learning” and “Systematic Thinking” are most predictable to “Organization Performance.” The result can provide an important reference in the management philosophy for the medical institution.