建構醫院目標管理制度之研究──以某區域級教學醫院為例

A Study on Constructing the Management by Objectives in Hospitals: the case of a Regional Teaching Hospital

本研究採用質性的研究方法，透過文獻研究法，進行國內外目標管理制度相關理論文獻及國內新制醫院評鑑相關資料之搜集、閱讀和整理、比對，進而建立本研究之目標管理理論架構，藉由本研究接受半結構式深度訪談對象之訪談結果，進行綜合評斷與論述，比較實際業界施行目標管理制度與目標管理之理論有何差異，最後依據標竿企業以及目標管理之理論針對研究對象機構執行目標管理時提出結論與建議。研究結果發現：一、遵循新制醫院評鑑條文對醫院施行目標管理制度有益。二、在目標管理實務經驗中較難達完全授權及自我評量，施行時最好配合其他相關管理制度。三、研究對象機構之目標管理制度之程序應先檢視其宗旨，再依其宗旨訂定整體目標、單位目標，而各層目標皆須轉化為具體量化指標，其過程中須層層把關，有良好的審核機制，執行目標者應有目標說明書已將目標執行狀況透明化；成果評價由上司以客觀指標評核；若遇環境快速變化必要時也需修正目標。四、研究對象機構於實施目標管理制度時應先推行至組長級以上之人員、大肆宣導推廣目標管理制度、安排教育訓練、檢視組織結構，並建議導入平衡計分卡及提倡獎勵制度。

Taking on qualitative methodology, the study, through literature review, brought together, examined, sorted out, and made comparison of literatures regarding management by objectives implemented by both domestic and overseas enterprises and data about new hospital accreditation process in Taiwan; and based on the results from semi-structured in-depth interviews, the study provided a comprehensive judgment and discourse, and compared the difference between theory and practice. Finally, the study attempted to provide data summaries and recommendations that could be used by the studying subject in the implementation of the system. 1.The observation of new hospital accreditation regulations is beneficial for the implementation of management by objectives in hospitals. 2.Complete authorization and self assessment are less achievable in the management by objections system. Other management system should be used to complement. 3.In the implementation of the system, the study subject should first examine its objective prior to the establishment of an overall goal and subordinate objectives. Each subordinate objective must be quantified and measurable. A method must be also introduced for checking the validity of the objectives. There must be a prospectus to describe the major features of the implementation in enough detail so that the supervisors may evaluate. The performance evaluation is conducted by supervisors using standards that are established objectively. Objectives must be modified in the course of time in order to take into account any sharp situation changes. 4.In the implementation of the system, the study subject should first get its section chiefs or higher level officers involved, make it known to every individual in the organization, arrange educational training, and examine organization structure. Balance Score Card approach and an awarding system may be considered.