運用組織轉變改善護理人員延遲下班問題

Improving the Issue of Nurses' Delay of Off-Duty from Work through Organizational Transformation

護理人員出現延遲下班之情形相當頻繁，本部發現此狀況不但讓護理人員工作負荷超重，降低同仁工作滿意度，甚至影響留任意願。進行現況調查發現，護理人員延遲下班30分鐘佔93%，平均延遲下班時間約40分鐘，延遲下班的原因為：作業流程複雜、工作內容繁重、附加非專業業務、團隊影響、行政因素與軟硬體環境等因素。運用Kotter（1995）組織轉變的八個階段：建立緊迫感、成立專案小組、創造願景、溝通共識、賦權工作任務、創造雙贏、鞏固努力的成果與制度化的改變，以進行改善措施專案計畫。組織轉變後，護理人員延遲下班比率由93%下降至20%以下；工作滿意度中的延遲下班改善滿意度由77%提升至91 %。期望藉此專案分享運用組織轉變策略，可以改善護理人員延遲下班與提昇工作滿意度。

Nurses often delay off-duty from work, which causes overload of their work, lowers their job satisfaction, and even impacts their job retention. A survey regarding the current situation revealed that 93% of nurses delayed off-duty over 30 minutes, and the average delay of off-duty was about 40 minutes. The causes of delay of off-duty included complicated workflows, heavy work contents, extra non-professional tasks, team influence, administrative factors, and the environmental factors involving software and hardware. Kotter's eight steps of organizational transformation were applied as an improvement project: establishing an urgent sensation, forming a taskforce team, creating a vision, communing consensus, empowering assignments, creating win-win situations, consolidating the outcomes of efforts, and institutionalizing the changes After the implementation of the organizational transformation, nurses' delay of off-duty from work decreased from 93% to below 20%; job satisfaction, in terms of delay of off-duty, increased from 77% to 91%. The author expects that sharing about and implementation of an organizational transformation as a strategy can improve nurses' delay of off-duty from work and promote their job satisfaction.