醫院品管圈活動推動成效及困難探討──以北部某醫學中心為例

Factors Influencing the Effectiveness and Obstacles in Implementing Quality Control Circles in One Medical Center of the Northern Taiwan

目的：了解員工對醫院品質改善活動成效及所遭遇之困難，探討個人、單位層級因素影響成效與遭遇困難之相關因素。方法：發展結構式問卷，對象為本院過去5年曾參加過院內品質改善活動共100人為問卷調查對象，回收有效問卷65份，回收率65%。結果：1個人成效：（1）未來願意繼續參加院內品管圈活動者，其對成效看法顯著高於回答視情況而定及不願意者（P＜001）。（2）清楚院內獎勵制度者，其對成效看法顯著較高於不清楚院內獎勵制度者（P＜005）。2遭遇困難：（1）填答未來不願意繼續參加院內品質改善活動者，其遭遇困難程度顯著高於回答願意者（P＜001）。（2）不清楚院內獎勵制度者比起清楚院內獎勵制度者，其遭遇困難的程度有顯著較高的情形（P＜005）。（3）單位內部無輔導員，其遭遇困難的程度比單位內有輔導員者顯著較高（P＜001）。結論：員工對於品管圈活動的參與，對於品管圈的成效有立竿見影之效。在推動上，輔導員是品管圈活動推動的重要角色，培養各職類具有輔導能力的輔導員，將有助於醫院未來品管圈的推動。此外，建立獎勵制度及重視員工權益，也是排除推動困難的重要關鍵。

The purpose of this study was to explore the staffs´ factors in promoting qualitycontrol circles implementation. Method：We developed a structured questionnaire The target of survey was a total of 100staffs who had participated quality improvement activities in the past five years. Thequestionnaire survey was conducted 65 valid questionnaires were recovered, with arecovery rate of 65%. Results：1. In terms of effectiveness:(1) those who are willing to continue participating in thequality control circle in the future are significantly higher than those who responddepending on the situation and are unwilling (P<001) (2) Those who know thereward system better than those who do not (P<005) 2. In terms of obstacles: (1) Those who are unwilling to continue participating in quality improvement activities in the future in hospital have significantly morechallenges than those who answered yes (P<001) (2) Those who are not clear aboutthe hospital reward system have significantly more challenges than those who areclear about the hospital reward system (P<005) (3) The units without counselorshave significantly more challenges than those who have counselors in the unit (P<001). Conclusion：Staffs' participation in Quality Control (QC) activities has an immediate effect on thequality control circle's effectivenessIn terms of promotion, counselors play an important role in the quality control circleactivities, and training of counselors in various categories will help the quality controlcircle in the long termIn addition, establish of a reward system and care for staffs' rights are also importantto eliminate the difficulties of promotion.