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研究生:鍾崑元
研究生(外文):Chung, Kuen-Yuan
論文名稱:醫院內部稽核系統雛形之建立
論文名稱(外文):A Prototype of Internal Auditing Systems in a Hospital
指導教授:鄭博文鄭博文引用關係
指導教授(外文):Cheng, Bor-Wen
學位類別:碩士
校院名稱:國立雲林科技大學
系所名稱:工業工程與管理技術研究所
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:1997
畢業學年度:85
語文別:中文
論文頁數:110
中文關鍵詞:醫院內部稽核醫療服務品質內部稽核系統國際品質管理與品質保證標準
外文關鍵詞:hspital's internal auditingquality of medical careinternal auditing systemsISO 9000
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近年來,醫院為因應全民健保的實施,積極地提昇醫療服務品質及經營績效,因此,各種管理活動如品管圈 (QCC)、流程改造 (BPM)、連續性品質改善 (CQI) 和國際品質標準 (ISO 9000) 等全面品質經營 (TQM) 活動之推行,冀望從管理和制度上根本改善品質。然而在這些活動的執行過程中,『落實性』、『連續性』、『改善的成效』和『成本效益』常未被有效地分析、追蹤及回饋給管理者,因此,醫院管理者常易作錯誤決策。
為此,本研究從醫療服務品質監測缺失的分析,找出醫院內部稽核範圍制訂的依據。在醫院內部稽核雛形模式的構建上,以ISO 10011為主幹,藉由運用品質機能展開 (QFD) 於內部稽核程序、IPA內部稽核程序評鑑模式、ISO 9000內部稽核程序與一般企業的內部稽核程序之探討,發展出一套醫院內部稽核的雛形模式。
本研究所得之結果如下所述。
1.本研究將醫院內部稽核系統分成稽核先行性分析、稽核組織建構、稽核流程規劃與執行、稽核回饋模式的建立與內部稽核績效評估等階段。
2.從稽核需求問卷導入研究對象的結果中顯示,醫院主管皆認為在醫院實施內部稽核有其必要性。而醫院在實施內部稽核前,必須先建立以下的內部控制制度:暢通的管理資訊系統;部門及員工之職權的明確劃分;建立醫院的跨部門協調合作模式;建立管理流程的回饋系統;建立品質改善活動的成效評估指標。如此本研究對象之內部稽核才可有效執行。


In the recent years, due to the implementation of National Health Insurance, hospitals must actively elevate the quality of medical care and management performance. Therefore, hospitals actualize all kinds of management activities to improve the medical care quality, such as Quality Control Circle (QCC), Business Process management (BPM), Continuous Quality Improvement (CQI) and International Quality Standardization Systems (ISO 9000). Whereas, during the execution of those activities,some factors such as the activities of the implementation, continuity, effect of improvement and effect of costs have not been analyzed, investigated and replied efficiently to the hospitals' managers, therefore, the hospitals' managers are easy to make erroneous decisions.
For the reasons shown above, this research decides the internal auditing scope in a hospital from the analysis of demerit assessment in the quality of medical care. This research constructs a prototype of internal auditing systems (IAS) in a hospital. The internal auditing prototype was based on ISO 10011 mainly, and other internal auditing models such as Quality Function Deployment (QFD), internal process assessment (IPA), ISO 9000 and internal auditing process in enterprises.
The results of this research are shown in the followings.
1. The IAS in a hospital is divided into anterior auditing analysis, auditing organization's construction, planning and execution of the auditing procedures, the internal auditing feedback model and the performance evaluation of internal auditing.
2. The results of the questionnaire for auditing demand from the hospital under this research show that the hospital's managers believe that it is necessary to execute internal auditing in their hospital. It is better to construct internal control systems before the hospital starting the internal auditing. Those internal control systems may include unimpeded management information systems; clearly define the scope of the functions and powers for every department and employee; construct the cooperation model across departments; construct the feedback systems of the management procedures; construct the performance evaluation indexes for the quality improvement activities. By doing so, the hospital under this research will perform internal auditing effectively.

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