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研究生:蕭明月
研究生(外文):Ming-Yue Siao
論文名稱:頂尖醫學品牌: 梅約醫學中心
指導教授:王弓王弓引用關係鄭有為鄭有為引用關係
學位類別:碩士
校院名稱:國立中央大學
系所名稱:產業經濟研究所
學門:社會及行為科學學門
學類:經濟學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:139
中文關鍵詞:梅約醫學中心病患至上團隊醫療醫療專業
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雖然上醫院並不是什麼愉快的事,縱使百般不情願,人們仍舊不可避免地去過幾回。與其他經濟上財貨或服務大相逕庭,購買皆是出於「既知且欲」;個人可能在「不知」甚至「不欲」的狀態下,接受健康醫療照護服務——這樣的市場自然創造了相當可觀的經濟產值。
自從創辦人梅約兄弟之父,威廉˙瓦洛˙梅約醫師,開始其醫師職業生涯,迄今已過了一百五十個年頭。在近廿年來,梅約醫學中心在美國新聞與世界報導(U.S. News & World Report)的醫療機構排名中,時常獨佔鰲頭,於諸多專業科別評比,皆拿下第一位的排名;同時在財富雜誌(Fortune)進行的全美前百名最適合就業的公司(Best Companies to Work For),奪得第八十六名;DiversityInc之組織多元性排名,將梅約醫學中心列為第十名;上開殊榮對於梅約醫學不過九牛一毛。
為找出梅約醫學中心在嚴峻的競爭下屹立不搖,並且越發壯大的秘密,本研究透過回顧梅約醫學中心、醫事專業、以及團隊醫療相關文獻;加之梅約醫學中心出版的官方資料,剖析梅約醫學中心所以成為頂尖醫學品牌的核心準則。
Though no one loves to stay at hospital, it is a willy-nilly place for you to go. No matter how reluctant you are, healthcare services differ from those of other goods and services, would be the “must buy” to everyone. There is a huge value in the market that having reference to it.
It has been more than one hundred and fifty years since Dr. William Worrall Mayo (father of the founders) started his career as a physician. In recent twenty years, Mayo Clinic has act as leader in U.S. News & World Report rankings, with more No. 1 ranked specialties than any other hospital in the nation. It has got #86 in Fortune, 100 Best Companies to Work For and ranked No. 10 in DiversityInc, just to name a few.
To find the secret behind its survival from the severe competition and the building of its strong brand, this research reviewed literature regarding Mayo Clinic, medical profession, and teamwork in health care organizations. Along with the official release of Mayo Clinic, this research figured out some principles making Mayo Clinic a successful health care organization.
摘要……………………………………………………………………………………………………………………………i
Abstract……………………………………………………………………………………………………………………..ii
致謝辭……………………………………………………………………………………………………………………... iii
目錄…………………………………………………………………………………………………………………………ⅳ
圖目錄……………………………………………………………………………………………………………………...ⅶ
表目錄……………………………………………………………………………………………………………………...ⅷ
一、緒論…………………………………………………………………………………………………………………….1
1.1 研究背景與動機…………………………………………………………………………………………………..1
1.2 研究對象……………………………………………………………………………………………………………..2
1.3 研究流程……………………………………………………………………………………………………………..4

二、 文獻回顧…………………………………………………………………………………………………………....6
2.1 醫療專業……………………………………………………………………………………………………………..6
2.1.1 人本………………………………………………………………………………………………………………..12
2.2 組織文化……………………………………………………………………………………………………………15
2.2.1 團隊合作…………………………………………………………………………………………………………16

三、 模型研究…………………………………………………………………………………………………………..19
3.1 梅約醫學照護典範……………………………………………………………………………………………..19
3.1.1 梅約醫學照護典範之服務要素…………………………………………………………………………42
3.1.2 梅約醫學史柯茲戴爾門診中心促進服務卓越性之策略目標..……………………………..43
3.1.3 PLEASE CARE 服務要旨計劃……………………………………………………………………………45
3.2 梅約醫學教育典範……………………………………………………………………………………………..47
3.2.1梅約醫學院教學課程設計…………………………………………………………………………………51
3.2.2梅約醫學教育研究所教學課程設計…………………………………………………………………...53
3.2.3 梅約醫學中心羅徹斯特院區內科住院醫師訓練計畫…………………………………………54
3.3 梅約卓越擴散模型……………………………………………………………………………………………..55
3.3.1 卓越擴散主要啟動因子……………………………………………………………………………………58
3.3.2 梅約醫學價值結構(Mayo Clinic Value Construct)………………………………………….64
3.3.3 梅約醫學價值創造系統(The Mayo Clinic Value Creation System)………………….74
3.3.4 小結………………………………………………………………………………………………………………..78

四、 綜合分析…………………………………………………………………………………………………………79
4.1病患端………………………………………………………………………………………………………………..79
4.1.1聚焦需求………………………………………………………………………………………………………….80
4.1.2近用性……………………………………………………………………………………………………………..82
4.2醫院端………………………………………………………………………………………………………………..83
4.2.1協同合作………………………………………………………………………………………………………….84
4.2.2技術設備………………………………………………………………………………………………………….85
4.2.3領導經營………………………………………………………………………………………………………….86
4.3 組織核心價值分析……………………………………………………………………………………………..87
4.3.1梅約醫學照護典範(The Mayo Clinic Model of Care)沿革……………………………….88
4.3.2 梅約醫學照護典範(The Mayo Clinic Model of Care)更動緣由……………………….91
4.3.3 各項政策與梅約醫學照護典範(The Mayo Clinic Model of Care)之分析比較….94

五、結論…………………………………………………………………………………………………………………103
5.1 研究結論………………………………………………………………………………………………………….103
5.2 研究限制暨建議……………………………………………………………………………………………….106
參考文獻………………………………………………………………………………………………………………..107
附錄...............................................108
一、中文部分
(1)中國醫藥大學醫學系解剖科&中國醫藥大學附設醫院放射部,電腦斷層攝影(CT)簡介,中國醫藥大學醫學影像學習園地,http://www2.cmu.edu.tw/~cmcmd/ctanatomy/imagetool/ctintro.html,最後瀏覽日:2017/06/12。
(2)中國醫藥大學醫學系解剖科&中國醫藥大學附設醫院放射部,磁振造影(MRI)簡介,中國醫藥大學醫學影像學習園地,http://www2.cmu.edu.tw/~cmcmd/ctanatomy/imagetool/mri.html,最後瀏覽日:2017/06/12。
(3)克里斯汀生(Clayton M. Christensen), 格羅斯曼(Jerome H. Grossman) & 黃捷昇(Jason Hwang),創新者的處方:克里斯汀生破、解醫護體系的破壞型解答,初版一刷,蔡承志、許長禮 譯,台北市,美商麥格羅希爾國際股份有限公司台灣分公司,2012。
(4)李納˙貝瑞(Leonard L. Berry) & 肯特˙賽特曼(Kent D. Seltman),向梅約學管理:世界頂尖醫學中心的三贏哲學,初版十一刷,陳琇玲 譯,台北市,美商麥格羅希爾國際股份有限公司台灣分公司,2015。
(5)托比˙寇斯葛洛夫(Toby Cosgrove),翻轉吧醫院——高效能協同醫療模式打造4贏照護體系,初版一刷,曹嬿恆 譯,台北市,美商麥格羅希爾國際股份有限公司台灣分公司,2015。
(6)約瑟夫˙米其里(Joseph Michelli),卓越,來自關懷,UCLA醫療體系打造頂級服務的五心級處方,初版一刷,郭政皓 譯,台北市,美商麥格羅希爾國際股份有限公司台灣分公司,2012。
(7)教育部新編國語辭典網頁:http://dict.revised.moe.edu.tw/cgi-bin/cbdic/gsweb.cgi?ccd=XHkbQ9&o=e0&sec=sec1&op=v&view=0-2
(8)孫緒媛,醫師及病患服務品質認知差距探討,成功大學,國際經營管理研究所,碩士論文,2013年6月。
(9)張沅合,醫療機構服務國際化競爭優勢之研究,亞洲大學,經營管理研究所碩士論文,2008年7月。
(10)國立高雄醫學大學官方網站,OSCE簡介,http://osce.dlearn.kmu.edu.tw/osce.htm,最後瀏覽日:2017/06/12。
(11)羅翊婷,台灣醫療院所品牌形象、品牌權益與顧客回應之關聯性研究,中華大學經營管理研究所碩士班碩士論文,2008年7月。
(12)衛生福利部統計資料,三、醫療保健支出,取自http://www.mohw.gov.tw/cht/DOS/DisplayStatisticFile.aspx?d=48150
(13)豐田生產方式研究會,圖解服務的豐田精實方式,初版二刷,許淳彥、鍾適光、賴啟昌 譯,台北市,財團法人中衛發展中心,2012。
二、外文部分
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(9)Carry M. Renders, Gerlof D. Valk, Simon J. Griffin, Edward H. Wagner, Jacques Thm. Eijk Van, Willem J.J. Assendelft, Interventions to Improve the Management of Diabetes in Primary Care, Outpatient, and Community Settings: A systematic review, Diabetes Care, October 2001; 24 (10): 1821–1833.
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(20) David R. Holmes, Malcolm R. Bell, Bernard J. Gersh, Charanjit S. Rihal, Luis H. Haro, Christine M. Bjerke, Ryan J. Lennon, Choon-Chern Lim, Henry H. Ting, Systems of Care to Improve Timeliness of Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction During Off Hours: The Mayo Clinic STEMI Protocol, JACC, February 2008; 1 (1): 88 –96.
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(22) Derek A. Haas, Richard A. Helmers, March Rucci, Meredith Brady, Robert S. Kaplan, The Mayo Clinic Model for Running a Value-Improvement Program, HBR, October 2015.
(23)Douglas Mccarthy, Kimberly Mueller, Jennifer Wrenn Issues Research Inc., Mayo Clinic: Multidisciplinary Teamwork, Physician-Led Governance, and Patient-Centered Culture Drive World-Class Health Care, Commonwealth Fund pub., August 2009; 1306 (27): 1-16.
(24)Edmund D. Pellegrino, Professionalism, Profession and the Virtues of the Good Physician, The Mount Sinai Journal Of Medicine, November 2002; 69 (6): 378-384.
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(27)Eric G. T Angalos, Robert A. Blomberg, Sheila S. Hicks, Claire E. Bender, Mayo Leadership Programs for Physicians, Mayo Clin Proc., March 1998; 73: 279-284.
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(29)Gerard Hastings, Laura McDermott, Putting social marketing into practice, BMJ, 2006; 332: 1210-1212.
(30)Glyn Elwyn, Amy Lloyd, Carl May, Trudy van der Weijden, Anne Stiggelbout, Adrian Edwards, Dominick L. Frosch, Tim Rapley, Paul Barr, Thom Walsh, Stuart W. Grande, Victor Montori, Ronald Epstein, Collaborative deliberation: A model for patient care, Patient Education and Counseling, 2014; 97: 158–164.
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(33)Herbert M. Swick, Viewpoint: Professionalism and Humanism Beyond the Academic Health Center, Academic Medicine, November 2007; 82 (11): 1022-1028.
(34)HOOVERS.COM, MAYO CLINIC Profile, Dec 2016.
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(51)Karen N. Eggleston, Nilay D. Shah, Steven A. Smith, Amy E. Wagie, Arthur R. Williams, Jerome H. Grossman, Ernst R. Berndt, Kirsten Hall Long, Ritesh Banerjee, Joseph P. Newhouse, The Net Value of Health Care for Patients With Type 2 Diabetes, 1997 to 2005, Ann Intern Med., September 2009; 151 (6): 386-393.
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