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研究生:陳俊銘
研究生(外文):Chun-Ming Chen
論文名稱:運用團隊資源管理模式提升醫療品質─以北區某區域教學醫院為例
論文名稱(外文):IMPLEMENTATION OF TEAM RESOURCE MANAGEMENT MODEL TO ENHANCE THE QUALITY OF MEDICAL CARE ─ ON A CASE STUDY REGIONAL TEACHING HOSPITAL IN NORTHERN TAIWAN
指導教授:林玥岑
指導教授(外文):Yueh-Ysen Lin
口試委員:李弘暉古思明
口試委員(外文):Hung-Hui LiSy-Ming Guu
口試日期:2013-06-19
學位類別:碩士
校院名稱:元智大學
系所名稱:管理碩士在職專班
學門:商業及管理學門
學類:企業管理學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:48
中文關鍵詞:醫療服務滿意度病人安全團隊資源管理
外文關鍵詞:medical service satisfactionpatient safetycrew resource management
相關次數:
  • 被引用被引用:2
  • 點閱點閱:349
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
隨著媒體及網際網路的普及,消費意識於現在社會上有不斷抬頭之趨勢,民眾亦越來越注重所受到的醫療照護品質,但醫療本身具有高度的資訊不對等,一般大眾了解不易,往往會因此造成抱怨甚至是醫療糾紛之產生。以病人為中心的服務模式已逐漸成為主流,但於目前健保制度下,整個醫療環境已出現醫護人力吃緊的情形,更顯得醫護之間的團隊合作更為重要。國內外均有文獻指出,醫療團隊資源管理能有效提升病人安全文化、員工及病人之滿意度。本研究目的在以急性一般病房之住院病人為例,初步探討導入團隊資源管理(Team Resource Management, TRM)教育訓練後,對個案醫院之病人住院經驗認知之影響,故本研究以行政院衛生署醫療品質政策辦公室之病人住院經驗調查問卷進行測量、分析,本研究於101年09月17日至102年3月22 日共發出340份問卷,有效問卷共334份,使用IBM SPSS Advanced Statistics 20.0軟體進行分析,透過描述性統計與獨立樣本T檢定等統計方法來探究研究假設。
本研究於實施TRM教育訓練後,發現住院病人就醫經驗之護理人員表現、其他醫療人員的表現、整體醫療人員的表現、其他服務及住院整體評估等測量構面均達顯著正向之影響。
The development of the Internet and other media has led to a rise in consumer awareness. As a result, people are increasingly focusing on the quality of health care that they receive. However, since the quality of the information available to patients is unequal, it may lead to incomprehension, complaints, and even medical malpractice disputes. A patient-centric service model is gradually becoming mainstream in hospitals and in the frame of the current health care system, the manpower shortage has highlighted the need for team work. Both domestic and international literature state that medical Team Resources Management can effectively enhance patient safety culture, and staff and patient satisfaction. This study of patients in an acute care general ward explores the impact of the implementation of Team Resource Management training on the patients’ experience perception. The Department of Health Healthcare Quality Policy Office’s questionnaire on hospital experience was used and the results analyzed. Three hundred and forty (340) questionnaires were distributed between September 17, 2012 and March 22, 2013; three hundred and thirty four (334) valid questionnaires were collected and the results put through IBM SPSS Advanced Statistics 20.0 software for analysis. Descriptive statistics and independent sample T-Test statistical methods were used to explore the research hypotheses.
The study found that education and training in the implementation of TRM had a significant impact on inpatients medical experience regarding nurses performance, the performance of other medical personnel, the medical staff overall performance, the assessment of all other services, and the hospitalization’s overall assessment.
書頁名...................................................i
論文口試委員審定書.........................................ii
授權書...................................................iii
中文摘要.................................................iv
英文摘要.................................................v
誌謝....................................................vi
目錄....................................................vii
第一章 緒論..............................................1
第一節 研究背景...........................................1
第二節 研究動機與目的......................................2
第二章 文獻探討...........................................4
第一節 醫療服務滿意度......................................4
第二節 維護病人安全........................................5
第三節 團隊資源管理........................................6
第三章 研究方法...........................................15
第一節 研究流程...........................................15
第二節 研究架構...........................................17
第三節 研究變項之操作型定義.................................17
第四節 研究假設...........................................18
第五節 研究對象與施測程序...................................19
第六節 樣本結構...........................................19
第七節 統計分析方法........................................23
第四章 研究分析與結果......................................25
第一節 各構面表現.........................................25
第二節 獨立樣本T檢定.......................................29
第五章 結論與建議..........................................39
第一節 研究結論............................................39
第二節 研究建議............................................39
第三節 研究限制與未來研究建議方向.............................40
中文文獻
1.吳永隆、吳宛蕙、侯紹敏、王拔群、王晨旭、林志明、黃清水(2009).我國TeamSTEPPS推行與應用之展望.醫療品質雜誌,3(2),82-85。
2.吳宛蕙、侯紹敏、吳永隆、葉宜珍、黃鈺茹、王拔群、于卓然(2008).利用團隊資源管理提升機構病人安全文化.醫療品質雜誌,2(5),84-87。
3.林師模、陳苑欽(2003).多變量分析:管理上的應用‧臺北:雙業書廊。
4.林獻鋒、賴世偉、李佳霙、張靖梅、賴明美、劉秋松、林正介(2001).中部某教學醫院自費健撿病人對醫院服務滿意度的調查.Mid-Taiwan Journal of Medicine, 6(3),167-172。
5.洪欣妏、蕭宇伶、楊玫蓉、劉中賢、陳誠仁、嚴元鴻(2011).導入醫療團隊資源管理(TRM)對提升醫療品質效應初探-以某區域醫院住院病人滿意度為例.醫療品質雜誌,5(3),48-56。
6.郭宜中、湯玲郎(2001).醫院服務品質與住院病患滿意度之研究—以二區域教學醫院為例.醫院,34(5),23-48。
7.郭德賓(2000).醫療服務業顧客滿意與競爭策略之研究.產業管理學報,1, 231-256。
8.葉美技、胡百敏、廖浩欽、廖訓禎、許文祥、吳銘斌(2007).影響初入加護病房家屬滿意度之相關因素.[Factors Relative to Satisfaction of the First Time Admitted to the Intensive Care Unit Patients' Family].重症醫學雜誌,8(4),146-155。
9.詹廖明義(2013).病患滿意度vs病患就醫經驗的意義.取自 http://blog.udn.com/ptsafetyrm/7784486
10.劉越萍(2009).利用醫療團隊訓練以促進病人安全.醫療品質雜誌,3(1),68-72。
11.盧昭文、鍾國彪(2000).醫師遭遇醫療糾紛之經驗與其認知、態度對醫師行為影響之研究─以大臺北地區為例(碩士論文).臺灣大學醫療機構管理研究所。
12.羅健銘、張斐綾、廖熏香、李偉強(2008).病人安全文化分析.醫療品質雜誌,2(4),68-73。
英文文獻
1.DeFontes, J., & Surbida, S. (2004). Preoperative safety briefing project. Permanente Journal, 8(2), 21-27.
2.Friedman, M. A. (1995). Issues in measuring and improving health care quality. Health care Financing Review, 16(4), 1.
3.Gordon, M., Ewy, G., Felner, J., Forker, A., Gessner, I., McGuire, C., & Waugh, R. (1980). Teaching bedside cardiologic examination skills using" Harvey", the cardiology patient simulator. The Medical Clinics of North America, 64(2), 305.
4.Gorham, W. A. (1962). Staff nursing behaviors contributing to patient care and improvement. Nursing Research, 11(2), 68-79.
5.Grogan, E. L., Stiles, R. A., France, D. J., Speroff, T., Morris, J. A., Nixon, B., & Pinson, C. W. (2004). The impact of aviation-based teamwork training on the attitudes of health-care professionals. Journal of the American College of Surgeons, 199(6), 843-848.
6.Hall, J. A., & Dornan, M. C. (1988). What patients like about their medical care and how often they are asked: a meta-analysis of the satisfaction literature. Social Science & Medicine, 27(9), 935-939.
7.Haller, G., Garnerin, P., Morales, M. A., Pfister, R., Berner, M., Irion, O., & Kern, C. (2008). Effect of crew resource management training in a multidisciplinary obstetrical setting. International Journal for Quality in Health Care, 20(4), 254-263.
8.Hansagi, H., Carlsson, B., & Brismar, B. (1992). The urgency of care need and patient satisfaction at a hospital emergency department. Health care management review, 17(2), 71-765.
9.Kirkpatrick, D. L. (1996). Techniques for evaluating training programs. Classic Writings on Instructional Technology, 1(192), 119.
10.Kohn, L. T., Corrigan, J., & Donaldson, M. S. (2000). To err is human: building a safer health system (Vol. 6): The National Academy Press.
11.Kosnik, L. K. (2002). The New Paradigm of Crew Resource Management: Just What Is Needed to Reengage the Stalled Collaborative Movement? Joint Commission Journal on Quality and Patient Safety, 28(5), 235-241.
12.LoBiondo-Wood, G., & Haber, J. (2005). Nursing research: Methods and critical appraisal for evidence-based practice.
13.McGreevy, J. M., & Otten, T. D. (2007). Briefing and debriefing in the operating room using fighter pilot crew resource management. Journal of the American College of Surgeons, 205(1), 169-176.
14.Oriol, M. D. (2006). Crew resource management: applications in healthcare organizations. Journal of Nursing Administration, 36(9), 402-406.
15.Pizzi, L., Goldfarb, N. I., & Nash, D. B. (2001). Crew resource management and its applications in medicine. Making Healthcare Safer: A Critical Analysis of Patient Safety Practices, 44, 511-519.
16.Pronovost, P., Weast, B., Rosenstein, B., Sexton, J. B., Holzmueller, C. G., Paine, L., Rubin, H. R. (2005). Implementing and validating a comprehensive unit-based safety program. Journal of Patient Safety, 1(1), 33-40.
17.Reason, J., Carthey, J., & De Leval, M. (2001). Diagnosing “vulnerable system syndrome”: an essential prerequisite to effective risk management. Quality in Health Care, 10(suppl 2), ii21-ii25.
18.Strasser, S., Aharony, L., & Greenberger, D. (1993). The patient satisfaction process: moving toward a comprehensive model. Medical Care Research and Review, 50(2), 219-248.
19.Taylor, C. R., Hepworth, J. T., Buerhaus, P. I., Dittus, R., & Speroff, T. (2007). Effect of crew resource management on diabetes care and patient outcomes in an inner-city primary care clinic. Quality and Safety in Health Care, 16(4), 244-247.
20.Thompson, E. M. (2009). OR nurses lead communication efforts. OR Nurse 2012, 3(6), 5.
21.Vincent, C., Taylor-Adams, S., & Stanhope, N. (1998). Framework for analysing risk and safety in clinical medicine. British Medical Journal, 316(7138), 1154-1157.
22.Wiener, E. L. (1995). Cockpit resource management: Academic Press.
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