組織結構會影響護理人員的離職與任務績效嗎？－以台灣醫院照護體系為例

Does organizational structure matter to nurses' turnover and task performance?-A view point in Taiwan's hospital system

10.29494/LN.201606_17(2).0001

劉淑芬(Doresses Liu)；高靖秋(Ching-Chiu Kao)；楊素月(Su-Yueh Yang)

組織結構 ； 離職 ； 任務績效 ； organizational team structure ； turnover ； task performance

領導護理

17卷2期（2016 / 06 / 01）

3 - 12

繁體中文

近年來，台灣醫療環境快速變化，醫療院所需以系統設計來確保有效的溝通和協調，並整合部門間力量，以達到組織績效。護理人員的離職率是組織績效重要衡量指標之一，過高的離職率將導致組織績效降低。同時組織績效可透過員工任務績效的實踐來展現。進言之，組織結構就是系統的基礎，主要目的之一為控制，包括控制組織成員間彼此的協調方式，以及控制激勵成長的方法，以增進組織最佳績效。就組織結構主要目的角度而言，台灣醫療院所現今的組織結構特質是什麼，對於護理人員執業環境的協調與激勵控制又有何影響，護理人員會選擇留任或離開職場，以及對於任務績效執行的可能影響是什麼，為本文討論的議題。

achieve organizational performance indicators, well-designed systems that ensure effective communication and coordination between departments and integrate resources within healthcare institutions are needed. In addition, nurses' turnover rate is an important indicator of organizational performance, such that a high turnover rate will result in reduced organizational performance. Organizational performance can be evidenced by employees' task performance. The organization structure is thus a foundation of the system. The main purpose of the organizational structure is to control members within an organization in a coordinated manner and in a way that motivates growth, and improves organizational performance. This paper describes characteristics of the organizational structure of Taiwan's healthcare institutions under the scope of the main purpose of the organization structure. In addition, the impact of the characteristic of organizational structures on the nurses' practice environment, intentions to In recent years, changes in healthcare environment occur rapidly in Taiwan. In order to leave, as well as the task performance are discussed.

1. 李長春,沈姵君(2008)。組織結構 、 員工工作滿意度與組織承諾對工作績效之影響 － 以不動產經紀人員爲例。台灣土地研究，11(1)，65-103。
   連結：
2. 林清河,施坤壽(2003)。組織結構 、 全面品質管理 、 ISO9000 與競爭優勢 、 組織績效之結構化模式分析。管理學報，20(5)，965-992。
   連結：
3. Brady, P.W.,Goldenhar, L.M.(2014).A qualitative study examining the influences on situation awareness and the identification, mitigation and escalation of recognized patient risk.BMJ Quality & Safety,23(2),153-161.
4. Chi, H. K.,Yeh, H. R.,Chiou, C. Y.(2008).The mediating effects of internal marketing on transformational leadership and job performance of insurance salespersons in Taiwan.The Business Review, Cambridge,11(1),173-180.
5. Classen, D. C,Kilbridge, P. M.(2002).The roles and responsibility of physicians to improve patient safety within health care delivery systems.Academic Medicine,77(10),963-972.
6. Cooke, H.(2009).Theories of risk and safety:what is their relevance to nursing?.Journal of Nursing Management,17(2),256-264.
7. Cumbey, D.A.,Alexander, J. W.(1998).The elationship of job satisfaction with organizational variables in public health nursing.Journal of Nursing Administration,28(5),39-46.
8. Daouk-öyry, L.,Anouze, A-L.,Otaki, F.,Dumit, N. Y.,Osman, I.(2014).The JOINT model of nurse absenteeism and turnover:A syste matic review.International Journal of Nursing Studies,51(1),93-110.
9. Dixon, N. M.,Shofer, M.(2006).Struggling invent high-reliability organizations in health care settings: Insights from the field.Health Services Research,41(4),1618-1632.
10. Frankel, A. S.,Leonard, M. W.,Denham, G. R.(2006).Fair and just culture, team behavior, and leadership engagement:The tools to a chieve high reliability.Health Services Research,41(4),1690-1709.
11. Gullatte, M. M.(2011).Nursing management : principles and practice.Pittsburgh, Pa:Oncology Nursing society.
12. Jones, G.R.,楊仁壽（譯）,許碧芬（譯）,俞慧芸（譯）(2005).組織理論與管理 - 理論與個案.臺北:台灣培生教育.
13. Mathieu, J.,Zajac, D.(1990).A Review and Meta-Analysis of the Antecedents, Correlates, and Consequences of Organizational Commitment.Psychological Bulletin,180(2),171-194.
14. Moenaert, R. K.,Souder, W. E.(1991).An Analysis of the Use of Extra Functional Information by R&D and Marketing Personal: Review and Model.Journal of Product Innovation Management,7,91-107.
15. Morgeson, F. P.,Delaney-KJinger, K.,Hemingway, M. A.(2005).The importance of job autonomy, cognitive ability and Job-related skill for predicting role breadth and job performance.Journal of Applied Psychology,90(2),399-406.
16. Pugh, D. S.,Hickson, D. J.(2007).Writers on Organizations.Sage Publications.
17. Robbins, S. P.(2003).Organizational behavior.New Jersey:Prentice-Mall.
18. Roseter, R. J.(2014).Nursing Shortage Fact. AmericanAsociation of Coleges of Nursing (AACN) Last Update April 24. Retrieved Feb 14, 2015 from Shethttp://www.aacn.nche.edu/ media-relations/NrsgShortageFS.pdf
19. Schaufeli, W. B.,Enzmann, D.(1998).The Burnout Companion to Study and Practice: A Critical Analysis.London:Taylor & Francis Press.
20. Shortell, S. M.,Rousseau, D. M.,Gilles, R. .,Devers, K. J.,Simons, T. L.(1991).Organizational assessment in intensive care units,(ICUS): construct development, reliability, and validity of the ICU nurse- physician questionnaire.Medical Care,29(8),709-723.
21. Vaughn, T.,Koepke, M.,Levey. S.,Kroch, E.,Tompkins, C.,Baloh, J.(2014).Governing board,c-suite, and clinical management perceptions of quality and safety structures, processes, and priorities in U.S. hospitals.Journal of Healthcare Management,59(2),111-128.
22. Walton, E. J.(2005).The persistence of bureaucracy: A Meta-analysis of Weber's model of bureaucratic control.Organization Studies,26(4),569-600.
23. 中央健保署 ( 2015 年 2 月 26 日 ) . 醫療服務指標 2015 年 03 月 18 日取自 http://www.nhi.gov.tw /Resource/webdata/1781 2 %E5%81%A5% E4%BF%9D-%E8%82%86 10402.pdf
24. 中央健保署(2011)。中央健保署 ( 2011 年 4 月 29 日 ) , 全民健康保險監理委員會第 191 次會議紀錄 , 2015 年 03 月 18H http://www.mohw.gov.tw/MOHW_ Upload/doc/1000429%E7%AC%AC191%E6 %AC%A1%E5%A7%94%E5%93%A1%E6 %9C%83%E8%AD%B0%E7%B4%80%E9 %8C%84_0031298001.pdf.。http://www.mohw.gov.tw/MOHW_Upload/doc/1000429%E7%AC%AC191%E6%AC%A1%E5%A7%94%E5%93%A1%E6%9C%83%E8%AD%B0%E7%B4%80%E9%8C%84_0031298001.pdf
25. 吳秉恩(1993).組織行爲學.臺北:華泰書局.
26. 李經遠(1991)。臺灣大企業組織結構三構面間之相關性。交大管理學報，12(4)，79-100。
27. 施淑惠,楊主行(2012)。官僚對工作倦怠之影響。健行學報，32(4)，49-68。
28. 溫金豐(2007).組織理論與管理.台北:學貫行銷.
29. 詹廖明義(2003).醫療事故的風險管理.台北:安立.
30. 衛生福利部 ( 2014 年 8 月 19 日 ) . 102 年醫事機構現況及服務量統計分析 ( 2015 年 03 月 18 日 ) 取 htp://www.mohw.gov.tw/cht/DOS/Statistic P.aspx?f_list_no=312&fod list no=5126&d | oc no=46170

1. 羅月雲,廖彥琦,張麗珍(2022)。探討醫院護理人員離職的決策經驗。嘉基護理，22(1)，12-21。