醫院全面資源管理之研究

Research for Hospital Total Resource Management

10.6843/NTHU.2012.00291

郭美利

全面資源管理 ； 營運績效 ； 績效指標 ； 簡易多屬性評等技術 ； 設備綜合效率 ； 醫院管理 ； Total Resource Management (TRM) ； Operating Performance ； Performance Index ； Simple Multi-Attribute Ranting Technique (SMART) ； Overall Equipment Efficiency (OEE) ； Hospital Management

清華大學工業工程與工程管理學系學位論文

2012年

碩士

簡禎富

繁體中文

台灣自1995年全民健康保險開辦後，隨著醫療費用不斷成長，出現財務危機。2002年7月，中央健康保險局正式對醫院實施總額支付制度，控制整體醫院之營收上限。另外，醫院需面臨各項醫院評鑑及訪查作業，在眾多條文規範以及面對其他醫院擴充及競爭下，營運成本日益增加。 因此，如何有效整合各種資源，產出最大效益，對醫院之生存發展非常重要。雖然，醫院管理者已採用許多績效指標來做評估，但既有的管理方式大多偏重於醫院經營策略或個別指標之局部最佳化，未能將企業的營運資源充分整合。 本研究發展醫院全面資源管理（Total Resource Management, TRM）架構建立系統化的管理機制，對醫院的營運資源做有效的規劃、管控執行、績效評估與檢討改善，並透過標竿學習找出改進的方向以持續提升營運績效，進而建立符合國內醫療體系之先進醫院管理模式。 藉由全面資源管理之理論基礎，建立醫院全面資源管理模式，經由審視人、機、料、法、財五項資源類別，建立11項根本目標及39項的績效指標，使評估作業更具效率。其次，指定當責單位依工具目標產生且執行改善方案，可增進資源使用效益。最後，在委員會及工作小組的監督下，進行定期報告、檢討、改善、追蹤，使各項管理作業及資源指標作更好的運用，達成資源管理的根本目標，實踐醫院資源管理的方針。 本研究並以新竹某區域醫院為例，進行全身螺旋式電腦斷層掃描儀的設備綜合效率OEE評估，及建構重大醫療儀器SMART採購評估模式二個實證案例，驗證本研究理論及資源管理流程確實具有效度和實用價值。

Facing the income ceiling policy, quality protocols, industry competition, and expanding financial burden among others, individual hospitals in Taiwan need to find ways to maximize its resources and minimize its costs in order to generate more profits. In spite of the fact that most of the Taiwan hospitals have adopted one method or another to help manage its administration or operation performance, the result seems partial and there is still a gap between available resources and overall integration. This study adopted the Total Resource Management (TRM) framework and aims to develop a systematic and effective Plan-Do-Check-Action (PDCA) methodology to optimize operational resources in the context of hospitals. By benchmarking proven successful models and standards in the medical industry, domestic hospitals are therefore able to sustain continuous growth by establishing its own advanced hospital management models. This Hospital Total Resource Management (HTRM) facilitates hospitals to examine the 5-M resources, which are man, machine, material, method, and money, in a more efficient and effective manner. First of all, the HTRM helps identify 11 fundamental objectives and 39 performance indexes from the 5-M resources in the hospital. Secondly, the HTRM requires all accountable to develop and implement feasible action plans to deliver the means objectives, which improves on the overall effectiveness. Finally, under the supervision by the HTRM working committee, all accountable must monitor, evaluate, improve, and report the progress on a regular basis, in order to meet up the fundamental objectives and performance indexes originally set by the hospital authority. The HTRM framework per se was introduced to a regional hospital located in Hsin-Chu, Taiwan, and successfully proved on its feasibility and validity through two case studies, which are respectively the OEE utilization analysis over the Whole Body System for Routine SPIRAL CT scanning, and the SMART procurement evaluation over major medical equipments in the hospital.

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