醫院評鑑制度的實施與檢討 : 以臺大醫院為例

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Title:	醫院評鑑制度的實施與檢討 : 以臺大醫院為例
Other Titles:	The implementation and review of the hospital accreditation system : a case study of the National Taiwan University Hospital
Authors:	林靖傑;Lin, Ching-Chieh
Contributors:	淡江大學公共行政學系公共政策碩士班劉淑惠
Keywords:	醫院評鑑;平衡計分卡;作業基金;Hospital Accreditation;Balanced Score Card;Operation Fund
Date:	2013
Issue Date:	2014-01-23 14:12:03 (UTC+8)
Abstract:	本研究以臺大醫院做為研究對象，因臺大醫院屬於教育部附屬單位機關，接受政府附屬機關作業基金的預算編制進行營運，為行政院衛生署醫院暨教學醫院評鑑為醫學中心等級，對於醫院暨教學醫院評鑑的準備以及受評的內容、過程具有足夠的參與經驗，加上醫院內部運用平衡計分卡評估其營運績效已行之有年，參考臺大醫院對於內部整體評估與外部稽核的內容與實作，透過歷史文獻分析與深度訪談法，探討臺灣醫院評鑑制度於醫院的實施情形與問題、釐清醫院評鑑制度與臺大醫院運用平衡計分卡、作業基金績效評估的關係並給予檢討及建議。　　研究發現臺灣醫院評鑑制度對醫院醫療品質以及經營管理具有實質幫助，醫院評鑑制度除重視醫療品質外，仍要以醫院整體品質的思維做評鑑考量；臺大醫院訂定平衡計分卡的各項指標與醫院暨教學醫院評鑑的內容確實是有互相補強的關係；臺灣醫院評鑑制度逐漸朝向以病人為中心的內容與指標的確能夠落實病人安全以及改善醫病關係的目的，但臺灣醫院評鑑制度對於醫院員工之工作權益的保障仍不夠完善，經營管理指標的角度並不應只注重管理者與員工的從屬關係，對於員工於醫院內各種工作權益與福利的保障與病人安全以及權益一樣重要。　　Science National Taiwan University Hospital is affiliated units belonging to the Ministry of Education, and accepts the special funds for operation. It is ranked Medical Center grade for Hospital Accreditation. National Taiwan University Hospital has enough participation experience through the process of accreditation for years, coupled with the use of the Balanced Scorecard within the hospital assess its operating performance, within the overall reference to National Taiwan University Hospital for evaluation and content of external audit and implementation. This study attempts to analyze the historical documents and using the depth interview to explore Taiwan''s hospital accreditation system to find the problems, clarify the relationship between hospital accreditation system and the National Taiwan University Hospital Balanced Scorecard.. The major findings of this study include three points: First, Taiwan''s hospital accreditation system not only focuses on the quality of medical care, but also on the management dimension. 　　Second, the indicators of Balanced Scorecard Cards using by National Taiwan University Hospital, which are complementary to the accreditation system. 　　Finally, Taiwan''s hospital accreditation system has gradually emphasize the patient-centered content, but not pay attention to hospital staffs’ interests and their rights.
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