醫院病房區清潔外包管理方式對外包績效影響之探討 -- 以北部地區 六家醫學中心為例
Effectiveness of Outsourcing Management Style in Hospital
Housekeeping─Example of Six Medical Centers in Northern Taiwan
中文摘要
本研究目的是瞭解北部地區六家醫學中心病房清潔外包之原因、負責監督之部門 及採購方式，並探討醫院清潔外包之病房護理主管管理風格，使用單位、監督單 位及外包商主管的管理方式與外包績效之差異及影響。
以北部地區三家公立和三家財團法人共六家醫學中心的病房護理主管為研究對 象，利用問卷調查研究方式，依據六家醫學中心所提供有清潔外包之病房數，
共發出257 份問卷給病房護理主管填寫，回收 222 份，回收率為 86.38%。另外 再輔以訪談法瞭解醫院之監督單位和外包商主管之管理方式。主要研究結果如下 1.財團法人醫院護理主管同意採取民主式的管理風格程度高於公立醫院。
2.公立與財團法人醫院外包管理方式中唯監督單位主管採取「監督過程」有差異 外，其餘均無差異。
3.公立或財團法人醫院主管的外包績效無差異。
4.公立或財團法人醫院主管的管理風格與外包管理方式均無相關。
5.公立醫院護理主管的管理風格與外包績效呈正相關，財團法人醫院則無相關。
6.公立醫院使用單位護理主管所採取的外包管理方式中「監督結果」、「控制誘 因」，監督單位主管之「監督過程」、「監督結果」和外包商主管之「監督過程」、
「監督結果」、「控制處罰」與外包績效呈正相關。經控制病房護理主管之管理外包
人員經驗因素之後，外包商主管採用之「監督過程」、「監督結果」對外包品質有 正面影響，而採取「監督過程」、「監督結果」和「控制處罰」則對工作時效有正面 影響。
7.財團法人醫院使用單位護理主管所採取的外包管理方式中「監督過程」、「監督 結果」、「控制誘因」、「控制處罰」，監督單位主管之「監督過程」、「監督結果」和 外包商主管之「監督過程」、「監督結果」、「控制誘因」、「控制處罰」與外包績效呈 正相關。經多變項分析後使用單位護理主管採用之「監督過程」和外包商主管採 用之「監督結果」、「控制處罰」對外包「品質」有正面影響，但監督單位主管採用 之「監督結果」對外包「品質」卻有負面影響。外包商主管採用之「監督過程」和
「監督結果」對「工作時效」有正面影響。
本研究建議醫院若考慮病房清潔外包，在簽訂合約之前必須謹慎的選擇外包商，
由過去的履約實績對其管理經驗先做瞭解和評估，如果外包商主管的管理方式 是採用「監督過程」和「監督結果」並適當的加以「控制處罰」，對清潔外包的「品 質」和「工作時效」會有較佳的表現。對於清潔外包的使用單位而言，則建議必須 配合監督合約執行的過程，病房才會有好的清潔外包績效。
英文摘要
The purpose of this study was to explore the relationship between outsourcing
contract style, management style of head nurses and the effectiveness of housekeeping outsourcing in six medical centers in northern Taiwan.
Six medical centers, including 3 public and 3 not-for-profit hospitals in northern Taiwan were included in this study. A questionnaire was sent to 257 head nurses in the six hospitals. There were 222 questionnaire completed. The return rate was 86.38%. Additionally, the researcher also interviewed monitoring unit managers of the six hospitals and the on-site managers of the outsourcing companies to understand their management style.
The main results of this study were as follows:
1. The head nurses in the not-for-profit hospitals, compared with the head nurses in the public hospitals, had significant preference for using a democratic management attitude.
2. The only difference of housekeeping outsourcing management style between the public and not-for-profit hospitals, was “process monitoring” of the monitoring unit.
3. There was no difference in the performance of housekeeping outsourcing in either the public or not-for-profit hospitals.
4. There was no correlation between the outsourcing management styles and the management attitudes of head nurses in either the public or not-for-profit hospitals.
5. There was a positive correlation between the performance of outsourcing and the management attitudes of head nurses in the public hospitals. There was no similar results found in the not-for-profit hospitals.
6. In the public hospitals, there were significant positive relationship between the
“process monitoring ”、“outcome monitoring” of on-site managers and the quality of housekeeping outsourcing. There were also significant positive relationship between the “process monitoring”、“outcome monitoring” and “using punishment for command” of on-site managers and work effectiveness.
7. In the not-for-profit hospitals, there were significant difference between the
“process monitoring” of head nurses and the quality of housekeeping outsourcing.
There were significant difference between the “outcome monitoring”、“using punishment for command” of on-site managers and the quality of housekeeping outsourcing . There were significant difference between the “outcome monitoring” of monitoring unit managers and the quality of housekeeping outsourcing. There were also significant difference between the “process monitoring”、“outcome
monitoring” of on-site managers and work effectiveness.
This study suggests that either public or private hospitals, should carefully choose housekeeping outsourcing company. The hospital management should understand and
evaluate management experience of the outsourcing company before signing an outsourcing contract. When appropriate “process monitoring”, “outcome monitoring”, and “using punishment for command” adopted by the outsourcing company, the job performance quality and effectiveness of housekeeping will be better. If the nursing unit participates the “process monitoring”, the housekeeping performance will be better also.
