5 6 1 9 High Performance and Humanity

+ 5 6 1 + 9 高效能與人性化兼顧的醫務管理 High Performance and Humanity Management for Medical Care Chung - Sheng Lai 賴春生 3 8 + 7 1 6 1 5 5 1 7 2 M. D. , E. M. B. A. , Ph. D 高雄醫學大學附設醫院 E - Mail：chshla@kmu. edu. tw Phone： 07 -3121101轉7680 2007. 11. 19 3 7

Chung-Sheng 生產線管理 ( POM) Production and Operation Management l l Production = service，生產=服務 Technical approach：operational problems in a clinical fashion, quantitative , qualitative Humanistic approach：worker’s perspective, employee motivation, job satisfaction 5 + l 6 1 +

Chung-Sheng Frederick Taylor l Father of “scientific” approach for production management (Theory X) l Late 1800 ~ early 1900, steel worker l Job→ smaller tasks→ find the most efficient way (Job fractionalization) l Stopwatch→ time and motion studies→ find the “one right way” of doing things l Workers→ soldiers + 5 6 1 +

Chung-Sheng Elton Mayo l l Father of the “ human relations movement” of production management (Theory Y) 1927, Hawthorne Works of the Western Electric Company, emotional state vs. productivity. l Regardless of changes in lighting, worker productivity increased. (Hawthorne Effect) l During the experiment works were being treated better by their supervisors. + Intensity of light→ productivity 5 l 6 1 +

Chung-Sheng Theory X, Theory Y, and Theory Z u u u 1960, Douglas Mc. Gregor renamed Taylor’s scientific approach X theory, and Mayo’s behavioral approach Y theory. X theory：科學管理方法　　　　 性本惡，lazy workers, rewards and punishment Y theory：人際關係管理方法　　　　　　　　 性本善，self-motivated workers, consultation and responsibility Z theory：科學與人際關係管理方法　　　　　　 1980, William Ouchi, X+Y, Japanese management, workers+ management→ quality cycle, workers as partners of the business 5 + l 6 1 +

Chung-Sheng 醫務運行之問題解決架構 Problem Solving Framework for Operations issues Service- providing process： l 1. 服務能量(Capacity)： How much service can I provide? 2. 服務時程(Scheduling)： How and when am I going to do it? 3. 衛材庫存(Inventory)： How much inventory is there and how can I reduce it? 4. 品質標準(Standards)： What do I consider efficient production and quality output? 5. 流程管控(Control)： Is the production process working? 如何將人性化的考量融入高效能的服務流程中？ + 5 l 6 1 +

Chung-Sheng 服務時程(Scheduling) l l l How and when am I going to do it? Gantt chart：Late 1800, Henry Gantt, time sequence of production, high performance, “Mr. Scheduling. ” Critical Path Method (CPM)：sophisticated way of determining optimal scheduling, 適用於牽連多單位， 比較複雜的服務。 每項事件(event)完成所需的時間，先後次序的排定，在單 位時間內提供最有效率的服務。 例子：臨床路徑(Clinical Pathway) 門診 Day surgery 離院服務 5 術前檢查 術前、術中及術後作業環環連結，路徑便捷，節省三天住 院時間。 臨床路徑中之弱勢族群考量？ 1 + + l 麻醉照會 6 l

Chung-Sheng 服務時程的排隊理論 Queuing Theory to Schedule l l Queuing Theory：A queue is any line that either people or products wait in before they are serviced, it is a mathematical tool to make waiting lines more efficient. A (Arrivals)：每單位時間平均到客人數 S (service)：每單位時間每排平均服務人數 M (Mathematic)：可提供服務的排數 5 *使用率(Utilization)：U=A/SM *每單位時間等待人數W=到客總人數(A)-單位時間 服務總人數(SM) *等待時間(WT)=每位顧客服務所需時間×(排隊之 序號-1) + l 6 1 +

Chung-Sheng The Balance of Ordering and Holding Inventory The EOQ Graph + 5 6 1 +

Chung-Sheng 品質標準與管控 (Standards and control) l l Control：Is the production process working? 何謂quality? It only means that the product or service “meets the standards. ” 何謂high performance? It means that the product or service not only meets the standards, but also “exceeds the standards. ” 那麼標準在哪裡？ 績效指標，各級醫院評鑑準則 在嚴峻的評鑑管制下，醫療人員之人性考量在哪裡？ 5 l Standards：What do I consider efficient production and quality output? + l 6 1 +

Chung-Sheng Thank you for your Attention ！ + 5 6 1 +