Organizational Change on Culture, Quality Improvement, and StrategicManagement－A Longitudinal Case Study of a Government Hospital

• Main Authors: Hsiu-Ying Lin, 林秀櫻
• Other Authors: Jenshou Yang
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/02865458954271000694

碩士 === 國立雲林科技大學 === 企業管理系碩士班 === 95 === Because of the changing environment in society every industry, including the medical profession, should consider the call for change. Among these industries, the government hospitals in Taiwan have the most demanding situation because they are still governed by an out-of-date management system imposed by the government and superimposed on established routines within the organization, thus making change difficult. In the past the hospital routine did not have to concern itself with management. There was a plentiful financial supply from government sources but this is changing because of shortages in the government’s health budget. New budget restraints are forcing change, as is the competition from the large, private hospitals - usually founded by trusts or religious groups. In addition to the reasons mentioned above, a public perception of weakness in the management system of hospitals should impel managers of all government hospitals to think seriously of what changes are needed and how to implement them. The hospital chosen for this study was chosen because it has seen progressive achievements implemented by three main managers during the hospital development over the past 24 years. Among the hospitals regulated by the Department of Health, Taiwan, these managers have produced the highest net profit for every dollar spent. How this was achieved is part the study of this paper. Information was collected and dialogue held with staff members and a clear picture developed on the three stages of change that have been implemented. The three stages of change which were identified were: a change of culture, the change which included the concepts of total quality management and the change with balanced scorecards. Using the information gathered, the researcher compared the results, and then identified the unique difficulties of successful change implementation of new government hospital management procedures and the important considerations that must be made. In the final process of the study, the researcher made a comparison between this case study and the reviewed literature. The purpose of the study is to be a factor in raising awareness in the need for change and to develop new theories for the implementation of these changes. From this study there are four main conclusions： 1. For government hospital change, the manager must consider the existing culture within the hospital and develop an organizational structure as flat as possible, and also recognize that strong but flexible leadership is essential. 2. To create effective change in the healthcare system, participation of doctors is essential. The unique condition of health care and its relationship to the general public must also be taken into consideration. 3. Because routines have been in place for a long time then there will be resistance to change. The changes must be closely monitored and objections addressed, because the pattern of resistance will change as the organizational change keeps going forward. 4. Because the first stage of the hospital change provided the foundation for future changes in the culture. It helped to ensure that the subsequent stages of development operate more effectively and are implemented smoothly.