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運用平衡計分卡改善醫院附設護理之家營運績效之個案研究

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2004 1 10 pair-t independent-t Wilcoxon

1. 1

p< .05 2 2003 3

p< .05 2. 1

2 3.

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Balanced Scorecard 1990 Robert Kaplan David Norton

strategic business unit, SBU

Kaplan & Norton, 1996 1998 2004 2004 2003 2000 2003 2004 2004 2002 2002 2003

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2 0 0 4 2002 2002 2003 2002 2004 2 0 0 4 2002 2002 2002 2003 2002 1 9 9 9 76.9% 64.1% 61.5% 51.3% 38.5% 25.6% 20.5% 2004 1. 28 2. 20 3 6 2004 1 2004 10 1998; Carr & Kazanowski, 1994; Muller & McCloskey, 1990; Robertson & Cummings, 1991

1. 2. 3 . 4. 5. 6. 7. 8.

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9 . 10. 11. 11 C V I 0.86 Likert scale 45 Cronbach's .87 Likert scale 31 Cronbach's .89 1. 2. / 3. 1. 2002 TQIP 1 / 2 72 a. / b. / c.

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/ 3 / 2. / 1. 1. / SWOT SPSS11.0 paired-t Wilcoxon -Mann-Whitney U test 1. 32 28 28 26 2 1 77.8% 66.7% 47.6% 52.4% 20-30 71.5% 61.9% 76.2% 1-2 71.4% 3 76.2% 9.5%

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2. 53 53 1 2 4 1 41 41 32 36 7 6 . 6 % 61.1% 80.6% 41-60 61.0% 88.9% 52.7% 63.9% 44.4% 36.1% 30.6% 2-3 25% 3. 36 58.3% 77.5 81 55.5% 49.9% 61.0% 50% 36.6 25-36 27.8% 4 91.7% 3 8.3% 88.9% 16 ᐒᄬ௃ნϩ݋! ׎ԋ฼ౣ! ׎ԋ٬ڮϷᜫඳ! ԋࣁᓬ፦୍ܺϷന٫ڂጄ ϐߏྣᐒᄬ! ଄୍ᄬय़ǹࣁΑ଄୍ԋфǴךॺᔈӵՖ߄౜ǻ ฼ౣЬᚒ! ฼ౣҞޑ Չ୏Бਢ! ᕮਏࡰ኱! ¾ फ़ ե ԋ ҁ฼ౣ ¾ Չ ᎍ ฼ ౣ! ቚуᔼԏǴ फ़եԋҁǴ ബ೷଄୍ᕮ ਏǶ! ¾ ׯ௦໣ύ୔ ୱྣៈ! ¾ уமଣϣѦ Չᎍ! ¾ ѳ֡؂ ׉؂Д ԋҁ! ៝࠼ᄬय़ǺࣁΑၲډᜫඳǴךॺჹ៝࠼ᔈ ӵՖ߄౜ǻ!! ฼ౣЬᚒ! ฼ౣҞޑ! Չ୏Бਢ! ᕮਏࡰ኱! ¾Γ ܄ ᜢ ᚶ฼ౣ! ගϲྣៈࠔ ፦Ǵቚу៝ ࠼ᅈཀࡋǶ! ¾ ཥቚӭϡϯ ࢲ୏೛ी! ¾ ཥቚ࡚ບՐ ଣྣៈ୍ܺ! ¾ ཥቚ؂Вᙴ ৣْ܊ڋࡋ! ¾ ៈ౛ϐ ৎ୍ܺ ᅈཀࡋ! ϣ೽ࢬำᄬय़ǺࣁΑᅈى៝࠼Ǵব٤ࢬำѸ ໪߄౜ڑຫǻ! ฼ౣЬᚒ! ฼ౣҞޑ! Չ୏Бਢ! ᕮਏࡰ኱! ¾ ࠔ፦฼ ౣ! ¾ ࢬำׯ ๓฼ౣ! ׯ๓୍ܺ ࢬำǴගϲ ྣៈࠔ፦Ƕ ¾ ຾Չߏය ྣៈࡰ኱ ᅱෳϷࠔ ፦ׯ๓௛ ࡼ! ¾ ׯ๓ፁ׷ ᆅ౛ࢬำ! ¾ ᓸየᗺ౰Չ ౗! ¾ གࢉวғ౗ ¾ ߚीฝ܄ᙯ Ր࡚܄ੰ܊ К౗! ¾ 䉆׷ᅅ஦౗ Ꮲಞᆶԋߏᄬय़ǺࣁΑၲډᜫඳǴךॺӵՖ ᆢ࡭ׯᡂکׯ຾ޑૈΚǻ! ฼ౣЬᚒ! ฼ౣҞޑ! Չ୏Бਢ! ᕮਏࡰ኱! ¾ ޕ᛽ᆅ ౛! ቚம঩πྣ ៈૈΚǴᔼ ೷஑཰ྣៈ ׎ຝǶ! ¾ Ӽ௨঩π ӧᙍ௲ػ! ¾ ڋۓמೌ ኱ྗೕጄ! ¾ ঩ππբ ᅈཀࡋ! ¾ ঩πᚆᙍ ౗! ¾ ྣៈמૈ ҅ዴ౗!

Kaplan, R. S., & Norton, D. P. (1996). The Balanced Scorecard: Translating strategy into action. Boston Massachusetts: Harvard Business School Press.

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11.1% 41.6% 13.9% 5 44.4% 8 -9 36.2% 27.8% 17.1 50.0% 20% 1. 1 84.19 SD=5.51 89.38 SD=6.93 p< .05 ቚம҅ዴ ྣៈמૈ ٬ڮ.!ගٮԴޣϷѨૈޣᓬ፦ޑВதғࢲྣៈǴගܹғࢲࠔ፦Ƕගٮќ΋ঁॶளߞᒘૼ бྕཪޑৎǶ! ! ᜫඳ.!ԋࣁᓬ፦୍ܺϷന٫ڂጄϐߏයྣៈᐒᄬǶ! ଄୍ᄬय़ ៝࠼ᄬय़ फ़եᔼၮ ԋҁ ϣ೽ࢬำᄬ य़ ୺Չߏྣ ࠔ፦ᅱෳ ׯ๓ፁ׷ ᆅ౛ࢬำ Ꮲಞᆶԋߏ ᄬय़ ගٮ঩π ௲ػ૽ግ ڋۓៈ౛ מೌ኱ྗ ໣ύ୔ୱ ྣ៝ ቚу᏾ᡏᔼ ԏ ගٮᅈཀܺ ୍ ගٮ؂Вᙴ ৣْ܊ڋࡋ ჴࡼࠔ፦ ׯ๓௛ࡼ уமଣϣѦ Չᎍ ڋۓགࢉ ᆅڋ኱ྗ ගٮ࡚ບ ࡭ុྣៈ ගٮӭϡϯ ࢲ୏!

Kaplan, R.S., & Norton, D.P. 2001 ARC 2001

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Wilcoxon p< .05 p< .05 2 2003 57.1% 2004 1-10 3 2 . 1 % 2 5 % 3 95 ٬ڮ „ ගٮԴޣϷѨૈޣᓬ፦ޑВதғࢲྣៈǴගܹғࢲࠔ፦Ƕ „ගٮќ΋ঁॶளߞᒘૼбޑৎǶ ᜫඳ „ ԋࣁᕮᓬ୍ܺϷന٫ڂጄϐߏයྣៈᐒᄬǶ ਡЈሽॶᢀ „ аࠔ፦ബ೷Γ܄ϯᓬ፦୍ܺǶ ߏයҞ኱ „ ᅈཀޑ঩πǴᅈཀޑ៝࠼Ǵԋࣁӄ୯ៈ౛ϐৎ኱ंᐒᄬǶ ύයҞ኱ „ ៈ౛ϐৎೖࢗϷຑ᠘ᓬ฻Ƕ อයҞ኱ „ คဂᆫགࢉ٣ҹวғǶ ᄬय़ ฼ౣЬᚒ ฼ౣҞ኱ Չ୏Бਢ ᕮਏࡰ኱ Ҟ኱ॶ ჴࡼ߻93.1-3. ჴࡼύ93.4-7. 93.8-10.ჴࡼࡕ ঩ππբᅈཀࡋᕴϩ ኱ྗϯϩኧ(%) >75% 84.19 72.5% -89.38 77.0% ঩πᚆᙍ౗(%) <50 57.1 - 32.1 ਻Ϫៈ౛ዽਡ >95 98.29 - 100.00 ᙌيמೌዽਡ >95 93.45 - 97.71 ܜ࿀מೌዽਡ >95 95.82 - 98.80 Ꮲಞᆶԋߏ ᄬय़ „ ޕ᛽ᆅ౛฼ౣ ቚம঩πྣៈૈΚǴᔼ೷஑ ཰ྣៈ׎ຝǶ 1.Ӽ௨ៈ౛Γ঩Ϸ՘౛঩ϐ ӧᙍ૽ግǶ 2.ڋۓӚ໨מೌ኱ྗೕጄϷ ዽਡ߄Ƕ 3.уமמೌᄽግǴቚம҅ዴ ྣៈמૈǶ ཮഍మࢱዽਡ >95 93.29 - 99.31 Πڥ֎ၰགࢉวғ౗ <0.11 0.05 0.14 0.26 ݜֿၰགࢉวғ౗ <0.16 0.13 0.29 0.17 ϣ೽ࢬำᄬ य़ „ ࠔ፦฼ౣ„ ࢬำׯ๓ ฼ౣ ׯ๓୍ܺࢬ ำǴගϲྣៈ ࠔ፦Ƕ 1.ڋۓགࢉᆅڋ኱ྗೕጄǶ 2.຾Չߏයྣៈϖ໨ࡰ኱ᅱ ෳǶ ဉगၰགࢉวғ౗ <0.03 0.00 0.00 0.00 ߚीฝ܄ᙯՐ࡚܄ੰ܊ К౗ <5.81 14.18 18.38 23.30 ᓸየᗺ౰Չ౗ <10.69 7.27 7.83 10.40 3.ჴࡼࠔ፦ׯ๓௛ࡼǶ 4.୺Չࠔᆅ୮ࢲ୏Ǵׯ๓ፁ ׷ᆅ౛ࢬำǶ ፁ׷ᅅ஦౗ <2.00 4.03 0.93 0.53 ៝࠼ᄬय़ „ Γ܄ϯᜢ ᚶ฼ౣ ග ϲ ྣ ៈ ࠔ ፦Ǵቚу៝࠼ ᅈཀࡋǶ 1.ཥቚӭϡϯҶ໕ࢲ୏Ƕ 2.ཥቚ࡚ບ൩ᙴ࡭ុྣៈ ୍ܺǶ 3.ཥቚ؂Вᙴৣْ܊ڋࡋ ៈ౛ϐৎ୍ܺᅈཀࡋᕴ ϩ ኱ྗϯϩኧ(%) ᏾ᡏ୍ܺᅈཀࡋளϩ 118 >72% >83 113.22 69.0% 81.69 -120.19 73.3% 83.51 ଄୍ᄬय़ „ फ़եԋҁ ฼ౣ „ Չᎍ฼ౣ ቚуᔼԏǴफ़ եԋҁǴബ೷ ଄୍ᕮਏǶ 1.ׯ௦໣ύ୔ୱྣៈǶ 2.уமଣϣѦՉᎍϷрଣ ྗഢ୍ܺǶ ѳ֡؂׉؂Дԋҁ(ϡ) <28,500 (È5%) 30,000 28,300 27,800

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p< .05 2. 1 0% 2 ?????? )X ? W.f@)g?O)Xg? ?W&Hf@YO)X?@@@@@)g? ?75??@@@@@@@)?hf? J(Y?e?@e?@H?hf? ?W.Yf?@e?@hg? ?.Y?@?@@@@@@@@@@hf??J5?hf?O)Xg??7H??@@@@@@@?@@@@@@)g?J@e?@f?@f?@h? ?W&@e?@f?@f?@h? W.Y@e?@@@@@@@f?@h?

.Y?@e?@M?@?g?@h??@g@??O)Xe?@h??@?@@@@@@@@@@)e?@h??@?N@?e@?g?@h??@?J@?e@?eO)X??@h??@?7@@@@@@@@@@)??@h??@?@M?e@?g?@h??@g@?g?@h??@g@?e?@@@@5h??@hf?I(Yh????????? 3.5% 3. 113.22 SD=13.73 120.19 SD=17.84 pair-t p< .05 4. 30,000 27,800 2,200 1. ᡂ໨Ӝᆀ Γኧ ԭϩК ᡂ໨Ӝᆀ Γኧ ԭϩК ᙍᆀ πբԃၗ ៈ౛Γ঩ 7 33.3 1ԃаΠ 1 4.8 ྣ୍៝ܺ঩ 14 66.7 1-2ԃ 15 71.4 ୯ᝤ 3-4ԃ 1 4.8 ҁ୯ 10 47.6 5ԃа΢ 4 19.0 Ѧ୯ 11 52.4 ᖏ׉࣬ᜢԃၗ ԃស ค 4 19.0 21-30ྃ 15 71.5 1ԃаΠ 6 28.6 31-40ྃ 2 9.5 1-2ԃ 6 28.6 41-50ྃ 2 9.5 3-4ԃ 2 9.4 51ྃа΢ 2 9.5 5ԃа΢ 3 14.4 ஆ࠷ރݩ ӧᏢ຾অύ ςஆ 8 38.1 ࢂ 2 9.5 ҂ஆ 13 61.9 ց 19 90.5 ௲ػำࡋ ଯᙍаΠ 4 19.0 ஑ࣽ 16 76.2 εᏢ(֖)а΢ 1 4.8

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1 2002 2002 2003 Robertson Cummings 1991 2002 1998 Carr Kazanowski 1994 2002 Kaplan Norton ᡂ໨Ӝᆀ Γኧ ԭϩК ᡂ໨Ӝᆀ Γኧ ԭϩК ܄ձ ௲ػำࡋ ت 14 38.9 λᏢаΠ 3 8.4 ζ 22 61.1 ଯύᙍ 14 38.9 يϩ ε஑а΢ 19 52.7 Ր҇ଛଽ 2 5.6 ΕՐচӢ(ፄᒧ) Ր҇ηζ 29 80.6 ৎύલЮΓЋྣ៝ 23 63.9 Ր҇Р҆ 2 5.6 ᏼЈੰ௃ᡂϯଌᙴόߡ 16 44.4 Րܻ҇϶ 1 2.8 ৎឦલЮྣ៝ૈΚ 5 13.9 ځд 2 5.6 ۚৎᕉნคݤִ๓Ӽ࿼ 13 36.1 ԃស ৎՐୃᇻ܈ଯኴ 6 16.7 21-40ྃ 8 22.3 ځд 2 5.6 41-60ྃ 22 61.0 ৎΓ௖ຎᓎ౗ 61ྃа΢ 6 16.7 ؂Ϻ 7 19.4 ஆ࠷ރݩ 2-3Ϻ΋ԛ 9 25.0 ςஆ 32 88.9 4-5Ϻ΋ԛ 6 16.7 ҂ஆ 3 8.3 ΋ຼ΋ԛ 11 30.6 ៨܈ჲ 1 2.8 Βຼ΋ԛ 3 8.3

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ᡂ໨ Γኧ ԭϩК ѳ֡ॶ ᡂ໨ Γኧ ԭϩК ѳ֡ॶ ܄ձ ࢲ୏٩ᒘำࡋ(ЃМໆ߄) ت 15 41.7 ֹӄ٩ᒘ 0-20 32 88.9 ζ 21 58.3 ᝄख़٩ᒘ 21-60 4 11.1 ԃស 77.5 ᆅၡ 60ྃаΠ 4 11.2 ค 5 13.9 61-80ྃ 12 33.3 1ᅿ 11 30.6 81а΢ 20 55.5 2ᅿ 15 41.6 ௲ػำࡋ 3ᅿ 5 13.9 λᏢаΠ 18 49.9 ၸѐੰў ଯύᙍ 6 16.7 ค 0 0.0 ε஑а΢ 12 33.4 1-2ᅿ 9 25.0 ΕՐ߻ۚՐރݩ 3-4ᅿ 11 30.6 ᐱۚ 2 5.6 5ᅿ(֖)а΢ 16 44.4 ᆶଛଽՐ 5 13.9 ߈ΒঁД࡚ບ൩ᙴԛኧ ᆶηζՐ 22 61.0 0ԛ 23 63.8 ᆶଛଽηζՐ 5 13.9 1-2 ԛ 9 25.0 ځд 2 5.6 3-5ԛ 4 11.2 Րٰ҇ྍ ߈ΒঁД࡚܄Րଣԛኧ ҁଣ 9 25.0 0ԛ 26 72.2 дଣ 18 50.0 1ԛ 7 19.4 ӼᎦៈύЈ 1 2.8 2ԛ 3 8.4 ৎύ 8 22.2 ߈ΒঁД࡚܄ՐଣϺኧ (n=10) 17.1 ΕՐਔ໔(Д) 36.6 1-10Ϻ 2 20.0 12ঁДаϣ 1 2.8 11-20 Ϻ 4 40.0 13-24ঁД 9 25.0 21-30Ϻ 4 40.0 25-36ঁД 10 27.8 ߈ΒঁД࡚܄Րଣບᘐ 37-48ঁД 7 19.4 ޤݹ 5 50.0 4ԃа΢ 9 25.0 ֿၰགࢉ 2 20.0 ࢒Мໆ߄ ځд 3 30.0 3ભ 3 8.3 4ભ 33 91.7

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߻ෳ ࡕෳ ᡂ໨ ѳ֡ॶ ኱ྗৡ ѳ֡ॶ ኱ྗৡ Z p ᕴϩ 84.19 5.51 89.38 6.93 -2.42 .015* ѳ֡ 2.90 0.19 3.08 0.23 ᕉნ೛ഢБय़ 6.00 0.77 6.62 0.97 -2.47 .014* πբᕉნޑӼӄ௛ࡼԖߥም 3.00 0.32 3.29 0.56 ᙴଣගٮޑҔނک೛ഢ಄ӝπբሡा 3.00 0.55 3.33 0.48 ஑཰ᇡӕБय़ 18.33 1.68 19.14 2.37 -1.15 .250 Ҟ߻πբޑᛙۓ܄ 2.84 0.69 3.05 0.52 ૈ׫ΕϷୖᆶߏයྣៈπբ 3.10 0.30 3.24 0.44 ྣ៝πբೢҺޑा؃ 3.14 0.36 3.19 0.51 ૈඓඝϷയҺπբ 2.95 0.50 3.29 0.46 Ր҇Ϸৎឦჹךޑ஑཰൧ख़ϷߞҺ 3.14 0.36 3.29 0.46 ᆶՐ҇Ϸৎឦ࣬ೀӝᒋᑼࢳ 3.19 0.40 3.38 0.50 ௨੤ϷπբໆБय़ 10.38 1.91 11.57 1.33 -1.88 .060 ؂Д௨੤ޑϦѳ܄ 2.76 0.44 2.95 0.50 πբϩଛޑӝ౛܄ 2.75 0.55 3.05 0.39 πբϩଛޑϦѳ܄ 2.70 0.57 2.95 0.40 Ҟ߻πբໆޑॄ಻ำࡋ 2.43 0.60 2.67 0.58 ӕᏆᜢ߯Бय़ 5.71 0.72 6.14 0.57 -2.07 .038* ӕ٣໔ӝբᆶᔅԆ 2.90 0.30 3.10 0.30 ӕ٣໔࣬ϕ൧ख़ 2.81 0.51 3.05 0.38 ሦᏤ಍໲Бय़ 11.09 1.22 12.29 1.71 -2.23 .026* ჹܭЬᆅ๏ϒךޑπբࡰᏤ 2.90 0.30 3.10 0.44 ჹܭЬᆅૈڐշךှ،ୢᚒ 2.48 0.68 3.05 0.38 ჹܭЬᆅૈௗڙךޑཀـ 2.76 0.54 3.05 0.50 Ьᆅჹךؼӳπբ߄౜๏ϒޭۓϷႴᓰ 2.95 0.22 3.10 0.54 ،฼ୖᆶБय़ 9.00 0.00 9.38 1.12 -1.48 .139 ୖᆶՐ҇ྣៈࠔ፦ޑೕჄ 3.00 0.00 3.10 0.44 ୖᆶੰ܊ୢᚒှ،ޑ૸ፕ 3.00 0.00 3.10 0.44 ೏௤៾ॄೢੰ܊ࢌ໨཰୍ 3.00 0.00 3.19 0.40 ૽ግϲᎂБय़ 14.67 1.80 15.52 2.14 -1.37 .171 ᙴଣϷൂՏගٮޑӧᙍ௲ػᐒ཮ 3.05 0.22 3.29 0.56 ӧᙍ௲ػૈᏢಞཥޕ᛽ 2.95 0.38 3.33 0.58 ӧᙍ௲ػૈගܹπբמૈ 2.95 0.51 3.15 0.49 ϲᎂڋࡋޑϦѳ܄ 3.00 0.00 3.00 0.32 ϲᎂڋࡋޑӝ౛܄ 3.00 0.00 3.05 0.23 ᖒၗዛᓰБय़ 9.00 0.95 8.71 1.23 1.20 .232 Ҟ߻ᖒၗᆶځдӕભᙴଣ࣬Кၨ 3.00 0.32 2.90 0.44 ᙴଣගٮޑӚ໨ᅽճ௛ࡼ 3.00 0.32 2.90 0.54 ᙴଣޑዛᓰڋࡋ 3.00 0.32 2.90 0.54 ! . *p< .05

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1996 p< .05 2003 2002 2 20%-30% 2003 2 % 4 % - 1 9 6 % 7 8 % Cohen-Mansfield, 1997; Harring-ton 2003 2003 29% ྣ୍៝ܺ঩(n=14) ៈ౛Γ঩(n=7) ᡂ໨ ѳ֡ॶ ኱ྗৡ ѳ֡ॶ ኱ྗৡ Z p ᕴϩ 92.63 7.23 86.86 5.24 -1.35 .177 ѳ֡ 3.13 0.26 3.00 0.18 ᕉნ೛ഢБय़ 6.86 0.95 6.14 0.90 -1.68 .093 ஑཰ᇡӕБय़ 19.07 2.43 19.28 2.43 -0.15 .879 ௨੤ϷπբໆБय़ 12.07 0.92 10.57 1.51 -2.28 .023* ӕᏆᜢ߯Бय़ 6.14 0.66 6.14 0.38 -0.27 .785 ሦᏤ಍໲Бय़ 12.42 1.95 12.00 1.15 -0.61 .543 ،฼ୖᆶБय़ 9.50 1.34 9.14 0.38 -0.52 .607 ૽ግϲᎂБय़ 15.50 2.21 15.57 2.15 -0.52 .607 ᖒၗዛᓰБय़ 9.07 1.07 8.00 1.29 -2.00 .045* . *p< .05 **p< .01 ***p< .001

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߻ෳ ࡕෳ ᡂ໨ ѳ֡ॶ ኱ྗৡ ѳ֡ॶ ኱ྗৡ t p ᕴک 113.22 13.73 120.19 17.84 3.18 .003** ѳ֡ 2.76 0.33 2.93 0.44 ᕉნ೛ࡼБय़ 28.81 4.47 31.50 4.41 4.77 .000*** 1ޜፓྕࡋ፾ύ 2.97 0.45 3.17 0.45 2Ӏጕܴߝࡋ፾ύ 3.11 0.32 3.25 0.44 3਼਻܈ܜ࿀೛ഢሸӄଳృ 3.09 0.28 3.23 0.43 4᏾ᡏᕉნమዅ 3.14 0.42 3.25 0.44 5ᕉნӼӄ܄ 3.12 0.42 3.29 0.46 6׉ൂǵ೏ൂ܈Պܺܭሡाਔૈᒿਔ׳ඤ 3.06 0.41 3.22 0.48 7׉ൂǵ೏ൂ܈Պܺమዅ๤፾ 2.97 0.45 3.22 0.42 8ВதৎႝҔࠔ٬ҔБߡ 2.97 0.49 3.18 0.46 9Ҷ໕Ϸൺ଼೛ࡼ٬ҔӼӄϷБߡ܄ 3.00 0.49 3.12 0.55 10ੰ࠻ϣ׉Տޜ໔ёᆢៈঁΓᗦد 3.06 0.33 3.19 0.40 ୍ܺᄊࡋϷמૈБय़ 34.06 4.74 35.22 7.23 1.205 .236 1ៈ౛Γ঩ޑ୍ܺᄊࡋᒃϪک๓ǴૈЬ୏ᜢᚶ 3.08 0.37 3.25 0.50 2ៈ౛Γ঩ޑៈ౛מೌᏹբዕግ 3.11 0.40 3.22 0.48 3ៈ౛Γ঩ගٮޑ଼நࡰᏤ 3.06 0.51 3.24 0.56 4ྣ୍៝ܺ঩୍ܺᄊࡋᒃϪک๓ǴૈЬ୏ᜢᚶ 3.08 0.44 3.19 0.58 5ྣ୍៝ܺ঩ޑמೌᏹբዕግ 3.11 0.40 3.20 0.53 6Ѧᝤྣ୍៝ܺ঩ޑᇟقྎ೯ૈΚ 3.03 0.29 3.17 0.45 7ᙴৣۓਔ଑ບϷᙴᕍ୍ܺ 2.97 0.47 3.12 0.48 8ᔼᎦৣගٮޑ໯१ᔼᎦ୍ܺ 2.76 0.62 3.21 0.54 9ޗπৣගٮޑᜢᚶᆶڐշ 3.09 0.60 3.26 0.45 10ൺ଼ݯᕍৣගٮޑݯᕍࢲ୏ 2.97 0.49 3.04 0.43 11ᙍૈݯᕍৣගٮޑݯᕍࢲ୏ 2.89 0.46 2.93 0.47 12ځдՉࡹ٣୍Γ঩ޑ୍ܺᄊࡋᒃϪک๓ 3.06 0.24 3.20 0.47 13דπΓ঩ޑЬ୏ᜢᚶϷڐշ 3.06 0.24 3.14 0.49 ྣៈၸำБय़ 27.83 4.60 29.47 4.61 2.729 .010** 1฻ংៈ౛ϐৎ׉Տޑਔ໔ 3.03 0.39 3.09 0.39 2ᒤ౛ៈ౛ϐৎޑΕՐЋុ 3.09 0.37 3.18 0.39 3πբΓ঩ૈϷਔӣᔈாޑྣៈሡ؃ 2.92 0.55 3.11 0.52 4ྣ៝ύૈݙཀঁΓᗦد 3.03 0.38 3.19 0.40 5ྣ៝ύૈݙཀӼӄ 3.06 0.41 3.17 0.51 6Ь୏ගٮৎΓ߈ݩᡣךޕၰ 2.91 0.56 3.14 0.54 7ගٮߐບ൩ᙴਔޑڐշ 2.94 0.59 3.14 0.49 8ගٮᆙ࡚൩ᙴਔޑڐշ 3.06 0.35 3.18 0.39 9ගٮᙯՐ࡚܄ᙴଣය໔ޑᜢᚶڐշ 3.07 0.37 3.16 0.45 10ৎឦ০ፋ཮ૈкϩ߄ၲཀـ 3.00 0.50 3.11 0.50 ྣៈ่݀Бय़ 22.53 3.39 24.00 4.25 2.559 .015* 1يᡏమዅЪҜጥคઇཞ 3.06 0.23 3.14 0.49 2Ѥަᜢ࿯ࢲ୏ࡋቚу 3.03 0.38 3.21 0.41 3໯१ٮᔈૈᕇளى୼ᔼᎦ 3.08 0.28 3.22 0.48 4཮഍೽Ϸ־ިమዅค౦ښ 3.03 0.29 3.19 0.40 5ӢݜֿၰགࢉՐଣޑԛኧ෧Ͽ 3.04 0.43 3.20 0.48 6ӢޤݹՐଣޑԛኧ෧Ͽ 3.11 0.32 3.17 0.47 7ៈ౛ϐৎԖႽৎ΋ኬޑྕធ਻ݗ 3.11 0.40 3.25 0.50 8ቼғ཮ϷӚᅿ࿯ቼࢲ୏ૈቚ຾ᆶৎΓ௃ག 3.14 0.35 3.31 0.47 ᕴᡏ୍ܺᅈཀࡋ 81.69 9.12 83.51 7.70 1.702! .098

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2001 2004 3 2002 2002 2003 2. 1 Cohen-Mansfield, 1997; Needleman, et al., 2002 27.8% 50% 2003; Loeb, et al., 2000; Yoshikawa & Norman, 1996 2

1999

2002

3.

2002 2002 2002 2002 Kaplan & Norton, 1996

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2002 4. 27,800 2,200 2001 22 35,160 2002 35,000 1. 1999 32(2):48-56 2. 2003 49:20-2 3. 2001 6:223-32 4. 2004 7 2004 5. 2004 51:31-64 6. 2004

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48:71-90 7. 2002 8. 2003 23:79-89 9. 2000 10. 2003 -66:1-18 11. 1998 -155:28-38 12. 2002 11 -13. 2002 -14. 2004 51(1):70-6 15. 2002 16. 2003 17. 2002 18. 2003 39(11):76-9 19. 1998 32:29-45 20. 2004 3(2):110-21 21. 2002 19(1):53-63 22. 2002 19:207-28 23. 2003 4(1):11-21 24. 2004

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29:38-58 25. 2004 8(1):13-24 26. 2001 34(2):54-64 27. 2003

-28. Carr, K. K., & Kazanowski, M. K. (1994). Factors affecting job satisfaction of nurses who work in long-term care. Journal of Advanced Nursing, 19(5): 878-83.

29. Cohen-Mansfield, J. (1997). Turnover among nursing home staff. Nursing Management, 28(5):59-60, 62, 64. 30. Harrington, C., Meara, J. O., Collier, E.,

& Schnelle, J. F. (2003). Nursing indica-tors of quality in nursing homes. Journal of Gerontological Nursing, 29:10-4. 31. Kaplan, R. S., & Norton, D. P. (1996).

The Balanced Scorecard: Translating strategy into action. Boston Massachu-setts: Harvard Business School Press.

32. Kaplan, R.S., & Norton, D.P. 2001

ARC

2001 33. Loeb, M., McGeer, A., McArthur, M.,

Peeling, R. W., Petric, M., & Simor, A. E. (2000). Surveillance for outbreaks of respiratory tract infection in nursing homes. Canadian Medical Association Journal, 162(8):1133-7.

34. Muller, C. W., & McCloskey, J. C. (1990). Nurses' job satisfaction: a pro-posed measure. Nursing Research, 39(2):113-7.

35. Needleman, J., Nuerhaus, P., Mattke, S., Stewart, M., & Zelevinsky, K. (2002). Nurse-staffing levels and the quality of care in hospitals. The New England Journal of Medicine, 345(22):1715-23. 36. Robertson, J. F., & Cummings, C. C.

(1991). What makes long-term care nursing attractive? American Journal of Nursing, 91(11):41-6.

37. Yoshikawa, T. T., & Norman, D. C. (1996). Approach to fever and infection in the nursing home. Journal of the American Geriatrics Society, 44(1):74-82.

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Fu-Mei Lin, Meei-Show Lu, Ming-Chin Yang, Wen-Ta Chiu

As the population is aging rapidly, quality, cost-effectiveness, and cus-tomer satisfaction should be the goals that long-term care institutions strive for. Balanced scorecard is a strategic management tool to transform strategies into practice, to effectively implement strategies so as to meet organization s mis-sions. The study was designed to be an interventional study, applying balanced scorecard in hospital nursing home, to establish strategic objectives and perfor-mance indicators, improve the perforperfor-mance of nursing home, and compare the differences of each performance indicator after implementing balanced score-card. The sample is selected by convenient sampling. The study subjects were selected from some hospital nursing home in Taipei, consisting of employees, residents and their relatives. Study instruments include employee satisfaction questionnaire, customer satisfaction questionnaire for nursing home, nursing technique audit statistics, quality monitoring statistics, and monthly services re-ports. Data collection was done from January to October in 2004. We used de-scriptive statistics, pair-t test, independent-t test, and nonparametric Wilcoxon test for data analysis.

The results of this study are as follow: 1.Learning and growth perspective: (1)Employees satisfaction was improved, and the difference is statistically sig-nificant (p< .05). The highest score is on harmonious interaction with residents and their relatives whereas the lowest score is on current workload . (2)The

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personnel turnover rate decreased from 57.1% in 2004 to 32.1% in 2003. (3)The nursing care techniques accuracy improved, and the difference is statistically significant (p< .05). 2.Internal process perspective: (1)Nosocomial infection rate, pressure sore point prevalence, and the rate of unexpected transfers/dis-charges to acute inpatient care all experienced a slight increase. The reason may be due to the delay of recruiting new members after certain staff members quit their job. (2)The rate of missed billing of medical supplies was decreased. 3.Customer perspective: the satisfaction score of residents relatives for the nurs-ing home was improved, and the difference is statistically significant (p< .05). 4.Financial perspective: the cost per bed per month was decreased.

參考文獻

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