The Application of Competing Values Approach to the
Relationships in Organizational Culture、Leadership
Styles and Organizational Effectiveness in the Nursing
Department of Hospitals
林月桂(Yueh-Kuei Lin);盧美秀(Meei-Shiow Lu)
摘要本研究採橫斷面之調查研究。目的在以競值途徑理論來探討臺北市內、且經行政院衛生署八十五 至八十七年醫院評鑑及教學醫院評鑑為醫學中心、區域醫院與地區醫院之護理部門之組織文化、 領導型態與組織效能之關係。研究以方便選樣、且護理主任需於該醫院任該職一年以上之醫院始 得為樣本醫院，同時再以多層取樣以護理主任、護理長與護理人員為樣本。本研究參考多位學者 所使用之競值途徑理論評量工具與問卷修編而成之結構式問卷表為研究工具；問卷共發出 1993 份，回收之有效問卷 1794 份（有效問卷為 90.01%）。研究結果發現：醫院護理部門之組織文化、 領導型態與組織效能三者間有顯著相關；醫學中心、區域醫院及地區醫院之護理部門之組織文化 及組織效能有顯著差異，但其領導型態未有顯著差異；在競值途徑下，三家醫學中心之護理部門 之組織文化、領導型態及組織效能之契合狀態均為部分趨同部分趨異；十一家區域醫院中，有四 家呈現高度趨同、其餘七家呈現部分趨同部分趨異；十四家地區醫院中，有一家呈現高度趨同、 二家呈現高度趨異、其餘十一家呈現部分趨同部分趨異。本研究結果可提供護理管理者之參考， 並建議：護理行政者要瞭解自己部門之組織文化、並營造護理部門整體性之組織文化；護理領導 者要瞭解自己之領導型態，適當調整、配合或塑造組織文化，以提昇組織效能；加強各層護理主 管與部屬之溝通；適當採行留任措施，降低流動率；要加強新進人員之職前訓練，協助員工適應 新環境。
This study is a cross-sectional research on the relationship of organizational culture, leadership style and organizational effectiveness in the local and regional hospitals and medical centers assessed by Executive Yuan Department of Health from 1996 to 1998 in Taipei City. Hospitals are sampled by convenience and over the one-year duration of nursing directors. Multiple stratified sampling is used to select a nursing director, head nurse, and nursing staff as research sample. The tool of this study is
a revised structured questionnaires used by many experts as a method of evaluating competing value approach. 1,993 questionnaires were given out and 1,794 valid questionnaires were answered and returned (valid response rate: 90.01%). The results show significant correlation among organizational culture, leadership style, and organizational effectiveness in the nursing departments of the hospitals; significant difference in organizational culture and effectiveness among the nursing departments of the medical centers, regional hospitals and local hospitals. However, there is no significant difference in leadership style among the nursing departments. In competing value approach, the consistency status of organizational culture, leadership style, and organizational effectiveness in three medical centers tend toward similarities in some aspects and difference in others; while in eleven regional hospitals, four are highly to tend toward similarities and the other seven tend toward similarities in some aspects and difference in others, and in the fourteen local hospitals, one is highly to tend toward similarities, two are highly to tend toward difference and the other eleven tend toward similarities in some aspects and difference in others. All the above findings can serve as a reference for nursing managers. The results also suggest the nursing administrators should understand the organizational culture of their own departments and cultivate the organizational culture of the entire nursing department. The nursing leader should understand his or her own leadership style and adjust, coordinate or create organizational culture appropriately to promote organizational effectiveness; the communication between nursing executives and subordinate of all levels should be enhanced; maintaining personnel procedures should be taken properly to reduce the flow rate; pre-occupational training for new staff should be enforced to familiarize them with the hospital environment.