醫療業服務失誤與服務補救:關鍵時刻取向研究 邱炳翰、張景旭
E-mail: [email protected]
摘 要
醫療服務業隨著民眾對醫療依賴與日劇增，但病人對醫療不再是專業權威下順從、依賴的角色；早期在「醫療消費主義」
提倡下，具高度接觸特性醫療產業，醫護人員如何避免因接觸互動產生的負面情緒經驗，可能會是決定醫療服務成功與否 重要因素。 以往學者探討服務失誤，大多採用關鍵事件技術(Critical Incident Techniqu, CIT)方法，但因其縮減受訪者資料 訊息分析方法，無法展開還原服務歷程每一次互動「關鍵時刻」。本研究以張景旭提出的主觀順序事件技術(Subjective Sequential Incidents Techneque, 簡稱SSIT)，分析病患就醫服務經驗接觸互動的「關鍵時刻」，嘗試深入探討醫療門診服務 失誤的情境因素。 本研究依據十六個醫療門診生氣故事案例，建構醫療門診六階段主觀服務遞送藍圖，以及從生氣故事案 例發現五種類型的氣點。其中「情節元素氣點」存在於服務遞送階段情節狀況，具備前後關聯氣點的特性，作為服務失誤 歷程「關鍵時刻」連續性具體的支持者，同時也提供研究服務失誤歷程補救的思考概念。
關鍵詞 : 主觀順序事件技術(subjective sequential incidents technique)，服務失誤(service failure)，服務補救(service recovery)，
關鍵時刻(moment of truth)，主觀服務遞送藍圖(subjective service delivery blueprint) 目錄
內容目錄 中文摘要 ．．．．．．．．．．．．．．．．．．．．． iii 英文摘要 ．．．．．．．．．．．．．．．．
．．．．． iv 誌謝辭 ．．．．．．．．．．．．．．．．．．．．． vi 內容目錄 ．．．．．．．．．．．．．．
．．．．．．． vii 表目錄 ．．．．．．．．．．．．．．．．．．．．． ix 圖目錄 ．．．．．．．．．．．．
．．．．．．．．． x 第一章 緒論．．．．．．．．．．．．．．．．．．． 1 第一節 研究背景與動機．．
．．．．．．．．．． 1 第二節 研究目的．．．．．．．．．．．．．．． 3 第二章 文獻探討．．．．．．
．．．．．．．．．．． 4 第一節 服務失誤定義．．．．．．．．．．．．． 4 第二節 服務失誤類型分 類．．．．．．．．．．． 4 第三節 服務補救．．．．．．．．．．．．．．． 14 第四節 醫療服務補 救．．．．．．．．．．．．． 18 第五節 顧客經驗管理．．．．．．．．．．．．． 20 第六節 自覺控 制感．．．．．．．．．．．．．． 22 第七節 戲劇理論．．．．．．．．．．．．．．． 25 第八節 醫 病關係．．．．．．．．．．．．．．． 28 第九節 服務遞送藍圖關鍵時刻(MOT) ．．．．．． 29 第三章 研 究方法．．．．．．．．．．．．．．．．． 34 第一節 研究方法選擇．．．．．．．．．．．．． 34 第二 節 研究步驟圖．．．．．．．．．．．．．． 34 第三節 研究問題．．．．．．．．．．．．．．． 36 第四節 研究對象及資料蒐集．．．．．．．．．． 36 第五節 SSIT方法資料分析步驟．．．．．．．．． 37 第六節 SSIT方法分析原則．．．．．．．．．．． 40 第四章 研究分析與發現．．．．．．．．．．．．．
． 42 第一節 主觀服務遞送藍圖MOT氣點分類．．．．． 42 第二節 醫療門診階段、情節分析．．．．
．．．． 45 第三節 醫療門診主觀服務遞送藍圖．．．．．．． 56 第五章 結論與建議．．．．．．．．．．
．．．．．． 71 第一節 本研究主觀服務遞送藍圖與醫療文獻比較． 71 第二節 主觀服務遞送藍圖管理意 涵．．．．．．． 88 第三節 研究限制．．．．．．．．．．．．．．． 92 第四節 後續研究者建議．．
．．．．．．．．．． 93 參考文獻 ．．．．．．．．．．．．．．．．．．．．． 94 附錄A 個案SSIT分析表格．
．．．．．．．．．．．． 106 附錄B 個案階段聯集表．．．．．．．．．．．．．． 128 附錄C 階段聯集表(正 式表格)．．．．．．．．．．． 136
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