| Summary: | 碩士 === 中國醫藥大學 === 醫務管理學研究所碩士班 === 94 === Because of the financial deflation of the National Health Insurance, the BNHI (Bureau of National Health Insurance) started to implement the global budget payment system to curb the growth of medical expenses and balance the financial deficiency, on July 1, 2002. It made the financial decrease of the hospital income continuously. In addition, the reduction of the insurance pay of drug, the profit of hospital management was deflated severely. For the disadvantaged minority relatively, the survival of the public hospitals is more critical.
The Department of Health (DOH) pays much attention to the quality of medical care (the business process perspective), the relationship of physician-patient (the customer perspective), the quality of the education and study (the growth and learning perspective). So, the DOH makes the use of hospital accreditation to push all hospital to respect the three perspectives. However, this will increase the cost of hospital finance. The balanced scorecard approach provides a clear prescription as to what companies should measure in order to ''balance'' the financial perspective. It will be a perfect system for the hospital manager to look for the balance point of the four perspectives.
By the change of the system of the case hospital, the superintendent introduced the map strategy and balanced scored into the hospital for the management of strategy and the recreation of the organization. I attend the whole process and study how to push the map strategy and balanced scorecard from the corporate level to the department level. By the learning group, all members knew what strategy map and balanced scorecard was, and set the vision and mission of the surgical department. By the structural analysis, the theory of strategy was developed. The strategy map and balanced scorecard was set up.
The successful experience of applying BSC at the surgical department of studied hospital relied on the strong support the leader of the hospital, the learning experience of the director of the department, the team work of the project, learning-type department, communication of training and information, setting the BSC based on the vision and strategy. By learning and growth, the professional ability was strengthened, then the internal process was improved, the cost was decreased, the service quality was improved and the patient’s satisfaction is elevated. At last, the performance of the surgical department developed.
The straits faced by the surgical department included how to distinguish the short-term and long-term objectives when setting the measurement and some action plans could not be completed by the deparment alone.
The strategy map and balanced scorecard is not only a static card, but a dynamic one as the cycle of PDCA (plan, do, check, action). The constitution, execution, check, alignment, re-execution and recheck of strategy is a continuous cycle. The hospital becomes the learning-type organization by the growth and learning perspective to increase the knowledge capital assets and enhance the core ability. The financial growth from the cultural change is slow. The strategy map and balanced scorecard is an instrument of strategic management. There is a common language of the team with good communication, just as the human neurological system. The strategy indicates the right direction and the measures and action plans express “doing the thing right’. The organization can generate the effect of fly wheel and be from good to excellent.
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