| Summary: | 碩士 === 國立臺灣大學 === 高階公共管理組 === 94 === Organizational transformation is a challenging and difficult job. Effective leadership and good management tool are required for direction, team build-up and goal achievement. Under this highly competitively and variably environment, in order for an organization to survive and to achieve its mission, the leader not only must master the management but also must provide common language, vision and value to motivate people. Although healthcare industry is protected by government and less influenced by globalization, but its expense far exceed the Gross Domestic Product (GDP) due to aging of population, progress of technology, increasing expectation of people, continuous supply of medical professionals and opening of new hospitals. Our National Health Insurance (NHI) started 11 years ago, but faced financial difficulties in recent years. Under the Hospital Global Budget system, NHI shifted its tension to the hospital by critical audit and floating value of payment to control the budget disregarding how many services provided by hospital. All hospitals suffered the dilemma without good solution.
The medical supply in Yun-Lin County has been less under adequacy. The general health of the people is also ranked the last in whole Island. National Taiwan University was asked to set-up branch in both school and hospital. After National Taiwan University Hospital merged and acquired the Yun-Lin Hospital, the Department of Health, at April, 2004 to become its Yun-Lin branch, the people increased the expectation to this hospital greatly. But due to inadequate manpower, facility, and problems in cultural conglomeration, system and rule setup, the hospital required clear direction, vast investment and synchronized devotion from all staffs.
Balanced scorecard (BSC) and strategy map initiated by Kaplan and Norton since 1990 not only emphasized the idea of balance among finance, customer, process and growth and development perspectives, but also became a good tool for strategy management and communication. It met our situation and requirement. After learning the experiences from McKay Memorial Hospital in promoting the BSC and strategy map, and also lessons from executive MBA classes, we started to establish the strategy-focused organization in our hospital step by step, first by book reading of all staffs leaded and motivated by Superintendent. Following the vision establishment and analysis of the external and internal environments, the strategy and strategic goals were decided. The strategy map of whole hospital was then built. After we decided the measurement indicators, their value and goals, initiatives and responsible departments, BSC of the whole hospital was also built. Each department was asked to build their strategy map and BSC in association with hospital’s one and executed their initiatives hardly. Besides promoting the action in every meetings and publications, we held two main strategic management meetings each year. First one in March focused on evaluation of the results of previous year, while second one in September focused on planning for the coming two years. Strategy map and BSC were modified if necessary.
In less then two years period, the above actions are accomplished smoothly. We also achieve fairly good results and are approaching our vision. The features of our project are following: leading by Superintendent, gradual action thru same organizational structure, no linkage with performance evaluation initially and hence less resistance. After initial success, much still have to be done for the change be well-established and culture been embedded in every member of hospital. The key successful factors and obstacles to be avoided can also provide good reference for those who plan to execute the similar project. The experience gained from this study can also provide good reference for government which is promoting organizational change in public hospitals and other organization which is undergoing transformation.
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