台灣實施全民健康保險後，醫療產業更加重視品質提升的議題。然而，鮮少文獻探討整體醫院之全面性品質的診斷之方法，研究往往侷限於功能性單位的流程最佳化。另一方面，雖然卓越經營被認為是檢視醫院全面品質與整體經營成效之方法，然而其所使用之評量指標並未針對醫院的特殊性訂定導致難在醫院中落實，而醫院最常使用之管理工具醫院評鑑卻往往耗費醫院大量資源與時間在準備評鑑而非改善品質。本研究目的為發展一個醫院卓越經營管理品質持續改善架構及配套方法，以Plan-Do-Check-Action的管理循環為基礎，不斷進行持續性地自主改善以強化醫院品質。其中，在規劃階段(Plan)確認醫院卓越經營導入之目標與願景，藉由短中長期各功能會議將卓越經營落實到醫院各單位；在執行階段(Do)以自評作業鎖定醫院需要強化的項目並發展自評作業所使用之醫院卓越經營評量基準與評量表；在檢查階段(Check)針對前述收斂之待強化項目以OEE的概念建立總體資源效益(Overall Resource Effectiveness, ORE)之評估指標並檢視資源效益是否達到要求之標準，並診斷資源損失；最後的改善階段(Action)進行標竿學習並制定改善方案，並回到規劃階段發展下期目標。另一方面，為了篩選醫院評鑑之重要指標，本研究以約略集合理論 (Rough Set Theory) 進行重要指標收斂以做為簡化醫院評鑑的依據，並整合卓越經營模式與醫院評鑑評量基準進而發展醫院卓越經營評量基準與評量表。最後以實證研究驗證醫院卓越經營管理品質持續改善架構，證實有助於醫院全面檢視經營績效並制定管理改善方案。

Since the policy of National Health Insurance Program in Taiwan limits the global budget between hospitals in Taiwan, hospitals forces to enhance the quality and optimize their resource efficiency. However, the previous studies focused on the functional process optimization instead of the quality level improvement of the overall hospital. Although Business Excellence is considered to be one of the approaches for measuring the total quality level and business performance of hospital, the indicators of Business Excellence are not entirely appropriate hospitals and also neither easy to practice. This study aims to develop a Business Excellence Framework of Hospital for Continuous Quality Improvement. In the planning part, identify the goals and visions of the hospital to practice in the functional sections; in the doing part, concentrate on enhancing the abilities of the key indicators by self-assessment with the Hospital Business Excellence Management Assessing Criteria and the evaluation form; in the checking part, build the Overall Resource Effectiveness to diagnose the resource losses; in the action part, make the actions by benchmarking and go back to the first planning part. In addition, this study aggregates the Business Excellence model and the Hospital Accreditation criteria to develop the Hospital Business Excellence Assessing Criteria and the evaluation form and screens the key indicators from Hospital Accreditation to be the necessary assessing indicators by Rough Set Theory for the doing part. The results have shown the practical viability of the proposed framework to drive collaborative efforts to enhance quality. This paper concludes with discussions on value propositions of proposed Business Excellence Framework of Hospital for Continuous Quality Improvement and future research directions.

中文
全民健康保險醫療費用協定委員會（2005），全民健康保險醫療費用總額支付制度問答輯。檢自：http://www.nhi.gov.tw/Resource/webdata/Attach_13636_2_8.2%EF%BC%9A%E7%B8%BD%E9%A1%8DQA%E6%89%8B%E5%86%8A%E7%AC%AC%E5%85%AD%E7%89%88%E5%90%AB94%E5%B9%B4.pdf，（2016年7月23日）
林雅萍（2017），談勞基法「一例一休」新上路對護理的衝擊與因應。慈濟護理雜誌，16卷1期，頁12-13。
洪欣妏、蕭宇伶、楊玫蓉、劉中賢、陳誠仁、嚴元鴻（2011），導入醫療團隊資源管理 (TRM) 對提升醫療品質效應初探-以某區域醫院住院病人滿意度為例。醫療品質雜誌，5卷3期，頁48-56。
財團法人中國生產力中心（2012），國家品質獎申請書範本。檢自：http://nqa.cpc.tw/NQA/Web/DownLoad/%E7%94%B3%E8%AB%8B%E6%9B%B8%E7%AF%84%E6%9C%AC%20101%E5%B9%B4.doc，（2014年9月5日）
財團法人中國生產力中心（2016），國家品質獎歷屆得獎名單。檢自：http://nqa.cpc.tw/NQA/Web/RF.aspx，（2016年7月22日）。
財團法人醫院評鑑暨醫療品質策進會（2012），衛生署新制醫院評鑑資訊。檢自：http://studentaffair.nuk.edu.tw/docs/dl.php?en=2012081508182238.xls&cn=%BD%C3%A5%CD%B8p%B7s%A8%EE%C2%E5%B0%7C%B5%FB%C5%B2%B8%EA%B0T，（2015年4月8日）
財團法人醫院評鑑暨醫療品質策進會（2015），104 年醫院評鑑基準及評量項目(草案) 。檢自：http://www.tjcha.org.tw/FrontStage/page.aspx?ID=587159B5-5C51-462E-B55F-AAAD755E3FAD&PID=088AB6C2-1B58-42F4-9E27-6597273D5ECF，（2015年4月8日）
財團法人醫院評鑑暨醫療品質策進會（2016），104年-107年醫院評鑑及教學醫院評鑑問答集。檢自：http://www.tjcha.org.tw/FrontStage/page.aspx?ID=587159B5-5C51-462E-B55F-AAAD755E3FAD&PID=088AB6C2-1B58-42F4-9E27-6597273D5ECF，（2016年11月20日）。
陳啟光、朱珮君、張君儀、彭翎媛（2012），建構一個驗證卓越經營模式效度之架構，品質學報，19卷4期，頁305-324。
教育部 （2016），104學年度大學校院一覽表。檢自：https://ulist.moe.gov.tw/Query/AjaxQuery/Discipline/3409，（2016年7月22日）。
黃彥瑜（2013）， 邁向華人首學: 清華全面品質管理的創新與實踐，遠見雜誌，台北。
經濟部工業局（2007），卓越經營評量體系自評手冊，經濟部工業局，台北。
經濟部工業局（2012），101-105年度企業經營品質躍升計畫計劃簡介。檢自：http://nqa.cpc.tw/NQA/Web/RQ.aspx，（2013年4月29日）
經濟部工業局（2013a），國家品質獎企業獎、中小企業獎、機關團體獎申請書。檢自：http://nqa.cpc.tw/NQA/Web/RQ.aspx，（2013年4月29日）
經濟部工業局（2013b），國家品質獎評審作業程序，經濟部工業局，台北。
經濟部工業局（2013c），國家品質獎評審標準評分參考手冊，經濟部工業局，台北。
廖慧娟（2007），醫院評鑑制度之革新-新制醫院評鑑制度。醫療品質雜誌，1期5卷，頁26-29。
衛生福利部中央健康保險署（2016），您瞭解總額支付制度嗎? 檢自：http://www.nhi.gov.tw/webdata/webdata.aspx?menu=17&menu_id=1029&webdata_id=1080，（2016年7月22日）。
鄭信忠（2013），初探醫院評鑑牙科照護評鑑基準條文。醫療品質雜誌，7期2卷，頁62-71。
簡禎富（2001），科技發展計畫績效評估項目與作業模式規劃研究，行政院國家科學委員會專題研究計畫（編號：NSC90-3012-P-007-001）。
簡禎富（2014），決策分析與管理: 紫式決策分析以全面提升決策品質（二版），雙葉書廊，台北。
簡禎富和林國義（2016），建構半導體晶圓廠整廠績效指標架構與全面資源管理，管理與系統，23期，4卷，頁451-474。
簡禎富和胡志翰（2011），全面資源管理架構：以晶圓廠為實證，品質學報，期，18期，6卷，頁581-607。
簡禎富和許嘉裕（2014），資料挖礦與大數據分析，前程文化，台北。
簡禎富、侯建良、吳建瑋、林國義、胡益芬、朱珮君（印刷中），推動高等教育全面品質管理之研究―以國立清華大學為實證。管理與系統。
簡禎富、趙立忠、朱珮君（2013），工業工程在臺灣醫院管理之研究與應用。工業工程，1期，頁1-8。
醫事司（2016），醫院評鑑改革大步走 簡化各類督考認證每年最多一次。檢自：http://www.mohw.gov.tw/news/572256120，（2017年3月30日）。
英文
Abujudeh, H. H., Kaewlai, R., Asfaw, B. A., and Thrall, J. H. (2010). Quality Initiatives: Key Performance Indicators for Measuring and Improving Radiology Department Performance 1. Radiographics, 30(3), 571-580.
Alapont, J., Bella-Sanjuán, A., Ferri, C., Hernández-Orallo, J., Llopis-Llopis, J. D., and Ramírez-Quintana, M. J. (2005). Specialised tools for automating data mining for hospital management. First East European Conference on Health Care Modelling and Computation, 7-19.
Alkhenizan, A. and Shaw, C. (2011). Impact of accreditation on the quality of healthcare services: a systematic review of the literature. Annals of Saudi medicine, 31(4), 407.
Athanassopoulos, A. and Gounaris, C. (2001). Assessing the technical and allocative efficiency of hospital operations in Greece and its resource allocation implications. European Journal of Operational Research, 133(2), 416-431.
Babakus, E. and Mangold, W. G. (1992). Adapting the SERVQUAL scale to hospital services: an empirical investigation. Health services research, 26(6), 767.
Banker, R. D., Conrad, R. F., & Strauss, R. P. (1986). A comparative application of data envelopment analysis and translog methods: an illustrative study of hospital production. Management Science, 32(1), 30-44.
Brossette, S. E., Sprague, A. P., Hardin, J. M., Waites, K. B., Jones, W. T., and Moser, S. A. (1998). Association rules and data mining in hospital infection control and public health surveillance. Journal of the American medical informatics association, 5(4), 373-381.
Camp, R. C., and Tweet, A. G. (1994). Benchmarking applied to health care. The Joint Commission journal on quality improvement, 20(5), 229-238.
Chien, C.-F. and Chen, L.-F. (2007). Using rough set theory to recruit and retain high-potential talents for semiconductor manufacturing. IEEE Transactions on Semiconductor Manufacturing, 20(4), 528-541.
Chien, C.-F., Chu, P.-C., and Zhao, L. (2015). Overall Resource Effectiveness (ORE) Indices for Total Resource Management and Case Studies. International Journal of Industrial Engineering, 22(5), 618-630.
Chien, C.-F., Chen, H., Wu, J.-Z., and Hu, C. (2007). Construct the OGE for promoting tool group productivity in semiconductor manufacturing. International Journal of Production Research, 45 (3): 509-524.
Chien, C.-F., Diaz, A. C., and Lan, Y. B. (2014). A data mining approach for analyzing semiconductor MES and FDC data to enhance overall usage effectiveness (OUE). International Journal of Computational Intelligence Systems, 7(sup2), 52-65.
Chien, C.-F., Hu, C.-H., and Hu, Y.-F. (2016). Overall Space Effectiveness (OSE) for Enhancing Fab Space Productivity. IEEE Transactions on Semiconductor Manufacturing, 29(3), 239-247.
Chien, C.-F., Lin, K.-Y., and Yu, A. P. I. (2014). User-experience of tablet operating system: An experimental investigation of Windows 8, iOS 6, and Android 4.2. Computers & Industrial Engineering, 73, 75-84.
Chien, C.-F., Peng, J.-T., and Yu, H.-C. (2016). Building energy saving performance indices for cleaner semiconductor manufacturing and an empirical study. Computers & Industrial Engineering, 99, 448-457.
Chien, C. -F., Tseng, F. -P., and Chen, C. H. (2008). An evolutionary approach to rehabilitation patient scheduling: A case study. European Journal of Operational Research, 189(3), 1234-1253.
Chiu, W. T., Yang, C. M., Lin, H. W., and Chu, T. B. (2007). Development and implementation of a nationwide health care quality indicator system in Taiwan. International Journal for Quality in Health Care, 19(1), 21-28.
Cima, R. R., Brown, M. J., Hebl, J. R., Moore, R., Rogers, J. C., Kollengode, A., and Team, S. P. I. (2011). Use of lean and six sigma methodology to improve operating room efficiency in a high-volume tertiary-care academic medical center. Journal of the American College of Surgeons, 213(1), 83-92.
Chu, P.-C., Chien, C.-F., and Chen, C.-C. (2016). Analyzing TFT-LCD array big data for yield enhancement and an empirical study of TFT-LCD manufacturing in Taiwan. International Journal of Industrial Engineering: Theory, Applications and Practice, 23(5), 318-331.
Correia, M. I. T. and Waitzberg, D. L. (2003). The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clinical nutrition, 22(3), 235-239.
Demirci, O., Clark, V. P., and Calhoun, V. D. (2008). A projection pursuit algorithm to classify individuals using fMRI data: Application to schizophrenia. NeuroImage, 39(4), 1774-1782.
El-Jardali, F., Jamal, D., Dimassi, H., Ammar, W., and Tchaghchaghian, V. (2008). The impact of hospital accreditation on quality of care: perception of Lebanese nurses. International Journal for Quality in Health Care, 20(5), 363-371.
European Foundation for Quality Management (2010). My first step with the EFQM Excellence Model. Retrieved from https://sites.google.com/site/myfirststepwithe
fqmmodel2010/home/self-assessment.
Ehrlinger, J., Mitchum, A. L., and Dweck, C. S. (2016). Understanding overconfidence: Theories of intelligence, preferential attention, and distorted self-assessment. Journal of Experimental Social Psychology, 63, 94-100.
Fayers, P. M. and Hand, D. J. (1997). Factor analysis, causal indicators and quality of life. Quality of Life Research, 6(2), 139-150.
Grzymala-Busse, J. W. (2006). Rough set strategies to data with missing attribute values. Foundations and novel approaches in data mining, 197-212.
Harrison, J. P., Coppola, M. N., and Wakefield, M. (2004). Efficiency of federal hospitals in the United States. Journal of medical systems, 28(5), 411-422.
Hassanien, A. E. (2004). Rough set approach for attribute reduction and rule generation: a case of patients with suspected breast cancer. Journal of the American society for Information science and Technology, 55(11), 954-962.
Ho, M. J., Chang, H. H., Chiu, Y. T., and Norris, J. L. (2014). Effects of hospital accreditation on medical students: A national qualitative study in Taiwan. Academic Medicine, 89(11), 1533-1539.
Huang, S.H., Dismukes, J.P., Shi, J., Su, Q., Wang, G., Razzak, M.A., and Robinson, D.E. (2002). Manufacturing system modeling for productivity improvement. Journal of Manufacturing Systems, 21(4), 249-259.
Institute of Medicine (US). (2001), Committee on Quality of Health Care in America.. Crossing the quality chasm: a new health system for the 21st century. National Academy Press.
Jaafaripooyan, E., Agrizzi, D., and Akbari-Haghighi, F. (2011). Healthcare accreditation systems: further perspectives on performance measures. International Journal for Quality in Health Care, 1-12.
Jacobs, R. (2001). Alternative methods to examine hospital efficiency: data envelopment analysis and stochastic frontier analysis. Health care management science, 4(2), 103-115.
Jeong, K. Y. and Phillips, D. T. (2001). Operational efficiency and effectiveness measurement. International Journal of Operations & Production Management, 21(11), 1404-1416.
Joint Commission International. (2015). Designing and writing standards for maximum impact on quality and patient safety. Retrieved from http://isqua.org/education/webinars/january-2015-webinar-with-paul-vanostenberg.
Joint Commission on Accreditation of Healthcare Organizations. (2002), “Health Care at the Crossroads: Strategies for Addressing the Evolving Nursing Crisis”, Oakbrook Terrace, IL: Joint Commission.
Keeney, R. L. and Raiffa, H. (1993). Decisions with multiple objectives: preferences and value trade-offs. Cambridge university press, New York.
Lee, Y.-C., Weng, S.-J., Hsieh, L.-P., and Wu, H.-H. (2015). Identifying Critical Dimensions of the Chinese Version of Hospital Survey on Patient Safety Culture in Taiwan from A Systematic Viewpoint. Journal of Medical Imaging and Health Informatics, 5(7), 1420-1428.
Leung, Y., Wu, W. Z., and Zhang, W. X. (2006). Knowledge acquisition in incomplete information systems: a rough set approach. European Journal of Operational Research, 168(1), 164-180.
Manjunath, U., Metri, B. A., and Ramachandran, S. (2007). Quality management in a healthcare organisation: a case of South Indian hospital. The TQM Magazine, 19(2), 129-139.
Miravitlles, M., Guerrero, T., Mayordomo, C., Sánchez-Agudo, L., Nicolau, F., and Segú, J. L. (2000). Factors associated with increased risk of exacerbation and hospital admission in a cohort of ambulatory COPD patients: a multiple logistic regression analysis, Respiration, 67(5), 495-501.
Mykletun, A., Stordal, E., and Dahl, A. A. (2001). Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. The British journal of psychiatry, 179(6), 540-544.
Nakajima S. (1988). Introduction to total productive maintenance. Productivity Press, Cambridge, MA, US.
Naylor, G. (1999), Using the business excellence model to develop a strategy for a healthcare organisation. International Journal of Health Care Quality Assurance, 12(2), 37-45.
Obenshain, M. K. (2004). Application of data mining techniques to healthcare data. Infection Control & Hospital Epidemiology, 25(08), 690-695.
Ordonez, C. (2006). Association rule discovery with the train and test approach for heart disease prediction. IEEE Transactions on Information Technology in Biomedicine, 10(2), 334-343.
O’Neill, L., Rauner, M., Heidenberger, K., and Kraus, M. (2008). A cross-national comparison and taxonomy of DEA-based hospital efficiency studies. Socio-Economic Planning Sciences, 42(3), 158-189.
Pawlak, Z. (1982). Rough sets. International Journal of Computer & Information Sciences, 11(5), 341-356.
Pawlak, Z. (2002). Rough sets and intelligent data analysis. Information sciences, 147(1), 1-12.
Peng, J. T., Chien, C. F., and Tseng, T. L. B. (2004). Rough set theory for data mining for fault diagnosis on distribution feeder. IEE Proceedings-Generation, Transmission and Distribution, 151(6), 689-697.
Rooney, A. L., and Van Ostenberg, P. R. (1999). Licensure, accreditation, and certification: approaches to health services quality. Center for Human Services, Quality Assurance Project.
SEMI E124-1107 (2007). Guide for definition and calculation of overall factory efficiency (OFE) and other associated factory-level productivity metrics. Semiconductor Equipment and Material International, Mountain View, CA.
SEMI E79-0200 (2000). Standard for definition and measurement of equipment productivity. Semiconductor Equipment and Material International, Mountain View, CA.
Shaw, C. D. (2004). Toolkit for accreditation programs. Melbourne: International Society for Quality in Health Care (ISQua).
Spendolini, M. (1992). The benchmarking book (No. 04; e-book.).
Tsumoto, S. (1998). Automated extraction of medical expert system rules from clinical databases based on rough set theory. Information sciences, 112(1), 67-84.
Vera, A., and Kuntz, L. (2007). Process-based organization design and hospital efficiency. Health Care Management Review, 32(1), 55-65.
Wang, X., Yang, J., Jensen, R., and Liu, X. (2006). Rough set feature selection and rule induction for prediction of malignancy degree in brain glioma. Computer methods and programs in biomedicine, 83(2), 147-156.
West, M. A., Guthrie, J. P., Dawson, J. F., Borrill, C. S., and Carter, M. (2006). Reducing patient mortality in hospitals: the role of human resource management. Journal of Organizational Behavior, 27(7), 983-1002.
Wisniewski, M. and Wisniewski, H. (2005). Measuring service quality in a hospital colposcopy clinic. International Journal of Health Care Quality Assurance, 18(3), 217-228.
Wu, J. Z., Hao, X. C., Chien, C. F., and Gen, M. (2012). A novel bi-vector encoding genetic algorithm for the simultaneous multiple resources scheduling problem. Journal of Intelligent Manufacturing, 23(6), 2255-2270.