Forum “Good neighbors and mutual understanding” Dialogue with Chinese Japanologists : the present and future of China-Japan relations

Both the Japanese and the Chinese usually think of Western culture when faced with the expression “different culture.” People in both countries have become conditioned to this way of thinking about Western culture since their first contacts with it. In both countries, intercultural or crosscultural research tends to focus on the cultures of the Western nations. As the phrase dōbun-dōshu (“same script, same race”) indicates, it seems common for the Japanese and Chinese, influenced by the great contrast with the West, to be more aware of cultural similarities than differences. It is usually permissible to view the cultures of Asia in the same light.China and Japan, however, dealt very different with the shock of the incursion of the “different culture” of the West. In the post-war years they were caught up in the East-West friction of the Cold War, and continued to view each other with antagonism. When diplomatic relations were normalized in 1972, people were strongly aware of differences in politics, economics, and society, but remained as unconscious of cultural differences as they were before the gap of more than fifty years. There is an enormous difference between Chinese and Japanese understandings of each other\u27s culture. It seems that not enough effort is made to promote mutual understanding based on the assumption that they are indeed different cultures.In order to further mutual recognition and mutual understanding without a time lag, a Japanology research team based in China is presently undertaking two different research activities. One is attempting to clarify the causes of this gap in mutual perception through analysis from social and cultural perspectives, while the other is involved in making surveys and records of repeated examples of actual dialogue. This paper is an introduction to the circumstances under which such dialogue is carried out.The example detailed here is a forum on “Good neighbors and mutual understanding” held on February 21, 2006, at the Kitanippon Shimbun Hall in Toyama, under the title “Dialogue with Chinese Japanologists: the present and future of China-Japan relations.” The panelists were ADACHIHARA Tōru (visiting professor, Wuling University, Hunan Province), NOTO Yoshitaka (executive director, Toyama International Center), LIU Xiaofeng (associate professor, Qinghua University, Beijing), and WANG Min (professor, Hosei University Institute of International Japan-Studies)

前列腺移行带腺体定量分析

目的通过定量分析良性前列腺增生(BPH)患者前列腺和成人正常前列腺移行带腺体各成分含量及相关组织学形态的变化,探讨良性前列腺增生症治疗方案的选择。方法用计算机图像分析系统对经HE染色的40例良性前列腺增生症患者手术切除的前列腺和10例成人正常前列腺移行带组织标本进行形态学定量分析,分别测定腺体、腺腔、上皮的平均面积及上皮细胞高度。结果(1)正常前列腺和BPH前列腺移行带上皮细胞高度分别为(24.87±4.53)μm和(19.06±5.49)μm(P0.05)。结论BPH前列腺组织主要以基质成分增生为主;BPH的治疗应以α受体阻滞剂和手术治疗为主

采用原研制剂制备米诺膦酸片及体外溶出度的一致性考察

制备米诺膦酸片,并以原研制剂为参比制剂,采用f2相似因子法对两者体外溶出度的一致性进行考察.建立合适的体外溶出度测定方法,研究参比制剂的溶出情况,通过单因素试验对辅料的用量进行筛选,制备出米诺磷酸片.比较自制品与原研制剂在不同溶出介质中的溶出行为,评价两者体外溶出行为的相似性.结果表明:制备的米诺膦酸片剂与原研制剂在4种不同pH值溶出介质中的溶出相似因子f2均大于50;制备的米诺膦酸片剂与原研制剂体外溶出行为相似.国家自然科学基金资助项目(81302652);;福建省自然科学基金资助项目(2015J01342

Reactor model with cross-flow for aromatics catalytic hydrogenation

[中文文摘]提出了一种抗硫中毒的芳烃加氢催化反应器模型,称之为交叉流反应器模型,把反应物料分为两股,其中含有噻吩的乙苯物料采用轴向连续流动方式由反应器进口进入催化剂床层,而氢气由铅直导管直接进入催化剂床层中,然后与乙苯物料混合。在氢气导管出口处形成含硫乙苯浓度低而氢气浓度高的特殊区域,因而硫对催化剂的中毒效应大幅度降低,整体上提高了乙苯加氢饱和反应效率。与传统轴向混合流反应器进行比较,在相同条件下交叉流反应器具有更好的整体加氢反应性能。分别建立了交叉流反应器与传统轴向混合流反应器模型,提出了两种反应器的催化反应转化率方程;利用此转化率方程,对实验数据进行处理,得到动力学参数,模型的计算结果与实验数据相吻合,也验证了在交叉流反应器中,硫的中毒效应明显减弱。[英文摘要]A novel reactor model named cross-flow reactor for aromatics catalytic hydrogenation was proposed.The reactants were divided into two flows:ethylbenzene with thiophene was introduced to the catalyst bed along the axial direction of the columnar reactor,while hydrogen was introduced into catalyst bed through a vertical pipe with openings.Because special areas with high H2 pressure and low H2S pressure were formed near these openings,the poisoning of catalyst by thiophene was substantially decreased,and consequently the reaction of et hylbenzene hydrogenation was improved as compared with the traditional reactor with mixed co-flow. Finally , kinetic models were established for this cross-flow reactor and the traditional reactor1And the conversion equations of these two reactors were given.By using these equations , the experiments data were fitted to obtain kinetics parameters. The calculation results agreed well with the experimental data. It was also demonst rated that sulfur poisoning in cross-flow reactor was weakened.国家重点基础研究发展计划项目(2004CB217805); 福建省“百千万人才工程”支持项目; 福建省自然科学基金项目(U0750016)

沿海产盐区与非产盐区18～45岁人群碘营养状况及甲状腺功能水平研究

目的掌握厦门市沿海产盐区与非产盐区居民盐碘、18～45岁人群碘营养和甲状腺功能水平状况,为采取针对性的防治措施提供依据。方法选择沿海产盐区翔安区和非产盐区集美区为调查点,调查居民合格碘盐食用率、18～45岁育龄期妇女和男性尿碘水平、甲状腺激素水平和海带、紫菜的摄入习惯。结果产盐区和非产盐区盐碘中位数均为27.21 mg/kg,合格碘盐食用率分别为95.33%和96.33%;18～45岁男性尿碘中位数分别为206.55μg/L和232.95μg/L,尿碘<100μg/L的比例分别为20.97%和10%;18～45岁育龄期妇女尿碘中位数分别为176.95μg/L和227.70μg/L,尿碘<100μg/L的比例分别为21.67%和25%;产盐区和非产盐区18～45岁男性和育龄期妇女的甲状腺激素TSH、Tg、FT3、FT4、TPOAb、TT3、TT4中位数均在正常值范围内;产盐区18～45岁男性的甲状腺功能亢进阳性率为3.4%、育龄期妇女的甲状腺功能减退和亚临床甲状腺减退症的阳性率均为1.67%,而非产盐区均为0。产盐区和非产盐区18～45岁男性和育龄期妇女中均有一定比例易患甲状腺免疫性疾病的人群。每月食用海带、紫菜的次数≥4次、1～3次和<1次的人尿碘组间比较无统计学差异。结论产盐区和非产盐区18～45岁男性和育龄期妇女碘营养总体处于适宜状态,应坚持食盐加碘措施,对育龄期妇女在婚前体检时开展常规碘营养水平和甲状腺功能检测

论通信卫星天线技术的新发展

现阶段我国的科学技术有了进一步提升，一些比较先进的科学技术在生活中的应用也比较普遍。通信卫星天线的应用就相对比较广泛，通过加强对通信卫星天线的发展现状以及发展趋势的理论研究，对实际的发展有着积极促进意义。</jats:p

通信卫星自适应调零多波束天线系统现状研究

自适应调零多波束天线系统在我国通信卫星中得到广泛的应用，随着相关科研工作的推进，多波束天线系统在功能、性质上衍生出一些新的理论经验，文章对通信卫星自适应调零多波束天线系统的相关理论进行阐述，并对其发展现状进行分析。总结技术发展成果，研究自适应调零多波束天线系统算法的实现过程，供相关研究人员借鉴参考。</jats:p

Ka波段通信卫星发展应用

文章先介绍了北美地区上空的Ka波段商用卫星，包括高清直播卫星和宽带接入卫星，随后分析了外军典型的Ka波段卫星，包括军事星系统、全球广播系统、宽带卫星通信系统，最后介绍了Ka波段卫星的未来发展趋势，希望能给相关人士提供有效参考。</jats:p

Use System Simulation for Programming Emergency Medical Operations: Allocated the Most Appropriate and Performance Evaluation

背景 近年來急診室醫療品質成為各界關注的焦點，對急診病人和醫院來說，急診部門是非常重要的一環，因為當急性病痛無法獲得處理，不僅身心受創，甚至可能有生命上的危險，急診病人必須先經由急診醫師完成適當治療處理再做後續治療。急診人口增加，是世界性的趨勢，而急診在社會上扮演著守護全體國民健康第一道防線的重要角色，面對國內快速成長的急診人口，急診照護品質確實令人重視。國內各大醫院(醫學中心)之急診單位的醫療服務無法與院內各部科充分有效的溝通及運作，因而造成醫療健康服務品質無法滿足病人的需求，例如:較長的病人等候時間，病床數量不夠，及急診室病人人數過度壅塞。為求提昇高品質的緊急醫療救護服務，本研究將以台灣中部地區公立醫學中心作為實際模擬作業環境，運用系統模擬技術來建構研究對象的模型，並利用改變不同的系統參數設定(亦即不同的急診室人員數量及醫療設備配置)來分析不同的急診室作業配置之效率。本研究使用個案醫院2010年1月至12月急診部病人66,095人次，就醫處置檔與就醫人次檔合併後且經留觀60,366人次進行研究與探討。本實驗結果將提供病人更有效率、更安全、與更專業的急診醫療作業，再則醫護人員則更可提昇其醫療作業的效率。運用系統模擬規劃急診醫療作業並找出急診部過度壅塞之衡量，與運用系統模擬規劃資料包絡分析法進行急診人力資源配置分配最合適化及績效評比，為醫學中心急診部門未來組織流程變革之參考，對急重症醫療具有重要文獻價值。 目的 1.利用離散事件模擬(Discrete Event Simulation, DES)的理論基礎，建構出一個急診病人就診流程模型，驗證並確認，瞭解目前系統是否有瓶頸的存在。 2.瞭解對象醫院急診單位之作業流程，急診病人之各類特質分佈，各項作業之時間分佈，急診病人之等候狀況。 3.以電腦模型模擬病人就診流程問題，藉由修改流程縮短病人等候時間與提昇品質，減少資源浪費。 4.研究急診流程時間的影響因素，進一步了解這些因素對各種檢傷分類時間變異的影響程度。 5.應用於對象醫院急診部資源分佈系統模擬規劃。並找出急診部過度壅塞之衡量，與運用系統模擬規劃資料包絡分析法，進行急診人力資源配置分配最合適化及績效評估。 方法 1. 分析現有急診單位之作業流程。 研究變項參數部分依照急診區域的不同將急診流程分為四塊主要區域進行探討，分別為檢傷區域(Triage Room，TR)、主要診間 (Main Emergency Department，MED)部分、急救室(Resuscitation Room，RR)部分、留觀區 (Observation Unit，OU)部分；目標是要找到醫生，護士，病床的組合，以提高效率與每個班次期間，檢傷區間、主要診間、急救室、留觀區及醫師，護士，病床數量最大限度的使用率。依據急診作業流程圖，以研究變項及參數部分輸入至模型中，建立之模擬模型；透過模擬軟體Simul8模擬中部某公立醫學中心急診室2010年1月至12月，得到輸出結果(急診醫學科、外傷科、獨立科及兒科)，透過Simul8模擬軟體的模擬，每相隔兩小時計算一次國家急診部過度壅塞衡量(NEDOCS)值，一天共統計12個NEDOCS值；可知急診單位的狀態。 2.與醫師以及急診相關人員進行訪談，討論急診運作流程，以及執行經驗。 3.與系統開發工程師討論架構以及所需技術。 4.規劃流程圖。 結果 本研究以中部某公立醫學中心急診部2010年1月至12月之急診病人數量，共66,095人次。經由調查統計分析所需60,366人數；由統計資料可知，病人人數集中在一、二、三級，其中又以二、三級人數最多。其中星期日急診病人人數最多(n= 196人)，每日平均165人；而每小時平均到達病人人數，在早上8點至下午4點這段早班時段為急診病人的巔峰時段，次之為下午4點至凌晨12點的小夜班時段。透過Simul8模擬軟體的模擬，每隔兩小時計算一次NEDOCS值，一天共統計12個NEDOCS值；可知急診室大於 90%的時間都處於擁塞的狀態。模型驗證經敏感度分析與t檢定來驗證模型的效度以及正確性。資源配置效率分析: 經由限制篩選後，總共組合數共有44組，各資源配置組合(決策單位)所獲得相對效率值與現況DMU1的比較為DMU5、 DMU12 、DMU21、 DMU22 、DMU23及 DMU24；但DMU5增加醫師人數在急診室作業較為無助人力改善作業。其中以DMU12即醫師於急救室：9名、主要診間：16名、留觀區：11名；護理人員於急救室：9名、主要診間：13名、留觀區為16名，即可達到高效率醫療作業。以DMU12三班制呈現輪值且高效率決策單位，為最合適醫療作業；以醫護工作人數資源配置、效率、效果及精實管理之下，DMU12為分配最合適化。同樣，在低效率之下(<0.9) 相同等待時間之績效評估，其中以DMU2 最合適化的醫護人員的三班制作業。 結論 本研究我們提出了一種混合的方法，結合離散事件模擬(DES)和資料包絡分析法(DEA)模型提供最佳的業組合決策單位方案。多個替代組合決策單位的效率及達到一個更豐富的基準分析。以醫護工作人數資源配置、效率、效果及精實管理之下，且運用系統模擬規劃急診醫療作業，可以完成分配最合適化及績效評估。Background In recent years, increasing patient census and department overcrowding are universal concerns in emergency department of medical center. Accurate predictions of patient flow and resource utilization in the emergency department are important in determining what aspects of emergency department operation could be modified to improve patient flow, reduce patient waiting times, and increase staff efficiency and morale, and thus direct change more effectively. In order to reach higher quality of emergency department operations based on teaching hospital as principle operating environment. We developed to use a computer simulation model of emergency department operations using simulation software (Simul 8). This model uses multiple levels of preemptive patient priority; assigns each patient to an individual nurse and physician; incorporates all standard tests, procedures, and consultations; and allows patient service processes to proceed simultaneously, sequentially, repetitively, or a combination of these to provide patients more efficient and professional medical care in emergency department. In other words, medical professionals can act against the clock, and reach the highest objective of life saving in emergency medical environment. This study is set forth to examine whether the quality and efficiency of emergency care will be improved by adjusting the order of procedures in the ED. This study used 66,095 records of emergency patients in an emergency department of a medical center from 2010-1 to 2010-12. We got some valuable points (N=60,366) from this study in considering re-engineering of emergency room in medical centers, which filled up the gaps of current understandings and myths of organizational restructures. Objectives 1.Use the discrete event simulates (DES) rationale to build a model for the emergency patients to receive a proper medical diagnostic flow. Verify and valid it feasibility. 2.Understand the working flow of the emergency department, the special characteristic distribution of the emergency patient, the time distribution of working process and situation of patient’s waiting time in the object hospital emergency department. 3.Simulate by the system to get a model of establishing proper medical diagnostic flow, reducing the patient’s waiting time, promoting quality and reducing the wasted resources. 4.Study the factors that influence the emergency department working flow，further understand which factor affects each time variation of the triage. 5.Apply the emergency department model time’s forecast pattern to the resources distribution design of the object hospital emergency department and to find the best resolution from the National Emergency Department Overcrowding Scale. Methods 1. Analyze current emergency department operations. 2. Interview and discuss medical operating procedures and operating experience with doctors and related people. 3. Discuss the framework and technology requirement with professionals of emergency department operations. 4. Plan flow chart. Result An ED simulation model was developed involving a cooperative effort at affiliated teaching hospital with medical center in Taiwan over a year period. We developed the model with a preexisting data set, along with institutional information and expert clinician input. The ED department has a 94 non-trauma bed capacity in the ED, divided into three individual areas. Specifically, these are: the Resuscitation Room (RM), with 10 beds reserved for critical care; the Main Emergency Department (MED), with 7 fixed beds and the Observation Unit (OU), with 77 beds in the OU. In this study, we simulate a model according to the situation in ED by System Simulation Technique, and use it to analyze the waiting time and system time of NEDOCS as indicator to determine the ED flow, find the optimization ways to prove the corrected model. We apply system simulation to build an emergency simulation model, to investigate the actual resource distribution recently. Then, learn the output from different resources reallocation model, analysis the efficiency of different model by Data Envelopment Analysis (DEA); compare this result with the actual situation. We use a mixed method combing DES and DEA models to identify the best performing operations across multiple alternatives. To the allocation simulation optimization and efficiency evaluation. To find DMU 12 with the optimization in the high efficiency evaluation. By the efficiency evaluation, we got DMU2 in the lower efficiency condition. Conclusion We provide a mixed method combing DES and DEA models to identify the best performing operations across multiple alternatives. The efficiency of DMUs across multiple alternatives allows for a richer benchmarking analysis to allocate simulation optimization and efficiency evaluation

Use Balanced Scorecard Model to set up the Strategic Performance -Emergency Department of Medical Center Hospital in Taiwan

自全民健保實施以後，台灣的醫療環境起了重大變化，且健保政策不斷的更新，醫院經營方式面臨生存的挑戰，為維繫醫院永續經營與面對醫療市場考驗，醫院一方面必須滿足病人就醫需求，另一方面又得維持醫院財務績效平衡，因此，醫院需以顧及醫院財務表現並持續提升品質為目前醫院生存的條件。醫療機構面臨如此激烈競爭的環境中，必須以急診部門來取得優勢，如何取得競爭優勢，建立一套完整的策略性績效指標求制度是必需的。平衡計分卡是一種有效的績效衡量制度，它可協助醫與人力需療機構將經營的策略轉化為實際的行動方案，目的在使策略易於付諸執行，並有效促進策略的完成及願景的實現。 　本研究以台灣北部某醫學中心且為公立醫院的急診部門為研究對象，目的在建構一完整的平衡計分卡及瞭解使用前後之年度差異及影響，並探討急診的人力資源。本研究設計為描述比較研究，採立意取樣，研究對象為急診醫護人員及病人。研究工具分為問卷調查及次級資料分析，病人問卷共發出432份，回收問卷153份，回收率為35.4%，急診護理人員發出72份，回收完整為63份，回收率為87.5%，醫師人員發出31份，回收有效問卷14份，回收率為45.16%。 　本研究於90年1月至12月，收集次級資料，其中含檢體報告時效控制品管表、急診病人抱怨統計表、檢體統計表、急診營運損益表及在職教育時數統計表。91年1月至12月於急診實施急診績效指標行動方案，在學習與成長構面，以在職教育中的到院前護理、服務態度訓練、電話禮貌訓練、電腦化訓練、急診新知、品管教育訓練等；內部流程構面，制定檢體收集及送出標準作業流程，設立單一窗口作業，如檢傷、掛號、計價及出入院，推廣資訊整合流程；顧客構面，建立院長電子信箱、收集病人抱怨專線，以專人處理，設計病人、醫師及護理人員滿意度調查；財務構面，在既有的成本中心作業，確定電腦計價，加強成本概念教育，選擇特儀及特材的收入之落後指標比較，並轉化為領先指標。資料以描述性統計並分析初級及次級資料，以SPSS12.0電腦統計軟體，Mann-Whitney檢定及Fisher’s的精確檢定方法。 　研究結果顯示，學習與成長構面，(1)護理人員在職教育時數在實施前為41.8小時，實施後為45.5小時，(2)醫師的研究計畫皆超過指標值5篇。而專業訓練，無論醫師或護理人員其滿意度皆最高；內部流程的改進構面，檢體在30分鐘內完成報告大於80%，其改變乃是由90年1月至91年6月之間檢體為60分鐘完成報告，於91年7月開始改進為30分鐘內完成報告，檢體退件率以90年度與91年度明顯的減少，在統計上有意義；顧客構面，病人滿意度以服務態度而言，90年為90%，91年為94%，滿意度提升4%，醫護之工作滿意度，醫師為81.5%，護理人員為75.3%，皆為多數醫護人員滿意；財務構面，歷年來急診財務皆為負數，但在91年各月的財務，其中5月、7月及8月之財務皆呈正面的成長，而減少虧損，急診營運有正向成長，90年與91年特儀與特材收入皆優越，( P&lt;0.05 )統計有意義。而人力資源及需求，以公立醫院而言，達到衛生署評鑑需要之基本人力，更加以訓練住院醫師或支援代訓醫師，加大盈餘的空間。 　由本研究結果得知，平衡計分卡可以運用績效指標實施，將四個構面皆明顯提升，建議將此平衡計分卡，推廣至所有成本中心的急診部門，在醫院自主管理下，達到病人、醫護員工及健保單位三贏的局面，並進一部推展至整個醫院單位。The National Health Insurance (NHI) had been implemented to the healthcare environment in Taiwan. The policy of the health insurance continued to change. The hospital faced to this condition, to set up the balance system between financial policy and the quality care is necessary. The operation of hospitals in Taiwan are facing difficult challenges to survive. To improve the quality of emergency care is the best way of the policy. How to use the balanced scorecard (BSC) model to set up the strategic performance is important. BSC is designed to establish a performance that is important and easy to perform the strategic map for our visions. This study was performed in emergency dependant (ED) of medical center hospital in north of Taiwan . The purposes of the study were to build up the BSC at an emergency department. To compare the differences before and after the BSC was implemented within two yeas. The research design was description and comparative and studied the human resources in ED. A purposive sampling was used to collect data from the questionnaire to the patient and healthcare worker. During the study 432 questionnaires were sent out for patents who visited ED and resulted 153 valid questionnaires 72 questionnaires were sent but for nurses and resulted 63 valid questionnaires 31questionnairs for the doctors with 14 valid questionnaires were collected. From January to December, 2001 we collected to secondary data including laboratory date patient complains finance reporting and job training time, we performed the BSC on 2002.BSCconsisted of four domains (1) Learning and growth : including practicing standard job training communication and telephone skills training Computer science emergency news and quality control .(2) Internal business process including standard process for laboratory tests ,one-way delivery services, register triage and counter, integrated information. (3) Customers: including patient complain services.(4) Financial: including planning cost concept training and cost –based center revising cost sheets, practicing standard counting process and using the computer. All of above the data were analyzed with spss12.0 Mann –Whitney test and Fisher’s exact test to statistic analysis .P&lt;0.05. The result revealed that (1) learning & growth : nurse on job training hours increased from 41.8 to 45.5 hours. The numbers of emergency physician’s research projects were over five. The ED staffs were all satisfied with professional training in ED after BSC. (2) Internal business process: The efficacy of laboratory tests was improved after BSC, The incidence of disqualified samples decreased after BSC. (3) Customers: The patients were satisfied with the service of ED Staff by increment of 4% after BSC. The healthcare workers were satisfied with good teamwork in ED. (4)Finance: The financial reporting showed positive increased on three months after BSC in 2002 and special material costs were improved after BSC (P&lt;0.05). From this study, we used the performance indicators to improve the quality of medical care in our emergency department. We recommended establishing the balanced scorecard model to the cost accounting center of medical center hospital in Taiwan.第一章 緒論 (1) 第一節 研究背景與動機 (1) 壹、 研究背景 (2) 貳、 研究動機 (4) 第二節 研究目的 (4) 第二章 文獻探討 (5) 第一節 績效評估之相關文獻探討 (6) 壹、一般指標 (6) 貳、醫院績效指標 (7) 一、 品質指標 (8) 二、 投入、產出、經營效率指標 (9) 三、系統整合與教研指標 (10) 參、傳統財務績效評估與策略性績效評估系統之比較 (11) 第二節 平衡計分卡理論之文獻探討 (11) 壹、平衡的意義 (11) 貳、平衡計分卡的四個構面 (12) 參、平衡計分卡之優點與評價 (13) 肆、平衡計分卡可能遭遇之問題 (14) 第三節 平衡計分卡的設計 (15) 壹、平衡計分卡之程序架構 (15) 貳、建立平衡計分卡的管理體系 (16) 參、平衡計分卡的實施步驟 (17) 第四節 平衡計分卡導入經驗探討 (18) 壹、國外企業界導入經驗探討 (18) 貳、國外醫院導入經驗探討 (19) 1.Duke Children’s Hospital。 (19) 2.May clinic。 (21) 3.Mentefiore Hospital 。 (23) 4.St. Anthony Central Hospital Burn Center。 (23) 5.Peel Memorial Hospital 。 (24) 6.加拿大安大略 (Ontario) 省醫院之平衡計分卡架構。 (24) 參、國內企業界導入經驗之探討 (26) 肆、國內醫院導入經驗探討 (27) 伍、如何訂立人力資源計分卡 (28) 第五節 文獻探討綜合討論 (31) 第三章 研究方法 (33) 第一部分：個案醫院急診部門導入平衡計分卡的方法與過程 (33) 壹、流程 (34) 貳、步驟 (35) 參、各構面平衡圖及策略因果 (38) 肆、各構面資料來源 (40) 伍、次級資料 (41) 陸、初級資料—問卷調查(I. 病人II.護士 III.醫師) (41) 柒、資料整理分析 (43) 第二部分 問卷研究方法 (43) 第一節 調查過程 (43) 第二節 急診部的平衡計分卡策略議題之建構 (44) 第三節 問卷設計 (47) 第四節 研究材料 (51) 第五節 資料處理與分析 (51) 第四章 個案醫院描述 (52) 第一節 個案醫院背景與內科在環境分析 (52) 壹、個案醫院背景介紹 (52) 貳、個案醫院內外在環境分析 (56) l 內部環境 (56) l 外部環境 (57) 第二節 急診部現行績效制度及人力資源之探討 (65) 第三節 平衡計分卡之推行經驗 (65) 第四節 平衡計分卡規劃設計 (66) 壹、構面的訂定 (66) 貳、平衡計分卡的建立 (67) 第五章 研究結果 (71) 第一節 學習與成長的構面 (71) 第二節 實施內部流程改變構面 (73) 第三節 顧客構面 (74) 壹、病人滿意度 (74) 貳、醫護人員 (79) 1. 護理人員方面 (79) 2. 醫師人員方面 (84) 第四節 探討財務構面 (86) 第五節 績效指標與人力需求構面 (89) 第六章 討論 (90) 第一節 比較實施平衡計分卡前後之學習與成長構面差異 (90) 第二節 比較平衡計分卡實施前後內部流程改變差異 (91) 第三節 比較平衡計分卡實施前後顧客構面之差異 (92) 第四節 比較平衡計分卡實施前後財務構面差異 (93) 第五節 比較平衡計分卡實施前後之策略性績效指標與人力需求 (95) 第七章 結論與建議 (96) 第一節 結論 (96) 第二節 研究特點與限制 (97) 第三節 建議 (97) 參考文獻 (99) 一、 中文部分 (99) 二、 英文部分 (105) 附件一：會議記錄 (111) 附件二：病人滿意度問卷 (115) 附件三：護理人員工作滿意度問卷 (119) 附件四：醫師人員滿意度問卷 (121) 附件五：急診病人滿意度專家效度 (123