| 摘要: | 近年來醫療產業環境的急遽改變，使得醫院面臨了極大的經營與存在的挑戰，臺北市立聯合醫院為了提升競爭優勢及經營績效，於九十四年一月一日起整合新市立醫療體系。組織變革伴隨而來的是人力、組織架構、經營型態等重大改變，本研究目的探討醫院組織變革後，員工組織變革之認知對於組織承諾與工作滿足之間的關係，及不同個人屬性員工在整合過程中對組織變革之認知、組織承諾與工作滿足的差異情形，以提供爾後公立醫院之整合時，管理者與人力資源策略之應用參考。
在完成信效度檢驗後，於十家院區於九十三年六月三十日以前到職（醫院整合前半年）至九十七年四月份仍在職員工，包括公職及約聘僱、臨時人員等，以普查方式收取問卷。共發出2910份問卷，回收2421份，問卷回收率為83.19%，回收有效問卷1995份，有效問卷回收率為82.4 %。主要結果發現：
1.不同屬性的員工對組織變革認知、組織承諾及工作滿足有部分顯著差異。
2.員工組織變革認知與組織承諾及工作滿足各構面相關分析中，除了組織變革認知之參與溝通認知及工作保障認知與組織承諾之價值承諾未達顯著相關外，其餘各構面皆呈現顯著正相關。
3.個人屬性與組織變革認知對組織承諾構面之影響，在性別、年齡、工作年資、僱用別、參與溝通認知、工作保障認知對組織承諾之留職承諾呈現顯著影響且有預測力；年齡、教育程度、變革效益認知、前程發展認知與工作保障認知對組織承諾之努力承諾呈現顯著影響且有預測力；年齡、工作年資、變革效益認知與參與溝通認知對組織承諾之價值承諾呈顯著影響且預測力。
4.個人屬性與組織變革認知對工作滿足構面之影響，在工作年資、僱用別、變革效益認知、前程發展認知及參與溝通認知對工作滿足之內在滿足呈現顯著影響且有預測力；工作年資、職務層級、僱用別、變革效益認知、參與溝通認知及工作保障認知對工作滿足之外在滿足呈現顯著影響且有預測力；工作年資、僱用別、變革效益認知、前程發展認知、參與溝通認知及工作保障認知對工作滿足之一般滿足呈現顯著影響且有預測力。
以上的結果可以提供醫院管理者，在部分員工屬性、組織變革認知與組織承諾及工作滿足間有關聯性，應就各項變革事項明確的告知員工，加強雙向溝通及重視員工外，使其了解醫院未來的計畫發展與前景，將資訊公開且透明化由各層級員工參與變革規劃，以讓員工能有強烈的認同感及工作滿足感，以積極協助變革工作讓醫院能永續經營。
Due to the dramatical change of healthcare environment recently, hospitals are facing humongous challenge in survival and management. The Taipei City Hospital was integrated into a new municipal health care system on 2005/01/01 for promoting her competition advantage and management performance. Organizational changes bring huge difference amount human resource, organization infrastructure, and management type. The target of this study is to investigate the effect of employee cognition toward organizational changes on organizational commitment and job satisfaction after change of hospital organization, and how those effects influent different employee personnel. By this study, it shall provide some reference materials for management and human resource department during integration of public hospitals.
After reliability and validity examination, we distributed questionnaire to employee whether their employment status were formal public-service, contracted, or day labored, and those who were been hired between 2004/06/30 (half year before hospital integration) and 2008 April from 10 different hospitals. Totally we send out 2910 questionnaire and received 2421 of them, and recruitment rate is about 83.16% which contains 1995 valid questionnaire (valid questionnaire recruitment rate is about 82.4%. Our main investigation shows: 1. employee in different attribution will have significant difference in organizational changes acknowledgment, organizational commitment and job satisfaction. 2. in the correlation among “employee cognition toward organization changes”, “organization commitment” and “job satisfaction” aspects, beside the organizational changes acknowledgment, commitment toward job guarantee, and value of organizational commitment, other respects had positive significant correlation. 3. in the effect of personal attribution and organizational changes acknowledgment; gender, age, tenure, profession, commitment toward involving communication and job guarantee had significant influence and predict power. Age, education level, organizational changes acknowledgment, commitment toward future development, and job guarantee had significant influence and predict power toward commitment of effort. Age, tenure, organizational changes acknowledgment, and commitment toward involving communication had significan influence and predict power toward commitment of value. 4. in the effect of personal attribution and organizational changes acknowledgment toward job satisfaction, tenure, profession, commitment toward effect of changes, future development, and involving communication had significant influence and predict power toward inner satisfaction. Tenure, hired level, profession, commitment toward effect of changes, commitment toward involving communication and job guarantee had significant influence and predict power toward external satisfaction. Tenure, profession, commitment toward effect of changes, future development, involving communication, and job guarantee had significant influence and predict power toward general satisfaction.
These findings can provide hospital managers that there had correlation among partial personnel attribution, commitment toward effect of organization changes, commitment toward organization and job satisfaction. Thus, managers should notify the employees clearly about the change activities, enhance mutual communication. Further, managers should try to let the employees understand the future plan and development of hospital, public the information and let each level of employees involved in the change activities, so that employees will have higher cognition of acceptation and job satisfaction, and this will make the employees help the change activities automatically, in order to lasting hospital operation. |
