衛生所獲政府服務獎的成功關鍵因素

Abstract

背景與目的： 衛生所作為基層醫療與公共衛生體系的第一線單位，長期肩負健康促進、疾病預防與長照銜接等多元角色。政府亦透過「政府服務獎」制度，期望表彰公部門在創新服務與效能管理上的優異表現，營造品質提升與學習的正向循環。然而，歷年獲獎名單中衛生所占比偏低，即便有創新實務成果，往往難以在評選制度下被充分辨識與肯認，顯示現行標準化評比機制未必能真實反映基層場域的特殊性與挑戰性。若此制度性落差未被正視，可能導致基層參與動機降低、資源分配持續傾斜，並壓抑基層單位創新行動與跨域合作意願，進一步影響整體公共服務品質與公平性。因此，本研究聚焦於探討衛生所成功獲得政府服務獎的經驗，分析其關鍵成功因素、參賽過程中的困難挑戰，以及獲獎後對組織的影響，期能釐清基層如何在制度場域中被看見，並提出制度與實務可行之改善建議。 研究方法： 本研究採質性研究設計，運用半結構式訪談大綱進行訪談，選取北、中、南、東四區曾獲政府服務獎之衛生所的主管與基層人員，涵蓋不同職級與參與角色，透過立意取樣與資料飽和原則選取受訪者，並輔以 NVivo 15 軟體進行內容分析與主題編碼，從中萃取具代表性的觀點與經驗。 研究結果： 本研究共訪談北、中、南、東各一家獲獎衛生所，計12位人員(6位主管與6位基層員工)進行個別深度訪談。研究結果顯示，在參賽過程的努力方面，衛生所最常提及「服務設計符合在地民眾需求」、「審視自己過去的服務」與「激發及調整員工的態度與熱情」等行動策略；於成功關鍵因素中，以「設計衛生所的獨特差異性」為最核心要素，其次為「服務設計符合在地民眾需求」及「建立信任來促進服務推動」。在困難挑戰方面，書面資料主要困難在於理解設獎要求與成果呈現，並指出資料準備耗時且整理不易；實地訪查則須因應時間壓力、調整表達方式並回應委員提問。人員角色分工方面，主管負責服務方向、能力指派、支持團隊與解決困難，基層員工則擔任執行任務與積極投入競賽準備；外部支持系統中，衛生局與外部單位提供合作與指導，醫院則協助資源、人力與醫療服務支援。於獲獎影響層面，多數衛生所回饋包含「努力被看見」、「服務持續精進」、「團隊向心力提升」與「成為標竿單位」等正向效益。 最重要發現： 本研究歸納出兩項最具代表性的發現：其一，「設計衛生所的獨特差異性」為成功關鍵，能從在地需求出發，創造具辨識度與可行性的服務模式，以突破制式評比的侷限；其二，「建立信任以推動服務」為實務核心，民眾對人員的信任可有效提升參與意願與接受度，成為基層創新推動的重要助力。 結論與建議： 本研究歸納出五項成功關鍵因素，包括「團隊與領導」、「服務創新與差異化」、「醫療服務便利及可及性」、「民眾感受」及「專家視角」，其中以「服務創新與差異化」最具關鍵影響力。在獲獎效益方面，整理出四個主要面向，分別為「維持競爭力及提升品質」、「提升認同感及向心力」、「標竿學習的對象」與「得到資源與改善」。整體而言，獲獎後的衛生所普遍展現出服務穩定、團隊凝聚、能見度提升與資源取得等正向效益，並持續朝向服務品質精進與制度內化方向發展。為支持基層推動創新與提升服務效能，建議主管機關強化前期輔導與資料累積機制，並協助媒合社區資源，以降低準備負擔；衛生所則應定期盤點需求、建立成果紀錄，並制度化參賽經驗。未來研究可擴大樣本、納入多元觀點，並追蹤獲獎單位後續發展，以補足制度設計與實務現場間的理解落差。

Background and Purpose: Health centers, as frontline units within the primary healthcare and public health system, have long undertaken diverse roles including health promotion, disease prevention, and long-term care coordination. The government has also established the Government Service Award to recognize outstanding innovation and performance in public sector services, fostering a positive cycle of quality improvement and organizational learning. However, health centers have consistently been underrepresented among award recipients. Despite innovative practical achievements, their contributions are often insufficiently recognized under standardized evaluation systems that may not accurately reflect the unique characteristics and challenges of grassroots settings. If this institutional gap remains unaddressed, it could lead to diminished motivation for grassroots participation, continued imbalance in resource allocation, and suppression of innovation and cross-sector collaboration willingness at the grassroots level, thereby further impacting the overall quality and equity of public services. Therefore, this study focuses on exploring the experiences of health centers that have successfully received the Government Service Award, analyzing their key success factors, challenges encountered during the competition process, and organizational impacts post-award. The goal is to clarify how grassroots efforts are acknowledged within institutional frameworks and to provide feasible recommendations for both policy and practice improvements. Methods: This qualitative study employed semi-structured interviews with managers and frontline staff from award-winning health centers across northern, central, southern, and eastern Taiwan. Participants were purposively sampled to cover different roles and levels of involvement, following data saturation principles. Interviews were analyzed using NVivo 15 for thematic coding and content analysis to extract representative perspectives and experiences. Results: A total of 12 participants (6 managers and 6 frontline staff) from four health centers were interviewed. Findings indicate that during the award application process, health centers frequently emphasized aligning service design with local community needs, reviewing past services, and motivating and adjusting staff attitudes and enthusiasm. The core success factor identified was “designing a distinctive service model,” followed by “aligning with local needs” and “building trust to facilitate service implementation.” Challenges included understanding award criteria, preparing extensive documentation, and managing time constraints during site visits while effectively responding to evaluators’ questions. Role distribution showed managers responsible for service direction, capacity assignment, team support, and problem-solving, while frontline staff focused on task execution and active competition preparation. External support from health bureaus and partner organizations, especially hospitals, provided critical resources, manpower, and medical service assistance. Post-award impacts reported included increased recognition, continuous service improvement, enhanced team cohesion, and becoming benchmark units. Key Findings: Two representative findings emerged: first, “designing a distinctive service model” based on local needs is a key success factor enabling health centers to transcend rigid evaluation frameworks by creating recognizable and feasible service models; second, “building trust to promote services” is fundamental in practice, as citizen trust in personnel effectively enhances participation willingness and acceptance, serving as a vital driver for grassroots innovation. Conclusion and Recommendations: Five key success factors were identified: “teamwork and leadership,” “service innovation and differentiation,” “convenience and accessibility of medical services,” “public perception,” and “expert perspectives,” with “service innovation and differentiation” exerting the greatest impact. Four major dimensions of post-award impact were summarized: “maintaining competitiveness and enhancing quality,” “strengthening sense of identity and team cohesion,” “serving as benchmarks for peer learning,” and “acquiring resources and driving improvements.” Overall, award-winning health centers demonstrated stable service delivery, greater team unity, increased visibility, and improved resource acquisition, all contributing to ongoing service quality enhancement and institutionalization.To further support grassroots innovation and improve service effectiveness, it is recommended that competent authorities reinforce early-stage guidance and systematic data accumulation mechanisms, as well as facilitate the integration of community resources to alleviate the preparation burden. Health centers are encouraged to regularly assess local needs, establish structured documentation of service achievements, and institutionalize their award participation processes to ensure sustainable operations and continuous improvement. Future research should consider expanding the sample size, incorporating diverse stakeholder perspectives, and tracking the long-term development of award-winning health centers to bridge the gap between institutional frameworks and frontline realities.