居家治療宅配服務之關鍵成功因素與因應方案分析─ 以腹膜透析洗腎為例

Abstract

過往對於居家治療的研究，大多著重要臨床面、政策面、科技輔助面和心理層面的探討，反而忽略了醫療產品宅配服務在居家治療的整個配套設計中所扮演的角色。本研究以在台灣已經有22年歷史的腹膜透析居家洗腎為例，嘗試找出達成洗腎患者居家治療宅配服務滿意度的關鍵因素，並在實務執行過程中種種限制條件下，如何以適當的因應方案來維持病人的服務滿意度。 台灣的宅配市場因電子商務以及電視購物的興起而大幅成長，然而檢視目前仿間所能提供宅配服務的各類型廠商，真正專精在醫療產品宅配的廠商是少之又少，更不用說是配送模式極為複雜的腹膜透析洗腎藥水的宅配作業。也因此造成洗腎藥水的宅配作業一直無法維持穩定的高品質服務。 因此，我們收集平日與洗腎腎友接觸極為頻繁的客服人員、司機的意見，加上腎友本身的問卷結果、客訴分析及宅配品質衡量指標，多方面的統計分析，找出了影響洗腎藥水宅配服務滿意度的三項關鍵性成功因素：正確無誤的送達潔淨的產品；訓練有素、言行得當與專業動作的司機；精準合理的到貨時間。 此外，我們更進一步分析不同區域別與不同醫院規模的洗腎腎友，對影響滿意度的三項關鍵因素是否有明顯不同，來做為執行時設定優先次序的參考依據；最後我們逐項對應三項關鍵成功因素，分別擬出短期及長期之因應方案，並對已執行之短期因應方案評估執行成效。當然，受限於資源與成本，我們也建議出不同區域有不同的方案執行優先次序。 要維持高品質的洗腎藥水宅配服務，長期因應方案的實施是重要關鍵，本文研究發現唯有藉重資訊系統的協助，才能更有效輔助相關作業人員，讓業者可以更胸有成竹的面對未來預期業務高成長所帶來的挑戰。

Most of the home care related papers focus on clinical、government policy、technical support and psychological study and ignore home delivery plays an important role in the home care system. This thesis takes peritoneal dialysis as sample; try to find key successful factors of patient’s home delivery satisfaction. In addition, we raise proper solution to maintain high patient satisfaction under budget and cost constraint. Taiwan home delivery market grows rapidly due to e-commerce and TV shopping rise. But we find there are very seldom companies proficient in deliver healthcare products, not to mention complex delivery process of peritoneal dialysis solution. Therefore, the kidney solution supplier is difficult to sustain stable and high delivery service quality. We collect the opinion of front line staff, including customer service representatives and drivers. Besides, we did a patient questionnaire survey、customer complaints analysis and identify home delivery quality KPI. Take this multi-dimensional input to clarify three key successful factors to satisfaction of peritoneal dialysis patient: deliver right and clean products、professional and courteous drivers、precise and reasonable arrival time. Moreover, we go deep in analyzing the different requirement of different area and different scale of hospital to support us in setting the priority of implementing solution. Finally, we issue short term and long term solution according to three KSF and evaluate the result after we have executed the short term solution. Of course, we have set priority of implementing solution in different area due to constraint of resourses and cost. In order to sustain high delivery service quality, implement long term solution is the key step. This thesis find information technology support plays a very important role, this is the only way to let kidney solution supplier to face the challenge of rapid market grow.