一直以來醫療業都是一個需要高品質且高成本的產業，急診室作為醫療體系中重要的一環，面對近年來我國急診服務量大幅攀升，人力以及空間皆有限的情況下，將造成醫療資源供需失衡，進而拉長病患的等待時間，產生壅塞的情況。然而長期處在壅塞的環境，對於病患的病情恐產生負面的影響，連帶導致醫護人員過勞，醫病關係惡化。有鑿於這樣的情境變化之下，如何解決壅塞問題儼然成為了醫療院所管理者的新挑戰。
　　本研究以南部醫學中心急診室為研究對象，透過精實醫療與服務創新兩大學術理論作為討論基礎，以服務創新四構面之模型為基本架構，接著再以精實醫療中八個浪費的概念檢視現況找出浪費之所在。本研究選用質性研究方法中的個案研究法，探究個案醫院如何藉由導入新科技來幫助流程優化，改善既有流程中的不足並消除浪費，以提升人員工作效率、縮短病患滯留在急診的時間，最終達到減少急診室壅塞。在資料蒐集過程中，為了解個案急診室導入新科技的時空背景、發展過程以及後續帶來之影響，因此選擇與不同層級、角色的利害關係人進行深度訪談，使本研究得以獲得初級資料，並以次級資料為輔，讓實務現象與理論之間的連結更為緊密。希冀本研究結果能提供給未來欲導入智慧醫療的醫療場域，一份可供參考的依據。

An emergency department of a medical center in southern Taiwan was the research subject of the study. This study adopted the two theories, Lean Medicine and Service Innovation as the bases, applied the Four Dimensional Model of Service Innovation as the structure and identified the waste of the resources by Eight Wastes in Lean Medicine. Also, case study in the qualitative research method was used to explore how the hospital in this case optimized the working process by introducing the new technology, improved the current process and reduced the waste. Furthermore, as the process improved, the working efficiency of the staff was promoted and the patients’ waiting time in the emergency department was shortened. Ultimately, the effects of overcrowding in the emergency department could be mitigated. During the process of data collecting, interested parties from different levels and roles were chosen and underwent in-depth interviews to better understand the backgrounds, developments and influences of the new technology introduced in the emergency department in this case. Once the primary sources were acquired and the secondary sources were used as auxiliary, the connection between the reality and theory could be strengthened. This study aims to provide the medical field dedicating to introducing smart health care in the future with a reliable reference.

壹、中文文獻
卓儒君. (2012). 以精實管理及模擬最佳化求解醫學中心急診室流程設計問題. 成功大學製造資訊與系統研究所學位論文, 1-94.
徐靖雯. (2017). 發展平台商業模式探索性研究: 以 Gogoro 為例. 成功大學經營管理碩士學位學程 (AMBA) 學位論文, 1-79.
曹俊平. (2016). 結合離散模擬模式及模糊多屬性決策方法求解急診室導入單元工程佈置問題. 成功大學製造資訊與系統研究所學位論文, 1-85.
莊立民, & 段起祥. (2006). 台灣服務業組織創新量表發展之研究. 產業論壇, 8 (2), 65-83.
陳向明. (2002). 社会科學質的硏究. 台北市: 五南圖書出版股份有限公司.
陳筱琪, 陳文良, & 謝靜如. (2015). 探討數位化時代台灣出版業所採取的成長策略: 服務流程再造與服務創新模式之觀點. 科技管理學刊, 20(3), 35-68.
陳麗蓁, & 曾欽耀. (2013). 休閒餐廳服務創新模式之探討-雲端科技之應用. 大仁學報(43), 103-112.
楊大和, & 謝瓊嬉. (2008). 電子業向汽車業取經-精實生產在 TFT-LCD 產業成功的應用. 品質月刊, 44(9), 8-15.
葉靜輝. (2014). 服務業人力資源管理措施與服務創新關聯之研究. 創新與管理, 11(2), 67-89.
蔡文甲, & 羅正英. (2011). 銀行業服務創新衡量之探討. 創新研發學刊, 7(1), 24-42.
蔡翠旭, & 林育安. (2011). 動態能力, 服務創新與市場績效之研究-以合作金庫銀行爲例. International Journal of LISREL, 4(2), 1-33.
中華民國衛生福利部(2016)。醫療服務量。2019年12月23日，取自中華民國衛生福利部統計處網址https://dep.mohw.gov.tw/DOS/lp-1868-113.html
中華民國衛生福利部(2017)。國民醫療保健支出(NHE)。2019年12月23日，取自中華民國衛生福利部統計處網址https://dep.mohw.gov.tw/DOS/lp-2156-113.html
中華民國內政部(2018)。內政統計通報_高齡社會。2019年12月23日，取自中華民國內政部網址https://www.moi.gov.tw/files/news_file/107%e5%b9%b4%e7%ac%ac15%e9%80%b1%e5%85%a7%e6%94%bf%e7%b5%b1%e8%a8%88%e9%80%9a%e5%a0%b1_%e9%ab%98%e9%bd%a1%e7%a4%be%e6%9c%83.pdf
中華民國衛生福利部(2018)。醫院平均每日醫療服務量統計。2019年12月23日，取自中華民國衛生福利部統計處網址https://dep.mohw.gov.tw/DOS/cp-1735-3243-113.html

貳、英文文獻
Arbune, A., Wackerbarth, S., Allison, P., & Conigliaro, J. (2014). Improvement through small cycles of change: Lessons from an academic medical center emergency department. Journal for Healthcare Quality, 39(5), 259–269.
Berry, L., Shankar, V., Parish, J., Cadwallader, S., & Dotzel, T. (2006). Through service innovation: Creating new markets. Sloan Management Review, 47(2), 56-63.
Betz, F. (1987). Managing technology: competing through new ventures, innovation, and corporate research. New York: Prentice Hall.
Bilderbeek, R., Hertog, P. d., Marklund, G., & Miles, I. (1998). Service in innovation: knowledge intensive business service (KIBS) as co-producers of innovation. Oslo: SETP group.
Christensen, C. M., Horn, M. B., Caldera, L., & Soares, L. (2011). Disrupting College: How Disruptive Innovation Can Deliver Quality and Affordability to Postsecondary Education. Washington, DC: Center for American Progress.
Drejer, I. (2004). Identifying innovation in surveys of services: a Schumpeterian perspective. Research policy, 33(3), 551-562.
Fagerberg, J., Mowery, D. C., & Nelson, R. R. (2005). The Oxford handbook of innovation. Oxford: Oxford university press.
Gallouj, F., & Weinstein, O. (1997). Innovation in services. Research policy, 26(4-5), 537-556.
Graban, M. (2011). Lean hospitals: improving quality, patient safety, and employee satisfaction. New York: Taylor & Francis.
Grinnell, R. M. (1993). Social Work Research and Evaluation. Itasca, IL: F.E. Peacock.
Gummesson, E. (1987). The new marketing—developing long-term interactive relationships. Long range planning, 20(4), 10-20.
Hertog, P. d. (2000). Knowledge-intensive business services as co-producers of innovation. International journal of innovation management, 4(4), 491-528.
Hertog, P. d., & Bilderbeek, R. (1999). Conceptualising service innovation and service innovation patterns. Research Programme on Innovation in Services (SIID) for the Ministry of Economic Affairs, Dialogic, Utrecht.
Judd, R. C. (1964). The case for redefining services. Journal of marketing, 28(1), 58-59.
Kellermann, A. L. (2006). Crisis in the emergency department. New England Journal of Medicine, 355(13), 1300-1303.
Khurma, N., Bacioiu, G. M., & Pasek, Z. J. (2008). Simulation-based Verification of Lean Improvement for
Emergency Room Process. Proceedings of the 40th Conference on Winter Simulation, 1490-1499.
Liker, J. K. (2004). The Toyota Way: 14 Management Principles from the World's Greatest Manufacturer. New York: McGraw-Hill Education.
Mason, J. (2017). Qualitative researching. UK: Sage.
Myers, M. D. (2019). Qualitative research in business and management. Thousand Oaks, CA: Sage
Ng, D., Vail, G., Thomas, S., & Schmidt, N. (2010). Applying the Lean principles of the Toyota Production System to reduce wait times in the emergency department. Canadian Journal of Emergency Medicine, 12(1), 50-57.
OECD. (1997). Proposed Guidelines for Collecting and Interpreting Technological Innovation Data–Oslo Manual. Paris: OECD.
OECD. (2005). Oslo Manual: Guidelines for Collecting and Interpreting Innovation Data. Paris: OECD.
Ohno, T. (1988). Toyota production system: beyond large-scale production. New York: Productivity Press.
Olshaker, J. S. (2009). Managing emergency department overcrowding. Emergency Medicine Clinics, 27(4), 593-603.
Ormston, R., Spencer, L., Barnard, M., & Snape, D. (2014). The foundations of qualitative research. London: Sage.
Regan, W. J. (1963). The service revolution. Journal of marketing, 27(3), 57-62.
Schull, M. J., Morrison, L. J., Vermeulen, M., & Redelmeier, D. A. (2003). Emergency department overcrowding and ambulance transport delays for patients with chest pain. Cmaj, 168(3), 277-283.
Schumpeter, J. A., & Opie, R. (1934). The theory of economic development Harvard University Press. Cambridge, Mass: Harvard University Press.
Tidd, J. (2001). Innovation management in context: environment, organization and performance. International journal of management reviews, 3(3), 169-183.
Vargo, S. L., & Lusch, R. F. (2008). Service-dominant logic: continuing the evolution. Journal of the Academy of marketing Science, 36(1), 1-10.
Voss, C. A. (1992). Measurement of INNOVATION and DesignPerformance IN SERVICES. Design Management Journal, 3(1), 40-46.
Voss, C. A., & Hsuan, J. (2009). Service architecture and modularity. Decision Sciences, 40(3), 541-569.
White, B. A., Chang, Y., Grabowski, B. G., & Brown, D. F. (2014). Using lean-based systems engineering to increase capacity in the emergency department. Western Journal of Emergency Medicine, 15(7), 770-776.
Womack, J. P., & Jones, D. T. (2003). Lean Thinking: Banish Waste and Create Wealth in Your Corporation. New York: Free Press.
Yang, T., & Lu, J. C. (2011). The use of a multiple attribute decision-making method and value stream mapping in solving the pacemaker location problem. International journal of production research, 49(10), 2793-2817.
Yin, R. K. (1993). Application of Case Study Research. California: Sage.