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研究生： 羅婕
Lo, Chieh
論文名稱： 以設計思考觀點探討跨專業團隊之問題解決過程:以自立支援機構雲林縣同仁仁愛之家為例
Exploring the Problem-Solving Process of Interdisciplinary Team from the Design Thinking Perspective: A Case Study of Self-Supporting Institution Yunlin County Tong-ren Long-Term Care Institution
指導教授： 仲曉玲
Chung, Hsiao-Ling
學位類別： 碩士
Master
系所名稱： 規劃與設計學院 - 創意產業設計研究所
Institute of Creative Industries Design
論文出版年： 2019
畢業學年度： 107
語文別： 英文
論文頁數： 127
中文關鍵詞： 跨專業團隊合作 、問題解決 、設計思考 、自立支援 、長照機構
外文關鍵詞： Interdisciplinary collaboration, Problem-Solving, Design Thinking, Self-Supporting, Long-term Care Institution
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    • 全球目前正在面臨高齡化危機，老年人口的持續成長加上家庭結構的快速變遷，增加了照顧服務需求。為了因應持續增加的長照需求，長期照顧機構需為住民提供更好的品質。跨專業團隊照護是當前醫療環境中重要的照護趨勢，有效率的跨專業醫療照護的合作才能提供以病人為中心的全面性照顧。設計思考的問題解決架構提供特定的階段性目標及過程區分，可作為探討自立支援機構跨專業團隊中問題解決過程之架構。因此，此研究以設計思考觀點探討跨專業團隊問題解決過程，並提出促進問題解決過程建議。
    本研究以質性研究方法，了解跨專業團隊和照服員間的合作過程。為了釐清研究問題，採用案例分析法，選擇自立支援機構「雲林縣同仁仁愛之家」作為研究個案。本研究以參與式觀察了解自立支援機構中跨專業會議討論過程，並以設計思考做為半結構訪談工具訪談跨專業團隊及照服員，了解自立支援機構中問題解決的過程。
    本研究發現跨專業團隊的價值在專業知識的提供，而照服員提供了個案觀察以及整合資訊的價值。從設計思考探討發現自立支援的問題解決過程是透過不斷迭代並修正照顧計畫，提供符合個案需求之照顧。研究發現自立支援合作多仰賴口頭溝通，照顧的知識、經驗難以系統化傳遞給其他參與者。從設計思考角度檢視，為了促進自立支援問題解決過程的合作架構，跨專業團隊可將內隱知識及溝通、合作過程紀錄並轉換為組織知識，未來可提供給組織內部、外部的參與者作為參考。

    The world is currently facing a crisis of ageing, which has led to an increasing demand for care services. The quality of long-term care institutions has to improve in order to cope with the increasing ageing population. “Interdisciplinary team care” is an efficient interdisciplinary medical care collaboration which can provide patient-centered, comprehensive care services. Design Thinking model provides a specific goal in stages. It can be the framework when exploring the problem-solving process in the Self-Supporting institution. Therefore, this research looks at the process of problem-solving of interdisciplinary collaboration through Design Thinking perspective and providing the suggestion which facilitate the problem-solving framework.
    The research conducts the “qualitative research method” to explore the collaboration framework between the interdisciplinary team and caregivers. In order to have a better understanding, the research selects a Self-Supporting institution “Yunlin county Tong-ren long-term care institution” as the subject of case study. The data are gathered through participant observation and semi-structured interview. The research uses participant observation to explore the interaction between stakeholders in the interdisciplinary meeting of Self-Supporting institution and utilizes Design Thinking as an interviewing tool to interview the interdisciplinary team, caregivers to clarify the role and value of interdisciplinary team and caregivers in the process of problem solving.
    The research findings are as follows, the Self-Supporting collaboration relies on verbal communication, the care knowledge and experience cannot be conveyed to others systematically. From the Design Thinking perspective, to facilitate the problem-solving framework in the Self-Supporting institution, the interdisciplinary team can record the tacit knowledge, communication and collaboration process and transfer to organizational knowledge.

    Table of Contents Chapter 1 Introduction 1 1.1 Background 1 1.1.1 Ageing Issues in Taiwan and the World 1 1.1.2 Active Ageing & Self-Supporting 4 1.2 Motivation 6 1.3 Research Objective & Question 9 1.4 The Key Terms and Concept of the Research 10 Chapter 2 Literature Review 11 2.1 Interdisciplinary Collaboration 11 2.1.1 The Definition and Model of Interdisciplinary Collaboration 11 2.1.2 The Stakeholders in the Interdisciplinary Collaboration 16 2.1.3 The Interdisciplinary Team Collaboration on Medical Care 17 2.2 Design Thinking 19 2.2.1 The Emergence and Evolution of Design Thinking 19 2.2.2 The Models of Design Thinking 20 2.2.3 Problem-Solving Concept 28 2.2.4 Design Thinking in Problem-Solving 31 2.3 Concept of Self-Supporting 32 2.3.1 The Introduction to Self-Supporting 32 2.3.2 The Process of Self-Supporting in Taiwan 36 2.3.3 Collaboration in Self-Supporting 39 Chapter 3 Research Method 41 3.1 Research Framework 41 3.1.1 Research Concept 41 3.1.2 Research Process 43 3.2 Research Method 44 3.2.1 Case Study 45 3.2.2 Participant Observation 46 3.2.3 Semi-Structured Interviews 46 3.3 Data Collection and Analysis 47 3.3.1 Case Selection 47 3.3.2 Data Collection 49 3.3.3 Data Analysis 51 Chapter 4 DATA Analysis and Finding 52 4.1 Data and Sampling 52 4.1.1 Documentation Data 53 4.1.2 Selected Cases 57 4.1.3 Data of Participant Observation 60 4.1.4 Data of Interview 61 4.2 Discovery: The Process of Understanding a Case 65 4.2.1 What Does an Institution Do to Understand a Case? 65 4.2.2 The Value of Interdisciplinary Team in Discover Stage 70 4.3 Define: How might We Help a Case? 77 4.3.1 Defining Problem of a Case Respectively 78 4.3.2 The Value of Interdisciplinary Team in Define Stage 83 4.4 Development: Creating the Care Plan to a Case 87 4.4.1 Development: Creating the Solution & Testing 87 4.4.2 The Values of Caregiver and Interdisciplinary Team in Develop and Deliver Stage 92 4.5 Delivery: Finding a Suitable solution for the Case 99 4.5.1 Delivery: Finding a Case-Oriented Solution to the Case 99 Chapter 5 Discussion and Conclusion 103 5.1 The Role and Value of Stakeholders in Self-Supporting Institutions: The Contribution of Stakeholders 103 5.1.1 The Value and Role of Interdisciplinary Team: The “Think Tank” 103 5.2 Case-Oriented Problem-Solving Framework in Self-Supporting Institutions: The Dynamic of Caregiver and Interdisciplinary Team 105 5.3 Design Thinking in Self-Supporting Collaboration Framework: The Reflection 110 5.4 Conclusion 114 5.5 Research Limitations and Future Suggestions 115 Reference 117 Appendix 122 List of Tables Table 2 1 The Definition of Interdisciplinary, Transdisciplinary and Multidisciplinary 12 Table 2 2 The Combination of Design Thinking Models 27 Table 3 1 Data Collection Steps. 50 Table 4 1 Case Information.. 57 Table 4 2 Data Collection: Interdisciplinary Meeting 60 Table 4 3 Interview Topics 61 Table 4 4 In-depth Interview Topics 62 Table 4 5 Semi-Structured Interview Topics. 63 Table 4 6 In-depth Interview Topics with Manager 64 Table 4 7 The Cause of Enrollment of Case A & Case B. 67 Table 4 8 1500kcal Table of Diet Plan. 89 Table 5 1 Exploring Self-Supporting Institution’s Problem-Solving Process Through Design Thinking 105 Table 5 2 The Problem-Solving Framework of Self-Supporting. 110 List of Figures Figure 1 1 The Number and Distribution of Persons Aged 60 Years or over by Region, in 2017 and 2050. 1 Figure 1 2 Taiwan’s ageing population. 3 Figure 2 1 Interdisciplinary Model. 14 Figure 2 2 Framework for Action on Interprofessional Education & Collaborative Practice. 17 Figure 2 3 Principles of IDEO 22 Figure 2 4 Divergence and Convergence in Design Thinking 23 Figure 2 5 The Double Diamond Design Process 25 Figure 2 6 5-Stage CPS Model 30 Figure 2 7 Self-Supporting Step. 37 Figure 2 8 Interdisciplinary and Caregiver Collaboration. 40 Figure 3 1 Research Framework 42 Figure 3 2 Research Process 43 Figure 3 3 Tong-ren Nursing Institution. 48 Figure 4 1 Cases of the Research. 52 Figure 4 2 The Organization Structure of Chang-tai Long-Term Care System 53 Figure 4 3 Tong-ren Institution. 54 Figure 4 4 Tong-ren Institution. 54 Figure 4 5 ZIZIBABA Self-Supporting Experience Camp. . 56 Figure 4 6 Case A 58 Figure 4 7 Case B 59 Figure 4 8 The Stakeholders in Discover Stage. 65 Figure 4 9 Genogram of Case A 71 Figure 4 10 Genogram of Case B 72 Figure 4 11 The ecological map of Case A. 73 Figure 4 12 The ecological map of Case B. 73 Figure 4 13 The Stakeholders in Discovery Stage. 75 Figure 4 14 Define: The Interaction and Role in the Defining Stage. 77 Figure 4-15, 4 16 Case Portfolio 78 Figure 4 17 Mini-Mental State Examination, MMSE 80 Figure 4 18 Activities of Daily Living, ADL 81 Figure 4 19 The Classification of Case A and Case B. 82 Figure 4 20 The Interactions and Roles in Development Stage 88 Figure 4 21 Knowing the Case by Observation (Case A). 91 Figure 4 22 The Process of Continuous Care Plan Revising in Delivery Stage. 92 Figure 4 23 Interdisciplinary Meeting. 101 Figure 5 1 The Collaboration Framework in Interdisciplinary Team and Caregiver. 106 Figure 5 2 The Problem-Solving Process for Case A. 107 Figure 5 3 The Problem-Solving Process for Case B. 108 Figure 5 4 The Design Thinking-based Case-Oriented Problem-Solving framework.. 112

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