摘要
為了提升病人安全，今日許多醫療機構應用了異常事件通報系統（Reporting system），希望能夠汲取過去的經驗，預防及減少異常事件或醫療錯誤的發生。然而，異常事件通報系統目前卻沒有被成功的執行，並且不若當初預期的被應用。本研究的目的即在找出哪些是影響醫事人員使用通報系統意願的因素，並提出相關建議，以提升使用的意願。
本研究利用在資訊管理領域中普遍被應用的科技接受模式為基礎，以問卷的方式調查可能影響醫事人員使用異常事件通報系統意願的因素，並利用Lisrel統計軟體，分析各個因素對於使用意願的影響程度。本研究的結果顯示，研究模型中所提出的因素對於通報系統的使用意願影響皆達顯著水準，其中，以主觀規範（subjective norm）的影響最大，顯示同事、下屬以及主管對於使用通報系統態度正面與否，將會重大的影響個人的使用意願。此外，通報系統介面是否容易操作（Perceived ease of use）以及能否能夠及時回饋並提供有用資訊（Perceived of usefulness ），亦對於使用意願有相當大的影響。本研究除了分析何為影響使用通報系統的因素外，亦提供了預測使用意願的模型，提供醫院規劃、評估通報系統之用。
關鍵字:異常事件, 通報系統, 科技接受模式, 病人安全

Objective: Today, many healthcare organizations have implemented health care reporting systems in the hope of learning from experience to prevent or reduce adverse events, medical errors or accidents. However, most applications have failed or not been implemented as predicted. This study presents an extended technology acceptance model (TAM) that integrates subjective norm, trust, and management support into the TAM to investigate what determines healthcare professional reporting system acceptance.
Design: The proposed model was empirically tested using data collected from a survey in the hospital environment. The structural equation modeling technique was used to evaluate the causal model and confirmatory factor analysis was performed to examine the reliability and validity of the measurement model.
Measurements: Questionnaire administered items measuring the behavioral intention to use the reporting system and five hypothesized antecedents.
Results: Our findings indicated that all variables significantly affected healthcare professionals’ behavioral intention to use the reporting system. Among them, the subjective norm had the most significant influence.
Conclusion: The proposed model provides a means to understand what factors determine healthcare professional’s behavioral intention to use a reporting system and how this may affect future use. In addition, antecedents to the behavioral intent can be used to predict reporting system acceptance in advance of system development.

1 Introduction……………………………………………………………………...1
2 Averse event reporting system……………………..…………….………..……3
3 Conceptual model and research hypotheses……………………………...…...4
3.1 Technology Acceptance Model……………………………………..….…5
3.2 Subjective Norm and Trust……………………………………..…….…..6
3.3 Management Support………………………..……………………………8
4 Research methodology and design…………………………………….………10
4.1 Measures………………………………………………………………….10
4.2 Subjects…………………………………………………………………...13
5 Data analysis and results………………………………………………………13
5.1 Descriptive statistics…………………..…………………………………14
5.2 Measurement model………………….………………………………….…15
6 Discussions……………………………………………………………………...20
7 Implications and Conclusions…………………………………………………22

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