台灣本土化醫院緊急應變及指揮系統（T-HEICS）之建構

Establishment of Taiwan Hospital Emergency Incident Command System

郭建成(Chian-Cheng Kuo)

指導教授 ： 邱文達

臺北醫學大學/公共衛生暨營養學院/傷害防治學研究所/碩士(2005年)

摘要

前言：台灣地理環境特殊，在自然與人為因素的作用下，使得災難頻傳，整體而言災難應變體系參差不齊，醫院本身的災難應變及指揮系統更顯得凌亂。 研究目的：調查台灣醫院緊急應變現況並以國外醫院緊急應變系統（簡稱HEICS）為架構，整合建構台灣醫院災難緊急應變及指揮體系（簡稱T-HEICS）；模擬醫院常見災難類型之T-HEICS動員模式；最後建議教育訓練相關事宜。 材料與方法：本研究於93年7月起至8月止，收集全國43 家醫院之災難應變及指揮系統做深入調查。另於，93年11月至94年4月，針對緊急應變相關領域之專業人士進行台灣本土化醫院緊急應變及指揮系統之建構做問卷調查。 結果：90％以上的醫院有設立緊急應變指揮系統，且明訂組織架構、工作權責與工作守則，但所有組織架構均不相同。超過87％的醫院有訂定大量傷患應變計畫，但相對於其他，像是輻射防護計畫、撤離計畫以及危害物質作業程序等，則相當少醫院有明訂之，甚至像災後復原計畫、病患追蹤表單有設置者更低於40％。在教育訓練與演習方面，則大多數皆有依規定執行，唯有桌上演練有78％的醫院沒有辦理。對於應變計畫之啟動與對外發言單位則缺乏較統一之單位負責。為改善上述缺點，本研究亦建構完成台灣本土化醫院緊急應變及指揮系統（T-HEICS）。並建議台灣醫院常見不同種類災害之T-HEICS動員模式以及教育訓練相關說明。 討論與建議：為整合台灣凌亂的現況，建構T-HEICS。如此便擁有共同語言及架構，有助於應付各種災難的救援及縱向、橫向的溝通聯繫。另外，建議將災難應變相關教育訓練移植至網際網路上，突破時間及空間限制。建議衛生行政單位推行認證制度，有助於檢核、監控緊急應變之成效與品質。

關鍵字

HEICS ； 災難 ； 醫院緊急應變計畫 ； 緊急應變指揮體系

並列摘要

Introduction: Because of the unique geographical features, there are many disasters occurring in Taiwan under both of the natural and artificial effects. In general, the entire emergency incident response systems are not united; therefore, it is more difficult to keep hospital emergency response in order. Objectives: Taiwan Hospital Emergency Incident Command System, T-HEICS, was established based on the integration of Taiwan’s current hospital emergency response system and the United States hospital emergency incident command system, HEICS. The purpose of this study is to examine that the new-established T-HEICS can be exploited effectively in Taiwan. Materials and methods: From July to August, 2004, the associated data was collected from 43 hospitals in the nation. From November 2004 to March 2005, some professionals and experts started to establish this localized HEICS. Results: 90 percent of hospitals in Taiwan have set their own emergency incident command systems with a variation in organized structures, job identities, and discipline manuals. More than 87 percent hospitals have a well-structured emergency plan for mass injured patients. Others need to improve their emergency plan including the anti-radiation plans, the evacuative plans, and a procedure of how to deal with hazard substances. Less than 40 percent hospitals have for post-disaster plans and tracking patients’ recovering conditions. For training programs and on-site demonstration practices, 78 percent hospitals have not considered table drills practice in their emergency plans or an announcing unit responsible for distributing the latest news about the incidents to the public. In order to enhance the current emergency system, a new localized HEICS must be established in Taiwan. This study verifies the functions of the training program and some beneficial advice from the experts regarding how to deal with the most common disasters occurred in Taiwan by using newly established T-HEICS. Conclusion: In order to improve the current situation, integrated T-HEICS must be established for all hospitals in the nation. It is contributive to establish vertical and horizontal communication of the disaster rescue, so that there may be a set of coherent codes and consistent structures. Furthermore, it is encourage to develop the HEICS training programs information access through the internet to conquer the space-time limitation. Also, it is suggested that the public health office must set up a proper regulation of the identifications to distinguish quality and result of the emergency incident inspection and control.

並列關鍵字

HEICS ； disaster ； hospital emergency response system ； emergency incident command system

參考文獻

3.石崇良、石富元(2002)。醫院災難應變模式回顧與前瞻。台灣醫學6:3 頁364-373

18.石崇良、石富元(2002)、醫院災難應變模式回顧與前瞻、台灣醫學(6)，3，364-373。

13.翁德怡、石富元(2002、災難事件的定義、分類與分級標準、台灣醫學(6)，3，350-356。

17.石富元(2000)、災難醫學、台灣醫學(4)，2，269-176。

27.陳建仁、邱文達、紀雪雲、張珩、馬惠明、涂醒哲、張博論、白璐、吳英璋、周碧瑟、張瑞杰、詹長權、馮燕、蕭震芳、張寶樹、陳國冬、王立敏、鄧昭芳、蘇明峰(2000)、重大災難之研究政策建言書、中華衛誌(19)，3，72-78。