大型醫院手術室重建的關鍵影響因素之探討-以臺大醫院東址四樓開刀房重建工程為例

Key factors for operating rooms renovation for large hospital

曾志國(Chih-Kao Tseng)

指導教授 ： 郭斯傑

國立臺灣大學/工學院/土木工程學研究所/碩士(2012年)

https://doi.org/10.6342/NTU.2012.01186

摘要

醫院設置的目的主要是救人生命及讓病人恢復身心健康的地方，而醫院中的手術室主要是進行外科手術治療的醫療場所，根據行政院衛生署的統計資料顯示，國內醫院每年手術量約160萬餘次，其中超過三成以上集中在前十五大醫院進行，且醫院中因外科手術而住院的比例亦已超過五成，其佔醫院營運的比重偏高。且據研究顯示，病患具有偏好異質性，以病患的觀點而言，不同的醫院之間並不能完全替代，若病患轉移到其他醫院就醫則其效用會降低。因此，大型醫院的手術室若因使用年限已盡或其他因素而須進行拆除重建工作時，對該醫院的營運及其病人的醫療服務，將產生重大影響。
手術室是醫院建築中系統最複雜、功能需求最繁多的區域，且其與醫院內各單位皆有相互關連性存在，現代化的手術室，包括了空氣潔淨技術、醫學無菌技術、醫院管理科學和建築規劃技術在內的跨領域綜合性的技術，所以醫院手術室是一項須要高度專業知識的建築領域。也因此醫院手術室的重建工作，不僅面臨法規的適用性、重建的方式、招標的模式，及如何在最短工期內並以合理成本重建完成等多方面考量。
本研究藉由文獻回顧、法規剖析及台大醫院東址四樓開刀房火災後重建過程的經驗，並透過專家訪談檢核後，整併歸納出大型醫院手術室重建工程在施工階段的關鍵影響因素計有十項及五十九項影響因子，相信能對後續同樣需要進行手術室重建工程的醫院及其執行單位在執行過程中可參考使用。本研究成果相信能降低大型醫院手術室重建執行過程中的風險。

關鍵字

關鍵影響因素 ； 大型醫院 ； 手術室 ； 重建工程 ； 施工 ； 施工階段

並列摘要

The main purpose of hospitals is to save lives and for patients’ physical and psychological recovery, and operating rooms in a hospital are facilities for surgical treatment. According to the Department of Health’s statistics, domestic hospitals perform surgery about 1.6 million times annually, more than 30% of which occur in the top fifteen large hospitals. In addition, hospitalization for surgery accounts for more than 50% of the total hospitalization, which makes up a higher rate of hospital operations. Studies have also shown that patients have preference heterogeneity, and from patients’ viewpoints, different hospitals can not be entirely substituted for one another. If a patient is transferred to another hospital, the utility for the patient will be reduced. Therefore, if the service life of an operating room in a large hospital is due or the operating room needs demolition and renovation for other factors, the operation of the hospital and medical services for its patients will be significantly affected.
Operating rooms are the areas with most complex systems and functional requirements in a hospital building and are inter-related with other units in the hospital. Modern operating rooms integrate interdisciplinary techniques including clean-room technique, medical aseptic technique, hospital management science and building planning techniques. Therefore, the construction of hospital operating rooms is a building area requiring highly specialized knowledge. Renovation of hospital operating rooms faces not only issues of the applicability of regulations, the method of renovation, and the way of tendering but also considerations of how the renovation can be done at a reasonable cost in the shortest period of time.
This study adopts literature review, analysis of the regulations and interview with experts as the major research methodologies. Through these methodologies and experience of participating in the renovation of the National Taiwan University Hospital operating room, the key factors for the renovation of large hospital operating rooms during the construction phase are identified and summarized into 59 impact factors in 10 categories. The key factors are believed to be useful and worth being referred to for hospitals and construction teams for future renovation of hospital operating rooms. The finding in this research is also believed to be able to help reduce the risk in the implementation of the renovation work.

並列關鍵字

Key factors ； Large Hospitals ； Operating Rooms ； Renovation ； Construction ； Construction phase

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