透過您的圖書館登入
IP:44.221.46.132
  • 學位論文

企業持續運作管理之研究: 以醫院防災應用為例

Applying Business Continuity Management System in Hospital Emergency Preparedness: a Study of Hospitals Disaster Preparedness

指導教授 : 黃崇興 陳俊忠

摘要


企業在面臨天然或是技術的緊急事件時,迅速展開復原工作,使企業迅速回復營運,稱之為「企業營運持續管理」。其目標在於提供面對未預期的衝擊事故進行風險管理,並以完整的應變及復原計劃,協助於事故後依計劃迅速進行復原工作。近年國際已經有相當完善的系統,也廣泛地運用在各企業機構,然而在本國的醫療機構仍然缺乏導入運用此系統的經驗。本研究從國際的營運持續管理指引中,尋找出可供本國醫療機構適用的持續運作管理的指引,協助機構在面對各危害,能維持機構的基本運作,提供高品質的醫療照護,維護人員健康安全,協助機構能永續經營。 本研究主要是採用狀況導引的規劃方式,先分析醫院最高風險的災害類別,選出高風險災害再聚焦於過去事件所引發的後果,以其所影響醫院關鍵功能的持續運作,來進行機構的持續運作規劃。研究採焦點團體及專家會議雙線進行的方式。從焦點團體,經由團體決策模式確認醫院未來的各種風險危害,並且從高風險危害中,找出曾經發生過的重大事件,分析其各種對醫院營運的衝擊。專家會議則從文獻中將醫院的各種關鍵服務功能,找出最關鍵的項目,再以專家會議中的事件分析,分析各關鍵功能受衝擊而發生營運危機的風險,再尋求可能的改善或是應變策略。 經焦點團體討論中,醫院人員認為危害以院內火災、疫災風險最高,其次為電腦當機、水災、醫用氣體中斷及颱風。本研究選用院內火災及疫災的事件,分析其後果,發現這些事件廣泛對於醫院的各基本關鍵服務功能都有很大的衝擊,且發生機率相當高。運輸、保安、環境清潔、後勤、醫用氣體等,過去不被重視的環節反而影響很重大。電力、通訊、資訊及水源等,過去有加以特別關注管理安全性反而稍高於其他項目。而各個關鍵服務功能的延續,必須各種措施,例如場所、人員、物品服務及作業流程的改變,來達成任務。 隨著醫療分工日益精細及機構往大型化發展,醫療的持續運作,面臨眾多災害的威脅,這些威脅後勤作業面可能更甚於醫療本身。從台灣醫療環境長期趨勢,醫院維持醫療核心能力而將非醫療業務委外似乎是必然的趨勢,然而目前醫療後勤持續運作的企業專業,不足以應付需求。企業營運持續管理提供醫療機構一個系統性而且全方位的管理方式,在災害未發生前即可有效率地管理風險,減少營運因災害的影響,在災害中可以減少因為衝擊而營運中斷,並且加速企業的恢復。營運持續運作管理,應該是醫院經營管理的核心技能之一。 長期看來,機構如果無法在自己的能力去做好風險管理與調整,委託專業的機構協助或是是另外一種可行的方法,只是這類型的服務在台灣尚待開發。如果能提供醫院營運持續及控制雙方風險的專業諮詢與建議,並且整合下游提供醫院勞務的公司,結合遠端控制、雲端資訊整合與物聯網,有新創服務模式的存在獲利空間,而且對於社會、醫療機構等,也都有很大的益處。

並列摘要


“Business Continuity Management” means the development of strategies, plans and actions to protect business processes or activities, respond effectively to threats from disasters, and restore promptly of normal operation. It consists of crisis management of unexpected event; business resumption planning about the recovery of core products or services related critical business functions; and the recovery of critical information assets. In spite of well-organized systems were established and applied successfully in some enterprises, there still wants a holistic approach healthcare organization in Taiwan to manage operation continuity risks. In this study, we tried to apply the comprehensive approach of business continuity management into Taiwan hospitals to ensure the continuity of critical operations during a disaster, protect the health of patients and personnel, as well as the recovery and resumption of normal operation. A scenario-based approach was used in this study: through hazard vulnerability analysis of this hospital, we identified the high risk hazards; then chose real events of these hazards in recent decade for business impact analysis. We analyzed the impacts of these events on the mission-critical function of hospitals, and then formulated possible solutions and strategies for similar situation in the future. A focus group panel that consisted of senile staffs in this hospital was established to conduct hazards vulnerability analysis, and identify the impacts to critical functions in their experiences. Expert panel which invited experts in hospital administration, emergency preparedness, and clinical care, identified the mission-critical element for hospital functions through literature review, and conduct business impact analysis for these items in past events, and came up with feasible strategies and solutions for hospitals. Hospital internal fire and epidemic were recognized as the highest risks among all hazards, followed by computer shutdown, flood, medical air failure and typhoon by senior hospital staff. In business impact analysis of a hospital fire and an epidemic in recent decades, many mission-critical functions impacted could affect the continuity of medical care delivery. Most vulnerable functions that not draw enough attention before included transportation, security, environmental sanitation, logistics, and medical gas. On the other side, electricity, communication, information, water and sewage system were more resilient, probably been retrofitted in previous earthquake in 1999. Many critical functions including equipment, personnel and their assignment, logistics supplies and processing, required fine tuning and adjustment to ensure continue operation. On the trend of growing larger in scale and more complex, healthcare systems in Taiwan confronted many operation interruptions from disasters, and probably more on the non-medical parts. The mainstream of medical environment in Taiwan tends to keep a lean medical core competence, and outsource the day-to-day non-medical services, while the logistics might not fulfill the essential demands in emergencies. Business continuity management system can provides a systemic and comprehensive approach for healthcare facilities, manages the risks effectively, mitigates the impacts from disasters, prevents operation interruption and facilitate recovery. The expertise of business continuity management should be one of the core competences of hospital management staffs. Third-party professional agencies, which currently not available in Taiwan may help hospital function continuity if the organizations lack the expertise to manage. This alternative option could be a profitable business model if it could provide expertise in business continuity planning and risk management for the healthcare system and their suppliers, integrating the downstream supply chain companies through internet remote monitor and control, information clouds and internet of things, notify and respond promptly in case of emergencies. This profitable model is also beneficial for the community and hospitals.

參考文獻


疾病管制局,2011,因應流感大流行執行策略計畫(第三版),台北:行政院衛生署疾病管制局。
林智暉、邱淑君、林永政、王聖帆、楊志元、金芝源、陳雨凡、黃莉芳、陳豪勇,2003,全球SARS風暴之台灣經驗,疫情報導 ,19卷6期:306-316。
Castillo, C., 2005, Disaster preparedness and Business Continuity Planning at Boeing: An integrated model, Journal of Facilities Management, 3(1) : 8-26. Doi:10.1108/14725960510808365
Cerullo,V., Cerullo, M.J., 2004. Business Continuity Planning: A Comprehensive Approach. Information Systems Management, 21(3): 70-78. Doi:10.1201/1078/44432.21.3.20040601/82480.11
Lockamy III A., McCormack, K., 2004, The development of a supply chain management process maturity model using the concepts of business process orientation, Supply Chain Management: An International Journal, 9(4): 272- 278. Doi: 10.1108/13598540410550019

延伸閱讀