醫學界常流行一句話『預防重於治療』,危機管理也以危機來臨前的防制機制為最高境界,一個有效的危機管理模式,可以在危機發生前予以排除危險因子;若不幸爆發危機,亦可以依各應變作業解決危險因子,降低危機所產生的損害。 本研究以收集危機管理模式相關文獻,加以探討分析,並以亞東醫院為例,進行現場觀察。經由文獻回顧,依努納梅克(Jay Nunamaker)等人提出之危機發生前、發生時與發生後的三個時期的管理策略,以及石富元醫師所建議醫院緊急應規劃管理九步驟來探索個案醫院危機管理模式。並透過『因應H1N1新型流感』與『電梯故障事件』,觀察個案醫院危機管理模式之運作模式。所得結果如下: (一)危機預防為危機管理的最高境界,建立並落實危機預防機制是非常重要的。危機的預防機制,除制定各項硬體設施之日常查檢規範外,亦有 1.演習:模擬各類危機狀況,檢試各項應變計劃與管理系統是否運作正常,亦可加深同仁對此災害應變的憝悉度,增加其自信。 2.檢討:對已發生的危機,以根本原因分析法,找出原因,予以改善;對於未發生的危機,以失效模式與效應分析法,探討可能發生的原因,加以預防。 3.依災害別設立專責單位,隨時觀察內、外部環境的變化,以利第一時間察覺警訊。 4.建置異常事件通報系統,除便利同仁通報異常事件外,亦可將其視為資料庫,定期由專業部門進行資料統計與分析。 (二)危機意識為危機管理首要條件,醫院組織複雜,危機因子種類繁多。因此每位同仁應有高度的「危機意識」,細心觀察周遭環境的變化,若發生異常狀況,立即通報。 (三)危機管理體系的運作若要成功,重要關鍵在資訊的溝通要順暢,無論是危機的特性、危機處理的進度、危機應變作業與危機造成損失等資訊,都需要透過健全的溝通系統來完成。
As the widely repeated medical cliché that prevention is better than cure, crisis management is also the best control mechanism before crisis coming. An effective crisis management model can eliminate all dangerous factors in advance, and, as if the crisis outbreaks, lower the damages it brings according to various emergency response procedures. This study focus on collecting thesis literatures related to crisis management, analyzing, and site observing at Far Eastern Memorial Hospital (FEMH). By means of thesis literature reviewing, this study is based on the three-stage crisis management theory of Jay Nunamaker, pre-crisis stage, in-crisis stage, and post-crisis stage, combing with the nine steps of Hospital Emergency Response Planning and Management suggested by Dr. Fun-Yuan Shin. Through two action plans of “Influenza A (H1N1)” and “Elevator Malfunction”, the study observes the operation model of crisis management of FEMH and concludes the following: I. Crisis prevention is the most necessary measure of crisis management. It is important to establish and practice all crisis prevention mechanisms. Besides regular checking procedures of facilities, the crisis prevention mechanisms also include: 1. Exercise: Simulate various crisis conditions and check the operation of response plans and management system normally. Furthermore, it drives staff to be familiar the response procedures and thus increases their confidences. 2. Review: For crisis happened, use Root Cause Analysis to find out the cause and solve it. For crisis not happen yet, use Failure Mode and Effect Analysis to figure out the reason and prevent it. 3. Organize different authorities for different damages. Observe the changes of inner and outer environments and become aware of damages at the first time. 4. Establish unusual incident reporting system. In addition to notifying staff the unusual incidents, it acts as a database for event statistics and analysis. II. Consciousness of crisis is the top requirement of crisis management. Due to the complexity of hospital organization and variety of crisis factor, each staff should own high consciousness of crisis – observe the change of environment carefully and alert relevant personnel immediately when damage happens. The smooth of information communication leads to the success of crisis management system. All information of characteristic of crisis, progress of crisis process, crisis response procedure and damage need be passed by sound communication system.
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