2016-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/646291摘要：本計畫是依「防災科技研究計畫」之5-3「跨區域型大量傷患事故緊急醫療應變體系作業模式」課題，研究內容為地區與區域緊急醫療能力評估、急救責任醫院持續運作與接收大量傷患評估及以八仙粉塵暴燃災例之研究分析。面對大量傷患事件時，醫療機構必須採取不同於平常流程的機制，來發揮突發的作業能力與能量，應付實際上的需求。在現行的醫療照護系統，社區來的緊急病患都會經過急診室的處理，如果運作不佳，可能會產生瓶頸，而使得病人得照護發生延誤的情況，造成死亡率或後遺症比率提高。本研究的分析大致上以醫療作業突發能量 3S 架構，配合價值流程圖等的作業流程研究來當成研究的主軸，去分析在醫療體系在大量傷患應變準備作業能量與能力的精進方案。特別是在組織行為與指揮體系、醫療持續運作、特殊危害及新科技的應用等面向的精進作為。希望能建構急診面對大量傷患事件運作模式的效能提升，確保能維持持續地運作，不會受到災難的衝擊而停頓，並以數值模擬分析的方式，探討急診大量傷患醫療運作之效率及效能之影響因素，並提出適當的運作模式建議本計畫為三年期的計畫，第一年注重在釐清問題，包括文獻資料分析、現況調查與災例探討，而第二年主要是流程分析及模型的建構，建立模型分析必要之基本元素與參數，第三年為利用作業管理的技術，改變及調整目前的作業流程，從數理模型進行作業流程的改進，並經由使用者的經驗轉化為處置之精進建議。本計畫可以建立新的大量傷患處置模式與流程，實際改善本國救護與醫療體系之災難應變能力，提升災難醫療的量能。建立緊急救護、醫療與企業流程的整合與開發，建立跨界研究平台。開發新科技的運用於災難應變中，或許也可以為資訊產業開發新的應用模式，不只有市場的潛在空間，也讓資訊科技實際上造福受災的人群。<br> Abstract: The healthcare facilities should alter their daily medical process in order to increase their capacity and capability to cope with the medical surge in a mass casualty incident. The casualties from thecommunity will be sent to emergency rooms for emergent care. Increased mortality and morbiditydue to treatment delay would be occurred in case of operational bottle neck in poor managedemergency rooms.In this project, we choice the 3S model (staff, stuff and structure) for medical surge frame work,incorporated with Value Stream Mapping as the primary tool for optimizing processes in emergencyrooms and improving capacity and efficiency. Organizational structure with Incident CommandSystem and RACI matrix, Business Continuity Management, CBRNE events and new informationtechnology will be examined and processes been adjusted to guarantee the resilience to all kinds ofhazards. Simulation model will be utilized to identify the keys to improve capacity and efficiencyand fine-tuned the processes for mass casualty incidents.The time frame of this project was three years. The first year we would focus on delineating thehospital medical operation through literature review, survey and case studies. Construction of ValueStreaming Mapping for alternative medical process, parameters setting, models simulation andvalidation will be the main task in the second year. In the last year, models would be compared andfine-tuned according to simulation result.