X醫院SARS危機管理

Abstract

廿一世紀初新興傳染疾病—嚴重急性呼吸道症候群（Severe Acute Respiratory Syndrome,SARS）以迅雷不及掩耳之勢席捲全球，台灣亦無法倖免於難。其實危機的發生，並不是完全不可預測，此次的SARS疫情，最早於九十一年十一月由廣州爆發流行，其後經由香港散播到越南、新加坡與加拿大等地，然而國外的經驗及教訓，並未獲得台灣政府當局及各大醫療院所的警惕與重視。 自九十二年三月十四日台大醫院報告勤姓台商SARS首例至同年四月二十四日和平醫院封院前一天，台大醫院共隔離治療九名SARS病患且未傳出死亡病例，表面上看似風平浪靜的疫情，暗地□卻已悄悄的在全台漫延開來。同年四月二十日，台灣召開全球一個SARS國際研討會，對外標榜「零死亡、零移出、零社區感染」的優異成果，直到同年四月二十四日和平醫院因院內交叉感染嚴重而走上封院一途，政府及各大醫療院所才驚覺危機的來臨，因此全台在SARS疫情來臨時錯失了掌控疫情及採取相關因應措施的先機，加上疫情來勢洶洶，才會一發不可收拾。 Ｘ醫院在疫情侵台前係由感染管制委員會負責監控及掌握SARS疫情；台大醫院報告SARS首例時，Ｘ醫院立即派人前往了解學習，並積極規劃抗SARS相關因應措施；Ｘ醫院在收治第一位通報的SARS病患時，便已做好相關準備措施；和平醫院封院之翌日，Ｘ醫院的院長立即指示胸腔科資深醫師擔任抗SARS執行長；之後隨著疫情的加温與擴大，Ｘ醫院立即提升危機處理層級，並擴大危機處理團隊。Ｘ醫院在此次抗SARS戰疫中採取相當周全的行動，成功的吸納從和平醫院及台大醫院所轉出來的SARS病患，因為Ｘ醫院的專業及用心，方使得疫情能夠有效的獲得控制，而不致於擴散至其他醫院。故院方在此次抗SARS過程中深獲美國CDC、AIT、台大感控小組及全國防治作戰中心指揮李明亮教授、疾管局蘇益仁局長的認可及肯定。 本研究試圖從SARS案例分析探討Ｘ醫院SARS危機管理過程，並經由Ｘ醫院危機管理者深度訪談結果，從整合危機管理理論的危機爆發前的活動、危機爆發時的活動、危機解決後的活動等三個危機管理階段及危機情境下的溝通活動作探討，以歸納出Ｘ醫院抗SARS之經驗及教訓，並針對Ｘ醫院危機管理系統尚可更精益求精之處提出建議。

The early 21st century newly developed contagious disease – the Severe Acute Respiratory Syndrome,(SARS) rolled over the globe as sudden as lightning and Taiwan also could not escape this by sheer luck. In fact, the occurrence of this crisis is not incompletely predictable as the SARS epidemic situation burst out and became widespread in Quangzhou in November 2002. Thereafter, it was stretched to Vietnam, Singapore and Canada etc. from Hong Kong. However, the overseas experience and lesson were not vigilant and emphasized by the Taiwan government and various large hospitals. From the first case of Taiwanese merchant Mr. Chin reported by the National Taiwan University Hospital in March 14, 2003 till the day before the sealing off of the Hoping Hospital in April 24, all together for the nine quarantined SARS patients in National Taiwan University Hospital, there was no news on case of death. Although the epidemic situation appeared calm on the surface, yet stealthily this disease silently spread out all over Taiwan. In April 20 in the same year, Taiwan convened the first global SARS International Symposium and boasted its excellent achievements of 「zero death, zero transfer out, zero community infection」. Until April 24 in the same year when Hoping Hospital had to seal off its hospital due to serious cross infection inside the hospital, the government and various large hospitals were alerted by the arrival of the crisis. Therefore, during the arrival of SARS epidemic situation, Taiwan had already lost its first opportunity to control the epidemic situation and to adopt related contingency measures. In addition, due to the furious development of the epidemic situation, it became irremediable. For X Hospital, before the epidemic situation attacked Taiwan, the Infection Control Committee was responsible for the monitoring and mastering of the SARS epidemic situation. When the National Taiwan University reported the first SARS case, X Hospital immediately sent people to understand and to learn and actively planned related contingency measures in the defense against SARS. When X hospital received the first reported SARS patient, they already prepared related preparation measures. On the next day of the sealing off of the Hoping Hospital, the Head of X Hospital immediately instructed the senior doctor of the thoracic cavity department to be the chief executive to fight against SARS. Thereafter, following the increase and expansion of the epidemic situation, X Hospital immediately enhanced its crisis management level and expanded the crisis management team. In this battle against SARS, X hospital adopted considerable complete action and successfully took over SARS patients transferred from Hoping Hospital and National Taiwan University. Due to the professionalism and attention of X Hospital, the epidemic situation could be effectively controlled and would not spread to other hospital. Therefore, in the course of the battle against SARS, the hospital won the approval and affirmation from CDC in US, AIT, National Taiwan University Infection Control Team and National Prevention and Cure Battle Center Commander Professor Lee Ming-Liang and the head of Disease Control Bureau, Su Yi-Ren. This research attempts to analyze and investigate on the course of SARS crisis management of X Hospital in this SARS case. In addition, through the result of in-depth interview with the crisis manager of X Hospital and from the three crisis management phases including the activity before the bursting of crisis, activity during the bursting of crisis and the activity after the crisis is solved and the communication activity under the crisis situation, an exploration is conducted so as to summarize the experience and lesson of fighting against SARS by X Hospital. Furthermore, aiming at the crisis management of X Hospital, suggestion is presented on how to keep on improving.