探討醫院支援高山醫療的發展歷程

To Explore the Development of High-Altitude Medicine for a Hospital

醫院支援高山醫療的長期過程，結合登山旅遊與醫療服務，可藉由實踐社群的發展模式來解釋。這個模式有三個組成成分：首先一、共同實務方面：結合興趣、專業、地緣、意義的醫療志工實務；二、社群人員方面：以地緣醫院為主要的核心社群人員，逐漸聚集社群。結合玉山排雲山莊醫務所成立以網路號召醫療人員參與；三、知識領域方面：初期由玉管處的高山醫療活動邀約參與學習，後來排雲醫務所建成啟用後再由專責醫院為主導，讓參與的醫療人員學習改善。在高山醫療的實踐社群中的五個發展階段：潛在期、結合期、成熟期、管理期和轉型期。須關注各階段的挑戰，把握關鍵重點、以持續發展實踐社群。

Normally, high- altitude medicine combining the climbing-mountain trip and medical service requires long-term process of development. The development of high- altitude medicine for a hospital can be capsulated by a model of communities of practice (CoP).The CoP model has three components. At first, in the common practice: the team combines multiple types of practices such as recreational interests, professions, geographical proximity, and medical volunteers. Second, in the membership, the core members are hospital staff from nearby communities; besides, a network of participants is linked by internet, and is based at Paiyun Lodge Medical Service Center. Third, in the domain of the shared knowledge, initially, Yushan National Park Headquarters invited high-mountain activities and as Paiyun Lodge was established, a hospital was dedicated to guide learning activities. There are five stages in the CoP development: potential, coalescing, maturing, stewardship and legacy. We should deal with the challenges of each stage, control the key fact