應用敏捷管理概念於新冠肺炎疫情期間進行醫院營運持續計畫

Business Continuity Planning of Community Hospital with Agile Management in the Time of COVID-19

醫院在經歷新冠肺炎疫情（Covid-19）時，應保證核心業務持續運作，以減少疫情所造成的衝擊，故需訂定醫院營運持續計畫（Business continuity planning, BCP）。個案醫院於疫情期間員工零確診，共計通報1例確診個案病例數和33例疑似個案病例數；急診就診人次相較去年同期減少24.1％（2020年2－5月），病人三日內與前次疾病相關性急診返診率為1.88％，則較去年同期（1.66％）增加。本文提出以敏捷管理（Agile Management）概念推動新冠肺炎疫情期間的醫院營運持續規劃經驗。首先，個案醫院運用敏捷概念以加速建立新冠肺炎疫情期間的感染管制措施，主要依照三個要點運作：第一是公開透明的溝通網絡；第二是完整有效的資源盤點；第三是協同合作的團隊文化。其次，個案醫院由院長（指揮官）成立敏捷領導團隊（新冠肺炎疫情指揮中心），以設定優先敏捷專案並指派負責人來領導及排除團隊遇到的阻礙；同時，本文發現透過敏捷管理的溝通模式能幫助團隊在動態調整時有所依循，讓功能不同的單位，組成具有相同目標（保護員工、照護病人、守護醫院）的團隊，共同建立防疫系統穩定性。最後，本文以病人為焦點的查證方式（Patient Focused Methodology, PFM）進行16次演練稽核計畫，可以逐層檢視防疫就醫流程、盤點防疫物資與確保環境安全，並可在符合感染管制的原則下，持續修正門急診、住院、手術檢查等各種情境之疑似個案轉送動線與流程。

When a hospital face new coronavirus diesease-19 (COVID-19) outbreak, hospital should ensure core business can continue to operate and reduce the impact of the epidemic outbreak. Therefore, it is necessary to formulate a hospital continuity planning (Business continuity planning, BCP). No hospital staff was infected with COVID-19 in this period. Besides, one confirmed COVID-9 infected case and 33 suspected COVID-9 infected cases were reported from this hospital. The total emergent room patients was decreased 24.1% (2020 February to May) as compared to the same period of last year. The 3-days revisit rate related to the same etiology of emergent room was 1.88% which was increased as compared to last year (1.66%). This article proposes the Agile Management (Agile Management) concept to share the continuous planning of hospital operations during the COVID-19 outbreak experience for other hospitals. First, the case hospital uses an agile concept to autonomously manage the team to accelerate the establishment of infection control strategy during the COVID-19 pneumonia epidemic. It mainly operates according to three main points: the first is an open and transparent communication network; the second is a complete and effective resource inventory; the third is Collaborative team culture. Secondly, in the case hospital, the superintendent (commander) established an agile leadership team (COVID-19 Epidemic Outbreak Command Center) to set a priority agile project and assign a person in charge to lead and eliminate the obstacles encountered by the team. At the same time, We had found that communication through agile management can help the team to follow in the dynamic adjustment, let the units with different functions can build a team with the same goals (protect employees, care for patients, guard the hospital), and establish the stability of the epidemic prevention system. Finally, the Patient Focused Methodology (PFM) is used to conduct 16 drills and audit plans, which can examine the epidemic treatment process, inventory the epidemic prevention materials and ensure the safety of the environment. Based on the guide of infection control, continuous and rolling revision of suspected patients transportation flow line and process in outpatients department, emergency room, admission and operation.