立 理 論 療 流 例 年 六
II
94 2 () ()Study of Preventives of Avian Influenza in Taiwan a Case of Kaohsiung Min-Sheng Hospital N93450009 96 () () Peter Chih-Yu Yang () () Hsien-Tang Tsai, Hwai-Hui Fu () () Iuan-Yuan Lu, Tsuang Kuo III
IV
SARS Mitroff (988) 35 -- AHP, analytic hiarachy process AHP 2 4 0. 8 0.395 0.2978 0.3066 0.353 [ ] V
Abstract Avian Influenza (AI) has made hundreds of people dead in Europe. The hospital system of Taiwan, standing in the first line of prevention and treatment, has to effectively employ the experience of SARS in order to tackle the new serious challenge of AI. Though Taiwan is not yet an epidemic area of AI, it is important for us to be well prepared to confront it. Given that prevention is more important than treatment. It is essential that we try our best to build up an efficiently preventive system for AI. This study aims to investigate what is most important and critical in the preventive system. More specifically, what is a priority to do in such a preventive system, especially in a limited condition of budgets and human resources? According to the five stages of crisis management proposed by Mitroff (988) (see page 35), the current study focuses mainly on operations in the second stage, preparation and prevention of crisis. In terms of analytic hierarchy process (AHP), it designs a questionnaire to systematically interview 2 doctors. Since four of them are outliers when the consistency test is considered, results are based primarily on the opinions of the remaining 8 doctors. The results are summarized as follows.. Before the crisis comes, both the training of doctors and nurses (weighted value = 0.395) and the regularization of preventive process (weighted value = 0.2978) are most important. 2. The regularization of preventive process (weighted value = 0.3066) is most economic in the limited condition of budgets that is available to the preventive operations. Accordingly, it is a best way to regularize the individual operations and spread the concept of the regularization. 3. The training of doctors and nurses (weighted value = 0.353) is most important in the limited condition of human resources, that recently appears gradual reduction among hospitals. That is, by means of rehearsal of related operations and of training courses, the crew in a hospital can have an understanding of AI spreading in a short period of time. 4. In consideration of hard equipments, the doctors to be questioned hold similar opinions, as mentioned above. Apparently, the mastery of various preventive operations in the preventive system plays a critical role in that whether the AI crisis will continue to develop. 5. Only in consideration of the effects of prevention, the training of doctors and nurses is also most important. In conclusion, the experts all think that the training of doctors and nurses is a priority, regardless of in what VI
conditions. The findings of the study hope to provide references for other hospitals by manifesting the order of the importance of different preventive operations in the preventive system. Keywords: AHP, prevention of Avian Influenza, crisis management, Kaohsiung Min-sheng Hospital VII
... I... II... II... III... IV Abstract... V... IX... X VIII
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2- SARS... 8 2-2... 6 2-3... 9 2-4... 22 2-6... 42 3- AHP... 47 3-2... 50 3-3... 5 4- I... 52 4-2 I 2... 53 4-3 I 3... 53 4-4 I 6... 54 4-5 I 7... 54 4-6 I 8... 55 4-7 I 9... 55 4-8 I 0... 56 4-9... 57 4-0 I... 57 4- I 2... 58 4-2 I 3... 58 4-3 I 6... 59 4-4 I 7... 59 4-5 I 8... 60 XI
4-6 I 9... 6 4-7 I 0... 6 4-8... 62 4-9 I... 62 4-20 I 2... 63 4-2 I 3... 63 4-22 I 6... 64 4-23 I 7... 64 4-24 I 8... 65 4-25 I 9... 65 4-26 I 0... 66 4-27... 66 4-28 I... 67 4-29 I 2... 67 4-30 I 3... 68 4-3 I 6... 68 4-32 I 7... 69 4-33 I 8... 69 4-34 I 9... 70 4-34 I 9... 70 4-35... 7 4-36 I... 7 4-37 I 2... 72 4-38 I 3... 72 4-39 I 6... 73 4-40 I 7... 73 XII
4-4 I 8... 74 4-42 I 9... 74 4-43 I 0... 75 4-44... 75 4-45 I 0... 76 4-46 I 6... 77 4-47 I 9... 77 4-48 I 6... 78 4-49 I 9... 79 4-50 I... 79 4-5 I 6... 80 4-52 I 9... 80 4-53 I... 8 4-54 I 3... 8 4-55 I 6... 82 4-56 I 7... 82 4-57 I 9... 83 4-58 I 0... 84 4-59 I 6... 84 4-60 I 6... 85 4-6 I 9... 86 4-62 I... 86 4-63 I 6... 87 4-64 I 9... 87 4-65 I... 88 4-66 I 3... 88 XIII
4-67 I 6... 89 4-68 I 7... 89 4-69 I 9... 90 4-70... 9 XIV
989 3 460 994 82 992 80 999 9 2 7.3 2000 8000 200 9 2800 2003 SARS 84 SARS SARS 05
SARS - 2
- AHP 3
. AHP 2. 3. 4
SARS SARS World Health Organization WHO 2003 3 5 SARS corona virus WHO 2003 4 6 SARS SARS SARS ~3 ~3 3~5 5~7 X SARS 38 SARS 2 7 0 SARS.5 SARS 24 SARS N95 SARS SARS SARS 5
apical pneumonia 2002 2 2003 2 5 305 05 WHO 3 4 3 6 Center for Disease Control CDC 3 7 2003 3 8 WHO SARS 27 SARS 0 3 8 792 3 24 3 28 WHO SARS Affected Areas SARS 300 53 3 30 6
85 SARS4 3 SARS 2000 75 4 6 WHO SARS 4 8 SARS 000 9 WHO SARS 4 28 38 20 5000 WHO SARS WHO 5 9 SARS 5 4 20 SARS SARS 5 23 WHO SARS 3 SARS 6 WHO 6 2 SARS 8435 780 SARS 6 23 SARS 24 WHO SARS 7 2 20 SARS 7 5 SARS SARS 7
2- SARS SARS H5NH7N2 SARS CoV. 38 X 5-9 3-0 (influenza) virus) 8
(virus) DNARNA 4% 6% (mutation) RNA ABC A BC (myxovirus) 00 µm 2- (RNA) (hemagglutinin H) (neuraminidase N)M2 H N 5H 9N 35 H H H2H3 N NN2 HPAI Highly Pathogenic AI Low Pathogenic AI H5NH7 H5N2H9 H5N antigenic drift antigenic shift A 9
05 H5N H5N 98 5000 H5N H5N A Influenza A Avian Influenza virus or Bird Flu 00% H5N reverse transcription 0
PCR assay RT-PCR ELISA A HI HA NI NA 2005 2 3 H5N H5N 56 60 30 00 9-35 HA test
HI test 2 3 C B 4 5 2
56 30 60 0 70 40 48 A 55 600 2 4 0. 56 997 (Amantadine) A H5N (Tamiflu) (Relenza) 3
4 (HPAI) ELISA Agar gel
precipitation AGP ELISA H 5 H 7 H5 H7 2 ( ) 3. 2-5
2-2 6
2. 7
0% 60 ( ) H5N 2-3 8
2-3 2004 8 23 H5N (92) 6 28 38 H5N 3 30 5 0 90 Banten Lampung 3 85 0 3 H5N 200 550 H5N 687 545 2487 2 2/6 0 9
2 /26 H5N 26 2003 H-7 H-9 H5N 0 20 92 2 H5N 997 A/H5N 8 6 999 2003 2 A/H9N2 0/8 50 3/6 2 3/9 H7 20 5 20
H5N 2004 3/8 H3 2004 2 3 2 A/H7N7 4 5 2360 H5N H5N 2,000 0 9 H5N 2 H5N 300 H5N 2
22 H5N 2-4 2006/03/22 2-4 2003 2004 2005 2006 0 0 0 0 0 0 7 5 7 5 0 0 0 0 4 4 5 5 0 0 0 0 8 5 8 6 6 0 0 0 0 7 2 29 22 0 0 0 0 0 0 2 2 2 2 0 0 7 2 5 2 0 0 22 4 0 0 0 0 0 0 2 4 2 4 3 3 29 20 6 9 0 0 93 42 3 3 46 32 95 4 42 29 86 05 (WHO) crisis Fink986 22
23 Barton993 Fearn-Banks996 Clark995/996 Lerbinger 997 King2002 996 999 Fink986 996 999
Lerbinger997 2 3 4 5 6 7 Pheng, Ho and Ann999 2 3 4 5 998 Nudell Antokol ( 994) (natural disasters) (accidents) (technological accidents) (induced catastrophes) (war-related emergency of civilians) Lerbinger(997) ( 90) 24
960 970 MitroffMcWhinney(990) 2- ( 2002 992) 25
2- Mitroff, I. I. & McWhinney, W. Crisiscreation by design.advances in Organization Development,:990. p07. Mitroff 988 2-2 26
( 992) 2000 2-2 Mitroff, I. I. Crisis Managementcutting through the confusion. Sloan Management Review, 988. p6. MitroffMcWhinney(990) 27
Hermann963 Pearson et al.993 Lerbinger997 Pearson993 200 500 2 3 4 5 996 998 2 3 999 992 Robinson(972) Milburn(972) Brecher(978) Fink(986) Dutton(986) Reilly(987) Weick(988) Rosenthal(989) 28
(992) (998) (2002) ( ) 29
Fink986 prodromal crisis stage acute crisis stage chronic crisis stage crisis resolution stage Fink986 Gigliotti and Ronald99 Darling994 Pearson and Clair998 999 2002 30
962 0 947 979 Federal Emergency Management Agent FEMA FEMA 979 Integrated Emergency Management System IEMS mitigation 2 preparedness 3 response 4 recovery Hermann963 2 3 4 WhoWhatWhenWhereWhy 5 6 7 3
32 8 9 0 Bland996 2 3 4 5 6 Augustine995 2 3 4 5 6
200 PDC PDC Prevention Detection Correction Smits and Ezzat 2003 CMT CMT Will996 2 3 4 5 6 7 8 9 0 Mitroff (988) 2-3 ( 998 2002) (Signal Detection) (Preparation and Prevention) 33
34 (Damage Containment) (Recovery) (Learning) Mitroff988 2-3 Lerbinger997 2 3 4 5 6 7 2
3 4 NyBlom2003 McIntyre998 Crisis Management Team CMT King2002 CMT 2CMT 3 4CMT 5 CMT 3 35
8 50 475 25 7 25000 20000 9000 0000 2 36
3 4 2 3 2 3 2-4 37
Mitroff (988) 2-3 3-2 2-5 http://www.kmsh.gov.tw/index.asp?strurl=hel02.htm&i=4 38
3-2 2-5. 5 2. 3. 4. 5. 6.. 4 2. 3.. 6 39
2. 3.. 4 2. 4 3. 4. 5.. 3 2. 3. 40
3-3 4
2-6 3:30-4:00 4:00-4:0 4:0-4:30 4:30-4:35 4:35-4:55 20 4:55-5:00 B DVD 5 5:00-5:55 DVD 50 5:50-6:05 DVD 5 42
6:05-6:30 25 6:30-7:00 7:00-7:30 43
Analytic Hierarchy ProcessAHP AHP AHP Wichlein993 996 997 999Linstone & Suroff2002 3-3- 44
2 4 C.I 0. 2 3 3 Saaty980 Analytic Hierarchy ProcessAHP 45
Group Brainstorming Delphi Method (complete hierarchy) AHP (Pair wise Comparison) n C n 2 46
3579 2468 3 I : J 3- AHP : 3 : I 5 : I 7 : I 9 : I 2468 : 2000 459 AHP 7-0 /9/8 /3/22 89 n A aji = aij a2 A = Μ an a 2 Μ a 2 n Λ Λ Λ an a 2 n Μ () λ A W A 47
(A λi)w = 0 (2) λmax A W W ' W ' W Arithmetic Mean λmax AW = W ' (3) ' ' ( n ) ( W / W... / ) λ = W n W n.. (4) max + Consistence Index Saaty980 C.I.0. λmax n C. I. =..(5) n λmax n 3-48
3-2 AHP AHP 2 30 3-2 4 0. 8 49
3-2 / I AHP I 2 AHP I 3 AHP I 4 AHP CI 0. I 5 AHP CI 0. I 6 AHP I 7 AHP I 8 AHP I 9 AHP I 0 AHP I AHP CI 0. I 2 AHP CI 0. 3-3 50
3-3 5
I 4-0.600 0.797 0.582 0.06C.I.0.0868 0. 4- I I '' 5 /5.0000 0.797 0.7635 /5 /3 /5 0.3398 0.06 0.2700 3 /5 0.880 0.582 0.644 5 5 5 3.3437 0.600 2.5960 λmax 4.2604 C.I. 0.0868 I 2 4-2 0.6906 0.387 0.85 0.0522C.I.0.0785 0. 52
4-2 I 2 I '' /2 /8 /5 0.3344 0.0522 0.2255 2 /6 0.7598 0.85 0.4767 8 6 8 4.4267 0.6906 2.9288 5 /8 0.889 0.387 0.6044 λmax 4.2356 C.I. 0.0785 I 2 4-3 I 2 0.2500C.I.0.0000 0. 4-3 I 3 I 3 ''.0000 0.2500.0000.0000 0.2500.0000.0000 0.2500.0000.0000 0.2500.0000 λmax 4.0000 C.I. 0.0000 I 6 4-2 0.6906 0.873 0.0643C.I.0.0738 0. 53
4-4 I 6 I '' 3 /3.0000 0.893 0.7573 5 /5.0000 0.893 0.86 /3 /5 /5 0.3398 0.0643 0.2767 3 5 5 2.9428 0.557 2.393 λmax 4.223 C.I. 0.0738 I 7 4-5 0.4872 0.285 0.309 0.0969C.I.0.48 0. 4-5 I 7 I 7 '' 4 4 2 2.3784 0.4872 2.2766 /4 5 3.396 0.285.2838 /4 /5 0.4729 0.0969 0.4066 /2 /3 0.6389 0.309 0.5664 λmax 4.4253 C.I. 0.48 I 8 4-6 0.4203 0.2685 0.899 0.23C.I.0.0785 0. 54
4-6 I 8 I 8 '' 4 3.862 0.4203.823 2.892 0.2685.23 /4 2 0.8409 0.899 0.806 /3 /2 /2 0.5373 0.23 0.4906 λmax 4.943 C.I. 0.0648 I 9 4-7 0.3462 0.3047 0.235 0.76C.I.0.0868 0. 4-7 I 9 I 9 '' /3 /5 0.508 0.76 0.599.0000 0.235.0000 3.36 0.3047.2353 5.4953 0.3462.4705 λmax 4.2604 C.I. 0.0868 I 0 4-8 0.4636 0.375 0.094 0.0672C.I.0.38 0. 55
4-8 I 0 I 0 '' 6 3 2.0598 0.375.605 /6 /7 3 0.570 0.094 0.4244 7 6 2.5457 0.4636.9007 /3 /3 /6 0.3689 0.0672 0.3009 λmax 4.345 C.I. 0.38 8 C.I. 0. 0.276 0.2683 0.2407 0.295 4-9 56
4-9 0.276 0.295 0.2407 0.2683 I 4-0 I 0.47 0.400 0.260 0.0468C.I.0.0684 0. 4-0 I I '' /7 /5 /6 0.2627 0.0468 0.200 7 4 2.3003 0.400.6590 5 /4 /5 0.707 0.260 0.546 6 5 2.3403 0.47.7382 λmax 4.205 C.I. 0.0684 I 2 4- I 2 0.6906 57
0.387 0.85 0.0522C.I.0.0785 0. 4- I 2 I 2 '' /2 /8 /5 0.3344 0.0522 0.3344 2 /6 0.7598 0.85 0.7598 8 6 8 4.4267 0.6906 4.4267 5 /8 0.889 0.387 0.889 λmax 4.2356 C.I. 0.0785 I 3 4-2 I 3 0.382 0.0455C.I.0.000 0. 4-2 I 3 I 3 '' /7 /7 /7 0.2324 0.0455 0.88 7.6266 0.382.2727 7.6266 0.382.2727 7.6266 0.382.2727 λmax 4.0000 C.I. 0.0000 I 6 4-3 I 6 0.3864 58
0.355 0.926 0.055 C.I.0.503 0. 4-3 I 6 I 6 '' /9 5 0.8633 0.926.0785 9.732 0.3864 2.5408 /5 /4 0.4729 0.055 0.6093 4.442 0.355.365 λmax 5.5309 C.I. 0.503 I 7 4-4 I 7 0.4232 0.304 0.808 0.099 C.I.0.0540 0. 4-4 I 7 I 7 '' /5 /3 /2 0.4273 0.099 0.3888 5 3.9680 0.4232.7292 3 /3 /2 0.8409 0.808 0.7496 2 2.442 0.304.2727 λmax 4.62 C.I. 0.0540 I 8 4-5 59
I 8 0.4287 0.355 0.926 0.055 C.I.0.052 0. 4-5 I 8 I 8 '' /2 0.8409 0.937 0.7856 2 2 3.862 0.4287.784 /2 2.0000 0.2304 0.9328 /3 /2 0.6389 0.472 0.5990 λmax 4.0557 C.I. 0.052 I 9 4-6 I 9 0.47 0.2950 0.585 0.294 C.I.0.052 0. 60
4-6 I 9 I 9 '' 3.36 0.2950.370 /3 /3 0.5774 0.294 0.662 /3 3 /4 0.707 0.585 0.7493 3 4.862 0.47.7342 λmax 4.0557 C.I. 0.760 I 0 4-7 I 0 0.382 0.0455C.I.0.0000 0. 4-7 I 0 I 0 '' /7 /7 /7 0.2324 0.0455 0.88 7.6266 0.382.2727 7.6266 0.382.2727 7.6266 0.382.2727 λmax 4.0000 C.I. 0.0000 8 C.I. 0. 0.3066 0.2944 0.2890 0.0 4-8 6
4-8 0.0 0.3066 0.2890 0.2944 I 4-9 I 0.463 0.89 0.0486C.I.0.087 0. 4-9 I I '' /6 /5 /6 0.2730 0.0486 0.2 6 5 2.3403 0.463.786 5 /5 /5 0.6687 0.89 0.5282 6 5 2.3403 0.463.786 λmax 4.264 C.I. 0.087 I 2 4-20 I 2 0.3200 0.0400C.I. 0.0000 0. 62
4-20 I 2 I 2 '' /8 /8 /8 0.202 0.0400 0.600 8.688 0.3200.2800 8.688 0.3200.2800 8.688 0.3200.2800 λmax 4.0000 C.I. 0.0000 I 3 4-2 I 3 0.382 0.0455C.I.0.000 0. 4-2 I 3 I 3 '' /7 /7 /7 0.2324 0.0455 0.88 7.6266 0.382.2727 7.6266 0.382.2727 7.6266 0.382.2727 λmax 4.0000 C.I. 0.0000 I 6 4-22 I 6 0.382 0.232 0.340 C.I.0.242 0. 63
4-22 I 6 I 6 '' /3 3.0000 0.232.32 3 /3.0000 0.232.962 /3 /3 0.5774 0.340 0.5774 3 3.732 0.409.732 λmax 4.6427 C.I. 0.242 I 7 4-23 I 7 0.374 0.89 0.803 0.0876C.I.0.034 0. 4-23 I 7 I 7 '' /3 /3 /4 0.4082 0.0876 0.366 3 3.732 0.374.5358 3 /3 /2 0.8409 0.803 0.747 4 2.688 0.3607.4430 λmax 4.023 C.I. 0.034 I 8 4-24 I 8 0.4550 0.2627 0.4C.I.0.0035 0. 64
4-24 I 8 I 8 '' /3 /2 0.6389 0.4 0.5653 3 2 3 2.0598 0.4550.8273 2 /2 2.892 0.2627.0548 /3 /2 0.6389 0.4 0.5653 λmax 4.004 C.I. 0.0035 I 9 4-25 I 9 0.5847 0.230 0.329 0.0523C.I.0.648 0. 4-25 I 9 I 9 '' 5 3 /5.36 0.230.0072 /5 /5 /5 0.299 0.0523 0.248 /3 5 /5 0.7598 0.329 0.5880 5 5 5 3.3437 0.5847 2.662 λmax 4.023 C.I. 0.648 I 0 4-26 I 0 0.382 0.0455C.I.0.000 0. 65
4-26 I 0 I 0 '' /7 /7 /7 0.2324 0.0455 0.88 7.6266 0.382.2727 7.6266 0.382.2727 7.6266 0.382.2727 λmax 4.004 C.I. 0.0035 8 C.I. 0. 0.353 0.326 0.2359 0.092 4-27 4-27 0.092 0.326 0.2359 0.353 I 4-28 C.I. 3.3344 0. 66
4-28 I I '' /6 /5 /7 0.2627 0.046 0.55 6 5 2.3403 0.403 4.7 5 /5 /5 0.6687 0.72 2.503 7 5 2.4323 0.4264 5.24 λmax 4.0033 C.I. 3.3344 I 2 4-29 I 2 0.3200 0.0400C.I.0.000 0. 4-29 I 2 I 2 '' /8 /8 /8 0.202 0.0400 0.600 8.688 0.3200.2800 8.688 0.3200.2800 8.688 0.3200.2800 λmax 4.0000 C.I. 0.0000 I 3 4-30 I 3 0.382 0.0455C.I.0.000 0. 67
4-30 I 3 I 3 '' /7 /7 /7 0.2324 0.0455 0.88 7.6266 0.382.2727 7.6266 0.382.2727 7.6266 0.382.2727 λmax 4.0000 C.I. 0.0000 I 6 4-3 C.I. 0.603 0. 4-3 I 6 I 6 '' /3 /3 0.5774 0.372 0.4460 3 /3.0000 0.2376.3380 3.36 0.326.3380 3.36 0.326.488 λmax 4.4808 C.I. 0.603 I 7 4-32 0.4565 0.297 0.734 0.0784 C.I.0.029 0. 68
4-32 I 7 I 7 '' /4 /3 /4 0.3799 0.0784 0.3232 4 3 2 2.234 0.4565.8736 3 /3 /2 0.8409 0.734 0.7065 4 /2 2.442 0.297.803 λmax 4.0873 C.I. 0.029 I 8 4-33 0.3750 0.250 C.I.0.0000 0. 4-33 I 8 I 8 '' /3 /3 0.5774 0.250 0.5000 3 3.732 0.3750.5000 3 3.732 0.3750.5000 /3 /3 0.5774 0.250 0.5000 λmax 4.0000 C.I. 0.0000 I 9 4-34 C.I. 0.6843 0. 69
4-34 I 9 I 9 '' 5 5 /3.6990 0.3402 2.8923 /5 /3 0.508 0.07 0.5785 /5 /3 0.508 0.07 0.5785 3 3 3 2.2795 0.4564.9795 λmax 4.6833 C.I. 0.6843 I 0 4-34 I 0 0.382 0.0455C.I.0.0000 0. 4-34 I 9 I 9 '' /7 /7 /7 0.2324 0.0455 0.88 7.6266 0.382.2727 7.6266 0.382.2727 7.6266 0.382.2727 λmax 4.0000 C.I. 0.0000 8 C.I. 0. 0.2999 0.2650 0.702 4-35 70
4-35 0.702 0.2650 0.2650 0.2999 I 4-36 C.I. 0.096 0. 4-36 I I '' /7 /6 /8 0.2336 0.0387 0.7 7 7 2.6458 0.4382.876 6 /7 /5 0.6435 0.066 0.4846 8 5 2.549 0.465.697 λmax 4.3289 C.I. 0.096 I 2 4-37 I 2 0.3230 0.324 0.0455C.I.0.0007 0. 7
4-37 I 2 I 2 '' /7 /8 /8 0.274 0.047 0.67 7.6266 0.324.2504 8.688 0.3230.2922 8.688 0.3230.2922 λmax 4.0022 C.I. 0.0007 I 3 4-38 C.I. 0.342 0. 4-38 I 3 I 3 ''.0000 0.99.0000 7 7 2.6458 0.5267 2.6458 /7 /7 0.3780 0.0752 0.3780 /7 7.0000 0.99.0000 λmax 5.0237 C.I. 0.342 I 6 4-39 C.I. 0.3877 0. 72
4-39 I 6 I 6 '' /7 5 3.2099 0.2620.378 7 3 2.407 0.4635 2.798 /5 /3 0.508 0.00 0.484 /3 0.7598 0.645 0.8254 λmax 5.632 C.I. 0.3877 I 7 4-40 C.I. 0.347 0. 4-40 I 7 I 7 '' 3 2.565 0.377.6380 /3 2 0.9036 0.277 0.952 /2 /2 2 0.8409 0.2026 0.9052 /2 0.8409 0.2026 0.8987 λmax 4.4062 C.I. 0.347 I 8 4-4 I 8 0.4600 0.2233 0.878 0.289C.I.0.058 0. 73
4-4 I 8 I 8 '' /3 /3 0.5774 0.289 0.5445 3 3 2 2.0598 0.4600.8923 3 /3.0000 0.2233 0.952 /2 0.8409 0.878 0.7700 λmax 4.742 C.I. 0.058 I 9 4-42 C.I. 0.2278 0. 4-42 I 9 I 9 '' 5 5 /5.4953 0.2575.2060 /5 /5 /5 0.299 0.055 0.242 /5 5 /5 0.6687 0.52 0.5393 5 5 5 3.3437 0.5758 2.6967 λmax 4.6833 C.I. 0.2278 I 0 4-43 I 0 0.325 0.0625C.I.0.0000 0. 74
4-43 I 0 I 0 '' /5 /5 /5 0.299 0.0625 0.2500 5.4953 0.325.2500 5.4953 0.325.2500 5.4953 0.325.2500 λmax 4.0000 C.I. 0.0000 8 C.I. 0. 0.3364 0.2987 0.239 0.5 4-44 4-44 0.5 0.2987 0.239 0.3364 75
I 0 4-45 0.4636 0.375 0.094 0.0672C.I.0.0684 0. 4-45 I 0 I 0 '' 6 3 2.0598 0.3580.460 /6 /7 /3 0.2985 0.059 0.250 7 9 2.873 0.4897 2.42 /3 3 /9 0.5774 0.004 0.4298 λmax 4.2052 C.I. 0.0684 I 6 4-46 I 6 0.3864 0.355 0.926 0.055 C.I.0.097 0. 76
4-46 I 6 I 6 '' /9 /2 /4 0.3433 0.075 0.336 9 /2.4565 0.3034.3638 2 /2.0000 0.2083 0.8632 4 2 2 2.0000 0.467.7264 λmax 4.292 C.I. 0.097 I 9 4-47 I 9 0.4059 0.2870 0.28 0.0890 C.I.0.052 0. 4-47 I 9 I 9 '' 3.36 0.2870.78 3 /3.0000 0.28 0.9075 /3 3 /4 0.4082 0.0890 0.3589 3 4.862 0.4059.7032 λmax 4.233 C.I. 0.04 I 6 4-48 77
I 6 0.4095 0.266 0.2364 0.0925 C.I.0.076 0. 4-48 I 6 I 6 '' /3 4.0746 0.2364.0045 3 4.862 0.4095.7503 /4 /4 /2 0.4204 0.0925 0.3848 2.892 0.266.0925 λmax 4.248 C.I. 0.076 I 9 4-49 I 9 0.5372 0.2466 0.428 0.0733C.I.0.0670 0. 78
4-49 I 9 I 9 '' 3 /2 /5 0.740 0.428 0.5936 /3 /4 /4 0.3799 0.0733 0.369 2 4 /3.2779 0.2466.0047 5 4 3 2.7832 0.5372 2.2847 λmax 4.2009 C.I. 0.0670 I 4-50 I 0.5359 0.2865 0.378 0.0398C.I.0.0938 0. 4-50 I I '' /7 /6 /8 0.2336 0.0398 0.75 7 7 2 3.463 0.5359 2.352 6 /7 /2 0.809 0.378 0.5963 8 /2 2.688 0.2865.483 λmax 4.285 C.I. 0.0938 I 6 4-5 I 6 0.326 79
0.2376 0.372 C.I.0.05 0. 4-5 I 6 I 6 '' /3 /3 0.5774 0.372 0.583 3.36 0.326.2743 3.36 0.326.2743.0000 0.2376.0000 λmax 4.533 C.I. 0.05 I 9 4-52 I 9 0.5279 0.3079 0.092 0.072C.I.0.0844 0. 4-52 I 9 I 9 '' 5 5 /3.6990 0.3079.3047 /5 /8 0.3976 0.072 0.297 /5 /3 0.508 0.092 0.407 3 8 3 2.930 0.5279 2.3045 λmax 4.253 C.I. 0.0844 I 4-53 I 80
0.4277 0.436 0.90 0.0397C.I.0.0830 0. 4-53 I I '' /7 /6 /8 0.2336 0.0397 0.72 7 5 2.4323 0.436.744 6 /5 /5 0.6999 0.90 0.5256 8 5 2.549 0.4277.754 λmax 4.2489 C.I. 0.0830 I 3 4-54 I 3 0.3647 0.277 0.2330 0.252C.I.0.0976 0. 4-54 I 3 I 3 '' 3 2.565 0.3647.5275.0000 0.2330.0000 /3 /4 0.5373 0.252 0.5490 /2 4.892 0.277.932 λmax 4.2929 C.I. 0.0976 I 6 4-55 I 6 0.6439 8
0.69 0.285 0.0585C.I.0.0590 0. 4-55 I 6 I 6 '' /7 /5 /2 0.3457 0.0585 0.2485 7 5 6 3.8068 0.6439 2.6700 5 /5.0000 0.69 0.788 2 /6 0.7598 0.285 0.529 λmax 4.770 C.I. 0.0590 I 7 4-56 I 7 0.3757 0.2400 0.209 0.824C.I.0.0804 0. 4-56 I 7 I 7 '' 3 2.565 0.3757.6048 /3 0.7598 0.824 0.7495 /2 2.0000 0.2400.040 /2 0.8409 0.209 0.8800 λmax 4.24 C.I. 0.0804 I 9 4-57 I 9 0.4669 0.330 0.06 82
0.0969C.I.0.0822 0. 4-57 I 9 I 9 '' 5 3 /2.6549 0.330.3847 /5 2 /5 0.538 0.06 0.4592 /3 /2 /3 0.4855 0.0969 0.456 2 5 3 2.3403 0.4669.9483 λmax 4.2465 C.I. 0.0822 I0 83
4-58 I 0 I 0 '' () /6 (/6) () /3 /3 6 (6) () 7 (7) /3 3 () /7 (/7) () /6 /9 3 (3) 3 (/3) 6 (9) 2.0598 (2.0598) 0.570 (0.2985) 2.5457 2.873 0.3689 0.5774 0.375 (0.3580) 0.094 (0.059) 0.4636 0.4897 0.0672 0.004.605 (.460) 0.4244 (0.250).9007 2.42 0.3009 0.4298 4.345 λmax (4.2052) 0.38 C.I. (0.0684) 4-59 I 6 4-59 I 6 I 6 '' () 9 (9) /5 (2) (4) /9 (/9) () () (2) λmax 5.5309 (4.292) 5 (/2) () () 4 (2) C.I. (/4) (/2) /4 (/2) () 0.503 (0.097) 0.8633 (0.3433).732 (.4565) 0.4729 (.0000).442 (2.0000) 0.926 (0.075) 0.3864 (0.3034) 0.055 (0.2083) 0.355 (0.467).0785 (0.336) 2.5408 (.3638) 0.6093 (0.8632).365 (.7264) 84
4-60 I 6 4-60 I 6 I 6 '' () 3 (3) /3 (/4) () /3 (/3) () (/4) 3 () λmax 4.6427 (4.248) 3 (4) (4) () 3 (2) C.I. () /3 () /3 (/2) () 0.242 (0.076).0000 (.0746).0000 (.862) 0.5774 (0.4204).732 (.892) 0.232 (0.2364) 0.232 (0.4095) 0.340 (0.0925) 0.409 (0.266).32 (.0045).962 (.7503) 0.5774 (0.3848).732 (.0925) 4-6 I 6 85
86 4-6 I 9 I 9 '' () 5 (3) 3 (/2) /5 (/5).36 (0.740) 0.230 (0.428).0072 (0.5936) /5 (/3) () /5 (/4) /5 (/4) 0.299 (0.3799) 0.0523 (0.0733) 0.248 (0.369) /3 (2) 5 (4) () /5 (/3) 0.7598 (.2779) 0.329 (0.2466) 0.5880 (.0047) 5 (5) 5 (4) 5 (3) () 3.3437 (2.7832) 0.5847 (0.5372) 2.662 (2.2847) λmax 4.023 (4.2009) C.I. 0.648 (0.0670) 4-62 4-62 I I '' () /6 (/7) /5 (/6) /7 (/8) 0.2627 (0.2336) 0.046 (0.0398) 0.55 (0.75) 6 (7) () 5 (7) (2) 2.3403 (3.463) 0.403 (0.5359) 4.7 (2.352) 5 (6) /5 (/7) () /5 (/2) 0.6687 (0.809) 0.72 (0.378) 2.503 (0.5963) 7 (8) (/2) 5 (2) () 2.4323 (.688) 0.4264 (0.2865) 5.24 (.483) λmax 4.0033 (4.285) C.I. 3.3344 (0.0938) 4-63
I 6 4-63 I 6 I 6 '' () 3 (3) 3 (3) () /3 (/3) () () 3 () λmax 4.4808 (4.533) /3 (/3) () () () C.I. () /3 () () () 0.603 (0.05) 0.5774 (0.5774).0000 (.36).36 (.36).36 (.0000) 0.372 (0.372) 0.2376 (0.326) 0.326 (0.326) 0.326 (0.2376) 0.4460 (0.583).3380 (.2743).3380 (.2743).488 (.0000) I 9 4-64 4-64 I 9 I 9 '' () /5 (/5) /5 (/5) 3 (3) 5 (5) () () 3 (8) λmax 4.6833 (4.253) 5 (5) () () 3 (3) /3 (/3) /3 (/8) /3 (/3) () C.I. 0.6843 (0.0844).6990 (.6990) 0.508 (0.3976) 0.508 (0.508) 2.2795 (2.930) 0.3402 (0.3079) 0.07 (0.072) 0.07 (0.092) 0.4564 (0.5279) 2.8923 (.3047) 0.5785 (0.297) 0.5785 (0.407).9795 I 87
4-65 4-65 I I '' () 7 (7) 6 (6) 8 (8) /7 (/7) () /7 (/5) () λmax 4.3289 (4.2489) /6 (/6) 7 (5) () 5 (5) C.I. /8 (/8) () /5 (/5) () 0.096 (0.0830) 0.2336 (0.2336) 2.6458 (2.4323) 0.6435 (0.6999) 2.549 (2.549) 0.0387 (0.0397) 0.4382 (0.436) 0.066 ( 0.90) 0.465 (0.4277) 0.7 (0.72).876 (.744) 0.4846 (0.5256).697 (.754) I 3 4-66 4-66 I 3 I 3 '' () () (/3) (/2) () () /7 () /7 () λmax 5.0237 (4.2929) (3) 7 () () 7 (4) C.I. (2) 7 () /7 (/4) () 0.342 (0.0976).0000 (.565) 2.6458 (.0000) 0.3780 (0.5373).0000 (.892) 0.99 (0.3647) 0.5267 (0.2330) 0.0752 (0.252) 0.99 (0.277).0000 (.5275) 2.6458 (.0000) 0.3780 (0.5490).0000 (.932) I6 4-67 88
4-67 I 6 I 6 '' () 7 (7) /5 (5) /3 (2) /7 (/7) () /3 (/5) (/6) λmax 5.632 (4.770) 5 (/5) 3 (5) () () 3 (/2) (6) () () 0.3877 C.I. (0.0590).2099 (0.3457) 2.407 (3.8068) 0.508 (.0000) 0.7598 (0.7598) 0.2620 (0.0585) 0.4635 (0.6439) 0.00 (0.69) 0.645 (0.285).378 (0.2485) 2.798 (2.6700) 0.484 (0.788) 0.8254 (0.529) I 7 4-68 4-68 I 7 I 7 '' () /3 (/3) /2 (/2) () 3 (3) () /2 () () λmax 4.4062 (4.24) 2 (2) 2 () () /2 (/2) C.I. () () 2 (2) () 0.347 (0.0804).565 (.565) 0.9036 (0.7598) 0.8409 (.0000) 0.8409 (0.8409) 0.377 (0.3757) 0.277 (0.824) 0.2026 (0.2400) 0.2026 (0.209).6380 (.6048) 0.952 (0.7495) 0.9052 (.040) 0.8987 (0.8800) I 9 4-60 89
90 4-69 I 9 I 9 '' () 5 (5) 5 (3) /5 (/2).4953 (.6549) 0.2575 (0.330).2060 (.3847) /5 (/5) () /5 (2) /5 (/5) 0.299 (0.538) 0.055 (0.06) 0.242 (0.4592) /5 (/3) 5 (/2) () /5 (/3) 0.6687 (0.4855) 0.52 (0.0969) 0.5393 (0.456) 5 (2) 5 (5) 5 (3) () 3.3437 (2.3403) 0.5758 (0.4669) 2.6967 (.9483) λmax 4.6833 (4.2465) C.I. 0.2278 (0.0822) 8 4-58 0.395 0.2978 0.254 0.34
4-70 0.276 0.295 0.2407 0.2683 0.0 0.092 0.702 0.5 0.34 0.3066 0.326 0.2650 0.2987 0.2978 0.2890 0.2359 0.2650 0.239 0.254 0.2944 0.353 0.2999 0.3364 0.395 9
Mitroff (988) 35 -- AHP 4 0.395 0.2978 0.3066 0.353 92
SARS 93
Mitroff (988) -- 94
. 200 2. 2002 3. 2000 456-483 4. 998 27 2-4 5. 998 266 5-9 6. 2002 6-9 7. 2002 9 35-40 8. 200 9. 996 226 7-29 0. 998. http://www.kmsh.gov.tw/index.asp?strurl=hel02.htm&i=4 2. 998 3. 999 Delphi Method 5-35 4. 996 6-24 5. 992 6. 2004-7. 999 272 83-0 8. 997 5(3) 4-28 95
. Augustine N.R. (995). Managing the crisis you tried to prevent, Harvard Business Review. 73(6), 47-58. 2. Barton L. (993). Crisis in Organizations: Managing and Communicating in the Heat of Chaos. Cincinnati: South-Western Publishing Company. 3. Bland M. (996) Training managers to handle a crisis, Training & Management Development Methods, 0(), 905-907. 4. Brecher, M. (978), Studies in Crisis Behavior, N.J: Transaction Books. 5. Clark J. (995/996). Hope for the best, but plan for the worst - the need for disaster planning, Employment Relations Today, 22(4): 4-53. 6. Darling J.R. (994) Crisis management in international business: keys to effective decision making, Leadership & Organization Development Journal, 5(8), 3-8 7. Dutton, J. E. (986) The Processing of Crisis and Non-crisis Strategic Issues, Journal of Management Studies, 23(5), September, 50-57. 8. Fearn-Banks K. (996). Crisis Communication: A Casebook Approach. NJ: Lawrence Erlbaum Associates Publishers. 9. Fink S. (968). Crisis Management: Planning for the Inevitable. New York: American Management Association. 0. Gigliotti R & Ronald J. (99) Emergency Planning for Maximum Protection. NewYork: Butterworth-Heinemann.. Hermann C.F. (963). Some consequences of crisis which limit the viability of organizations, Administrative Science Quarterly, 8, 6-82. 2. Hermann ed., International CrisisIn-sight from Behavioral Research, Free Press, 972, 3. King G III. (2002). Crisis management & team effectiveness: a closer examination, Journal 96
of Business Ethics, 4(3), 235-249. 4. Lerbinger O. (997). The Crisis Manager Facing Risk and Responsibility. NewJersey: Lawrence Erlbaum Associates. 5. Linstone, H.A. & Turoff, M. (2002). The Delphi Method: Techniques and Applications. London: Addison Wesley press 6. McIntyre M.G. (998). The Management Team Handbook: Five Key Strategies for Maximizing Group Performance. San Francisco: Jossey-Bass. 7. Milburn, T. W. (972) The Management of Crisis, in Charles F. Hermann ed. International CrisisInsight from Behavioral Research, Free Press, 259-277. 8. Mitroff, I I. & McWhinney, (990) W. Crisis creation by Design, Advances in Organization Development, No., 05-4. 9. Mitroff, I I. (988) Crisis ManagementCutting Through the Confusion,Sloan Management Review,Winter, 5-20. 20. Nudell, M. & Antokl, N. (999) The Handbook for Effective Emergency and Crisis Management, DetroitFree Press. 2. NyBlom S.E, Reid J, Coy W.J & Walter F. (2003). Understanding crisis management, Professional Safety, 48(3), 8-24. 22. Pearson C.M & Clair J.A. (998) Reframing crisis management, Academy of Management Review, 23(), 59-76. 23. Pearson C.M & Mitroff I.I. (993). From crisis prone to crisis prepared: a framework for crisis management, The Academy of Management Executive, 7(), 48-59. 24. Pheng LS, Ho DKH, Ann YS. (999). Crisis management: a survey of property development firm, Property Management, 7(3), 23-25. 25. pp.2-35. 26. Reilly, A. H., (987) Are Organizations Ready for Crisis? A Managerial Scorecard, Columbia Journal of World Business, Spring, 79-88. 97
27. Robinson, James A., Crisis An Appraisal of Concepts And Theories, in Charles F. 28. Saaty, T. L. (977), Scenarios and Priorities in Transport Planning to the Sudan, Transportation Research, (5) 343-350. 29. Saaty, T. L. (977). A Sealing Method for Priorities in Hierarchical Structural, Journal of Mathematical Psychology, vol.5, 274-28. 30. Saaty, T. L. (977). A Theory of Analytical Hierarchies Applied to Political Candidacy, Behavioral Sciences, 22(4), 237-245. 3. Saaty, T. L. (996). The Analytic Network Process Decision Making with Dependence and Feedback, RWS Publications, Pittsburgh. 32. Saaty, T.L. (980). The Analytic Hierarchy Process. New York, U.S.A.: McGraw-Hill press. 33. Smits S.J & Ezzat N. (2003) Thinking the unthinkable - leadership's role in creating behavioral readiness for crisis management, Competitiveness Review, 3(),-23. 34. Weick, K. E. (988) Enacted Sense making in Crisis Situation, Journal of Management Studies,25(4) July, 305-37. 35. Wichlein, R.C.(993) Identifying Critical Issues and Problems in Technology Education-Using a Modified-Delphi Technique. Journal of Technology Education,5(), 55-7. 36. Will P. (996). Crisis management, Career Development International, (5), 26-28. 98
6 4 99
00 9: 8: 7: 6: 5: 4: 3: 2: : :2 :3 :4 :5 :6 :7 :8 :9
0 9: 8: 7: 6: 5: 4: 3: 2: : :2 :3 :4 :5 :6 :7 :8 :9
02 9: 8: 7: 6: 5: 4: 3: 2: : :2 :3 :4 :5 :6 :7 :8 :9
03 9: 8: 7: 6: 5: 4: 3: 2: : :2 :3 :4 :5 :6 :7 :8 :9
04 9: 8: 7: 6: 5: 4: 3: 2: : :2 :3 :4 :5 :6 :7 :8 :9