運用模擬技術建構長期照顧機構緊急疏散模式

Abstract

台灣高齡人口逐漸增加，長期照顧機構亦隨著需求增加。然而台灣是個經常會面對各種天然災難的區域。地震、水災、風災、火災對於長照機構內的移動弱者是相當致命的威脅。因此我們應該重視遭遇需要緊急疏散狀況時，如何能在最短時間之內將長照機構內的住民移動到相對安全區域，以避免長者或失能者遭遇憾事。 本研究藉由文獻回顧的過程，整理出長照機構中各類住民的移動速率分佈與疏散準備時間，接著運用離散事件模擬(Discrete Event Simulation, DES)的理論基礎，以電腦軟體建構出長期照顧機構疏散系統模擬模型。該模型可針對機構建築物之出入口空間配置、疏散動線規劃、協助疏散人力數量、住民類別與數量、避難者步行速率及疏散準備時間等影響避難疏散時間的要素，進行多種因素排列組合建模。分析模型產出數據後找出最理想的空間或人員配置策略及疏散模式，提升機構住民的安全性，作為長期照顧機構防災疏散管理之參考。 研究結果發現協助疏散人員優先幫助距離自己出發點較近的寢室住民，則總移動距離會比較短。協助疏散人員較少的時候，每增加一名人力，即可換來疏散時間大量縮短，後續增加人力則呈現邊際效用遞減。男性住民較多時的疏散時間會比女性住民較多時的疏散時間短。增加協助疏散人員出發點以及逃生出口（相對安全區域）的數量與分散度可縮短總疏散時間。將移動能力較弱、移動速率較慢者安排在相對安全區域附近的寢室，可減少其移動距離，使得總疏散時間縮短，相對就能增加住民存活的機會。 本研究透過系統模擬研究方法驗證多個影響長照機構疏散時間的關鍵因素，並提出通用的疏散動線與住民寢室安排策略，可供各類型長照機構、建築及消防主管機關參考運用。突破了模擬研究普遍針對單一機構設置情境，而導致研究結果外推性不足的狀況。建議相關應變規劃者可多加運用系統模擬研究分析方法，將可在不影響真實世界情況下實驗各種因素的交互作用，降低生命財產的損失。

With the rapid growth of the aging population in Taiwan, the demand for long-term care facilities also increases. However, Taiwan is one of the most vulnerable areas frequently suffering from natural disasters. Earthquakes, floods, typhoons, and fire disasters are quite deadly threats to the “refuge weakling” in long-term care facilities. Therefore, we should pay more attention to how we can transport the residents of the long-term care facility to a relatively safe area in the shortest time when encountering emergency evacuation situations, so that the elderly or the disabled can avoid misfortunes. Through the process of literature review, this study sorted out the evacuation speed distribution and preparation time of various residents in the long-term care facility, and then used the discrete event simulation (DES) rationale to build an evacuation model for long-term care facility with computer software. The evacuation model can simulate the combinations of multiple factors that affect the evacuation time, including the location and quantity of the entrance and exit space of the building, the evacuation route, the number of manpower to assist in the evacuation, the type and number of residents, the moving speed of evacuees, the evacuation preparation time, and others. This research analyzes the output data of the model to find out the most ideal space or staffing strategy and evacuation mode to improve the safety of the residents of the facility, and be as a reference for the long-term care facility for disaster prevention and evacuation management. The results of the study found that when assisting manpower give priority to helping residents in rooms closer to their starting point, the total travel distance will be shorter. When there are few people assisting in the evacuation, each additional manpower can greatly shorten the evacuation time. However, the marginal utility of increasing manpower for evacuation time diminishes. When there are more male residents, the evacuation time will be shorter than when there are more female residents. Increasing the number of starting points of assisting manpower and escape exits (relatively safe areas) can shorten the total evacuation time. Arranging residents with weaker mobility and slower speed in the rooms near relatively safe areas can reduce their moving distance, shorten the total evacuation time, and increase the chance of survival of the residents relatively. This study verified multiple key factors affecting the evacuation time of long-term care facilities through system simulation research methods, and proposed a general evacuation route and residential room arrangement strategy, which can be used as a reference for various types of long-term care facilities and government agencies. This research breaks through the simulation research usually only uses a single institution as the object, which leads to the limited extrapolation of research results. It is recommended that emergency response researchers can use more system simulation research and analysis methods, which will be able to experiment with various factors without affecting the real world and reduce the loss of life and property.