公私協力抗疫-以台北慈濟醫院承接加強版集中檢疫所為例

Abstract

為處理日益複雜的公共政策議題，近年各國政府紛紛採取公私協力治理方式，結合民間資源，跨領域、跨專業的健全政策制定與強化執行效能。而我國中央與地方政府，無論在交通、旅遊、教育或健康長照等領域上也早有公私協力先例。2020年全球爆發新型冠狀病毒肺炎疫情（Covid-19），各國政府在防疫政策上亦借助民間力量，緊急生產防疫物資與收治隔離染疫病人。我國2020年在境外防疫、口罩國家隊與全民防疫意識下，抗疫有成。但2021年疫情轉而嚴峻，爆發本土社區傳播大流行，5月新北市與台北市進入三級警戒，新北市政府更於2021年5月及2022年4月兩波疫情高峰之際，成立加強版集中檢疫所收治確診病人，由市府各局處單位，與民間私人醫院及飯店業者共同協力營運集檢所，藉以紓緩醫療量能的不足。 在疫情如此危急下進行公私協力合作，參與其中的各利害關係人之動機為何？如何互動及磨合？如何達成協力目標？實值得深入探討。本研究以台北慈濟醫院所承接之新北市新店集檢所為研究對象，並以Ansell & Gash（2008）發展的協力治理架構作為評估基礎，以質性訪談蒐集資料，藉以分析集檢所中公私協力的互動過程與影響因素。 研究發現，集檢所涉及醫療照護、門禁安全、房務清消等多方專業，的確有賴醫院與飯店資源投入。另因疫情嚴峻且政府人力與專業有限下，急需民間單位參與防疫，故協力過程中在權力、資源與知識上，公私雙方也展現較為對等。此外，促進型領導力及包容參與式的討論機制，在集體智慧下產出的規範制度，具透明公平之效；而創造以病人為中心的協力過程與慈濟文化，則可強化團隊成員間彼此的溝通、信任、理解及承諾。而正向的協力關係，也有助於集檢所的收治成效。最後本研究提出集檢所有公私協力之必要性、須強化各協力因素、彈性滿足與重視公私契約外的非預期需求、適時更新安全組作業規範、有效且謹慎的使用社群溝通工具與落實防疫教育訓練等建議，提供未來政府機關與醫療機構管理者協力防疫政策時參考。

In order to address the increasingly complex public policy issues, governments around the world have increasingly adopted public-private partnership governance approaches in recent years, combining resources from the private sector to enhance policy development and strengthen implementation efficiency across various domains and expertise areas. In our country, both central and local governments have established precedents for public-private collaboration in fields such as transportation, tourism, education, and healthcare long-term care. In 2020, a global outbreak of the novel coronavirus disease (Covid-19), prompted governments around the world to incorporate private sector resources to urgently produce pandemic supplies, isolate and provide treatment for infected individuals. In 2020, our country prevented the pandemic from entering our country, established a national mask production team, and increased public awareness of epidemic prevention, we successfully managed the pandemic. However, in 2021, the situation took a turn for the worse, with the widespread of local community outbreak. In May, both New Taipei City and Taipei City entered Level 3 alert, and the New Taipei City government established enhanced centralized quarantine facilities during the peaks of the outbreak in May 2021 and April 2022. These facilities were jointly operated by various municipal government departments, private hospitals, and hotel industry partners to alleviate the strain on healthcare capacity. The motivations behind the collaboration between various stakeholders in such a critical pandemic situation, their interactions, coordination, and how they achieve cooperative goals are worthy of in-depth exploration. This study focuses on the New Taipei City Xindian Quarantine Center operated by Taipei Tzu Chi Hospital as its research subject. It utilizes the collaborative governance framework developed by Ansell and Gash (2008) as an analytical foundation and gathers qualitative interview data to analyze the interaction processes and influencing factors in the public-private collaboration within the quarantine center. The study found that the quarantine center involves multiple professional aspects such as medical care, access security, and housekeeping, which indeed rely on resources from both the hospital and hotel sectors. Additionally, due to the severity of the pandemic and limitations in government manpower and expertise, the involvement of private sector entities in epidemic prevention was urgently needed. Therefore, in the collaborative process, there was a relatively balanced distribution of power, resources, and knowledge between the public and private sectors. Furthermore, facilitative leadership and inclusive participatory discussion mechanisms, coupled with norms established through collective intelligence, contributed to a transparent and equitable system. The creation of a patient-centered collaborative process and the influence of Tzu Chi culture reinforced communication, trust, understanding, and commitment among team members. These positive collaborative relationships also contributed to the overall effectiveness of the quarantine center's operations. In conclusion, this study proposes recommendations for future government agencies and healthcare facility managers engaged in collaborative epidemic prevention policies. These recommendations include the necessity of public-private collaboration, the need to strengthen various factors influencing collaboration, flexibly addressing and prioritizing unforeseen needs beyond the public-private contract, timely updating safety and operational guidelines, the effective and cautious use of community communication tools, and the implementation of epidemic prevention education and training. These suggestions aim to serve as references for future collaborative epidemic prevention efforts.