非常時医療事業継続計画Medical Business Continuity Plan (m-BCP)

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What's GOA?


GOA (Goal Oriented Action)

GOA is a goal-oriented emergency response method.

“All's well that ends well.” is similar to the GOA way of thinking.

Because EBM (Evidence Based Medicine) has become established in medicine, work with low evidence level is avoided.
Medical practice with perceived danger is also avoided.
However, it is special during a disaster.
Overcoming the crisis with flexible ideas helps patients.

The goal is important.

Introduction to GOA



GOA needs a goal.

Set team goals and share with staff.

The goal can be anything, so there is no problem with the goal of “withdrawing from medical practice and keeping staff safe”.

The important thing is to set goals.



It is important that the people concerned look at the same goal.
It is important that the people concerned understand the goals.
I think that all the people concerned can overcome some difficulties by focusing on the same goal.

It is even better if interested parties are also aiming for the same goal.



BCP and DRP are plans, and BCM is management, but GOA is directly linked to practical actions.
In an emergency situation, it is not possible to give instructions for detailed work, so it is left to the judgment of the site.

Goal orientation is useful for acting conscientiously.

GOA created a new evidence


Vertical evacuation

Vertical evacuation using elevators was prohibited in Japan.

As the number of high-rise buildings increased, the need for vertical evacuation by elevator increased.

Mori Building studied elevator evacuation and developed an evacuation method.

This is because even if it was prohibited in the event of a disaster, if there were people who used elevators, we wanted to make it usable.

虎ノ門ヒルズで非常用エレベーターを活用した避難計画の運用を開始 超高層複合タワーで初めて東京消防庁より認定を取得 森ビル株式会社は、この度、火災時における歩行困難者の避難手段確保を目的に、虎ノ門ヒルズにおいて、非常用エレベーターを利用した避難計画の認定を取得、運用を開始しました。これは、東京消防庁が昨年10月に運用を開始した「高層建築物等における歩行困難者等に係る避難安全対策」に基づくもので、超高層複合タワーでは初めての認定取得となります。 従来、火災時にエレベーターを利用した避難誘導は禁止されていましたが、昨年9月30日に発表された指針により、東京消防庁管内の高層ビルや高層マンションで火災が発生した際、高齢者や障害者など歩行困難者に限り、一定条件のもとで非常用エレベーターによる避難が可能となりました。これを受け当社では、虎ノ門ヒルズにおける運用の検討を開始。所轄の芝消防署と綿密な協議を重ねながら、書類の届け出、標識の設置、認定に向けた検査を経て、この度、歩行困難者の一時避難エリアの設置、および非常用エレベーターを活用した避難計画の認定に至りました。 当認定取得により、歩行困難者を一時避難エリアに待機させ、消防隊到着までの間、防災センター係員による非常用エレベーターの操作によって、火災時の混乱や混雑を回避したスムーズな避難誘導が可能となります。 現在、六本木ヒルズ森タワーや六本木ヒルズレジデンスでも導入に向け協議をすすめており、今後は、アークヒルズなどヒルズクラスのビルおよび新規開発プロジェクトにおいても、積極的に導入を検討してまいります。 『高層建築物等における歩行困難者等に係る避難安全対策』とは2013年4月に、第20期火災予防審議会から「高齢社会の到来を踏まえた高層建築物等における防火安全対策のあり方」について答申がなされたことをふまえ、東京消防庁が策定。同年10月より、東京消防庁管内の高層ビルで認定を開始しました。一定の条件を満たし、認定を取得した施設は、消防隊が到着するまでの間、防災センター係員が非常用エレベーターを使用して歩行困難者などの避難誘導を行うことができます。 ■認定に必要となる主な条件 ・歩行困難者などが待機できる「一時避難エリア」の設置(水平方向の避難対策) ・歩行困難者などを避難誘導するための非常用エレベーターの設置(垂直方向の避難対策) ・施設を利用する歩行困難者の情報を事前に把握し、自衛消防隊により避難誘導ができる体制 当社では、建物の耐震性能や防火設備の充実など、ハード面における取組みだけでなく、定期的な震災訓練の実施および新たな技術やシステムの導入・開発など、ソフト面からもさまざまな対策を講じています。 当社は今後も、建物の高層化や高齢化など社会の流れに合わせて、行政および関係機関との連携を深めながら、安全・安心な街づくりを進めてまいります。

Mori Building: Start operation of evacuation plan using emergency elevator at Toranomon Hills. - Acquired certification from the Tokyo Fire Department for the first time in a high-rise complex tower -

Tokyo Fire Department: Evacuation safety measures for people with difficulty walking in high-rise buildings

Nikkei: Building Fire, Evacuate by Elevator Tokyo Fire Department (April 18, 2013)




This exercise is also being conducted for patient safety.
It's a good way to discuss taboos.
For example, the reuse of disposable medical materials is not usually reused, but may be unavoidable in an emergency.
The staff will think seriously by simulating hands-on exercises.


In-hospital local guidelines

It is also important to establish in-hospital guidelines and have a unified recognition among the parties concerned.
For example, it is natural to change gloves for each procedure, but create a guideline that admits not to change in an emergency.

It is difficult to recognize violations of laws and regulations in the guidelines.
In that case, it is also useful to introduce past disaster cases.

For example, the matters to be included in the prescription are stipulated in Article 21 of the Enforcement Rules of the Medical Doctor Law.
In the Great East Japan Earthquake, doctors used origami as a substitute for prescriptions.
Although the law could be violated, the goal of “prescribing drugs to patients” was achieved.

Doctoral Law enforcement regulations

Article 21
The doctor must specify the patient's name, age, drug name, dosage, usage, dose, date of issue, period of use, and name or location of the hospital or clinic, or the doctor's address. Must be name stamp or signed.

Doctoral Law enforcement regulations (Japan)

Ministry of Health, Labor and Welfare (Japan): Regulations related to the delivery of prescriptions


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