Applying information technology (IT) to support or magnify a competitive business strategy has been recognized which IT had adopted by enterprises. Many examples of various enterprises illustrate applying IT to create and sustain competitive advantage. Applying information strategy is becoming a trend for success and also for coping with dramatic environmental changing.The Institute of Medicine (IOM) brought patient safety issue into the public attention in its 1999 report “To Err is Human”. It is estimated those medical errors responsible for 44,000 and 98,000 deaths in the United States per year. Medical errors are causing patient’s death, permanent loss of health functions, etc.. Facing on these errors, main strategy for preventing errors is applying IT strategy. Many studies and surveys show that information technology can effectively reduce the rate of medical care errors and adverse events, up to 50%.Thus, information technology plays the role as a gatekeeper for promoting and protecting patient safety in various fields of medical care. The object of this thesis is from historical review to explore various IT strategies adopted by hospitals to improve patient safety and to explore of Taiwan hospitals applying patient safety information technologies to pursue patient safety and its contribution. We are designing this research by three phases. Phase I study, various of SCI literature review from 1990 to 2005 and in-depth interview with physicians, administrators from hospital was used to collect the data. Phase II study; from previous literature reviewed, the model and comments will gather from Phase I interviews to develop a structured questionnaire. Phase III study, In order to reduce the probability of misinterpretation, a Delphi approach was used to further revise and validate the extended framework, which has been synthesized from Phase I and Phase II study. Patient safety has become an important trend and international health facilities operation guidelines. Therefore, hospitals need a well-developed plan to implement in the near future by steps to achieve risk free hospital for patient treatment. We are happy to share our findings to hospitals and learn more on what we can do to make the hospital a safer place for all type of errors.Hospitals not only pursuing a patient safety goal by innovative information technologies but also diffusing, assiminating as a trend of enhance patient safety era. Key Words: Patient Safety, Medical Error, RFID, Electronic Medical Record.

因國人健康意識改變，就醫動機除了疾病之診斷治療之外，亦要求醫療活動之安全與品質。現行醫療訴訟實務，無論採用契約責任或侵權責任為請求權基礎，多以醫事人員是否有過失行為為主要爭點；然而，造成醫療損害的原因包括管理過失及人為過失，而醫療錯誤常發生在人與物的介面之中，此種訴訟方式將使醫療錯誤隱藏於醫事人員過失背後，無法呈現出醫療損害發生原因之全貌，亦無法對醫療品質改善及病人安全提升有所助益。本文以維護病人安全及提升醫療品質為目標，以醫院病人關係為基礎，重新定義醫院醫療服務及其內容，並建構醫院醫療服務之民事責任。 醫院之醫療服務係指「病人就醫過程中，醫院為診治病人所提供之一切專業醫療服務。」此定義涵括病人就醫過程中，所有需要專門醫事人員執行之醫療行為，及相關輔助之醫療軟硬體。 在醫院病人之醫療契約方面，病人締約目的為「以『專業』『安全』之醫療照護體系，達到控制或降低疾病可能風險的目標」，醫院依債務本旨應以「『專業』『安全』之醫療照護體系」為給付。醫院若違反其契約上給付義務，致病人受損害者，將可構成債務不履行責任。 在醫院醫療服務之侵權責任方面，無論僱用人侵權責任採推定過失或無過失責任模式，於醫療實務之適用上皆有許多缺點，而且無法對病人安全及醫療品質有所助益，我國應參考德國組織義務理論及美國醫院組織責任，建立醫院本身義務之理論基礎與具體內容，使醫院因醫療錯誤造成病人損害時，能獨立負起侵權責任。而違反保護他人法律之侵權責任因涉及法律認定之解釋問題、法律體系混淆及法律經濟因素，於醫療服務之適用仍有待研究。 醫院醫療服務是否能適用危險責任，應依立法目的、服務本質、分散風險可能性、舉證困難等因素，決定其適用可能性。鑑於侵權行為之個人責任原則無法提升醫療品質，病人亦無法得到實質賠償，美國學界開始提倡醫療企業責任，以醫院作為醫療錯誤的唯一賠償責任人，使醫院致力於醫療錯誤之防免，達到維護病人安全及提升醫療品質之效果。考量我國目前醫療環境，在醫院企業化經營下，無過失責任於醫院醫療服務之適用應有重新審視之空間，以充實我國醫療糾紛民事損害賠償法制。實務應思考何謂「醫療服務提供欠缺安全性」的概念，以促進病人安全與提升醫療品質。