Hoff Timothy, Jameson Lottie, Hannan Edward, Flink Ellen
University at Albany, State University of New York, NY, USA.
Med Care Res Rev. 2004 Mar;61(1):3-37. doi: 10.1177/1077558703257171.
The potential role of organizational factors in enhanced patient safety and medical error prevention is highlighted in the systems approach advocated for by the Institute of Medicine and others. However, little is known about the extent to which these factors have been shown empirically to be associated with these favorable outcomes. The present study conducted an intensive review of the clinical and health services literatures in order to explore this issue. The results of this review support the general conclusion that there is little evidence for asserting the importance of any individual, group, or structural variable in error prevention or enhanced patient safety at the present time. Two major issues bearing on the development of future research in this area involve strengthening the theoretical foundations of organizational research on patient safety and overcoming definitional and observability problems associated with error-focused dependent variables.
医学研究所及其他机构所倡导的系统方法强调了组织因素在提高患者安全和预防医疗差错方面的潜在作用。然而，关于这些因素在多大程度上已通过实证研究证明与这些良好结果相关，我们知之甚少。本研究对临床和卫生服务文献进行了深入回顾，以探讨这一问题。该回顾结果支持了这样一个总体结论：目前几乎没有证据表明任何个体、群体或结构变量在预防差错或提高患者安全方面具有重要性。与该领域未来研究发展相关的两个主要问题包括加强患者安全组织研究的理论基础，以及克服与以差错为重点的因变量相关的定义和可观测性问题。
