Carayon P, Hundt A Schoofs, Alvarado C J, Springman S R, Ayoub P
Center for Quality and Productivity Improvement, University of Wisconsin-Madison, 610 Walnut Street, 575 WARF, 53726, USA.
Ergonomics. 2006;49(5-6):470-85. doi: 10.1080/00140130600568717.
The objective of this study is to understand the viewpoint of healthcare providers with regard to patient safety in outpatient surgery settings. Two methods were used to gather data from the healthcare providers: (1) questionnaire with open-ended questions about six predefined stages of the patient care process; (2) survey with closed questions. With the first method, the main quality and safety of care issues concerned communication to patients, coordination of reports and forms, patient and staff time pressures and standards of care. The first two stages of the outpatient surgery process, i.e. patient work-up prior to day of surgery and patient admission and preparation on the day of surgery, yielded many more comments than the other four stages. The results of the structured questionnaire show that, overall, the healthcare providers report high quality of care provided by themselves (98%) and their surgery centre (96%). With regard to patient safety (i.e. cancellations of surgeries, patient safety problems and serious mistakes), there was a clear difference in perceptions reported by the physicians vs. the nurses and other staff. Nurses and other staff were more likely to report patient safety problems than physicians. The combination of qualitative data from the initial questionnaire and the quantitative data from the structured questionnaire provides a rather complete view of the outpatient surgery staff perceptions of quality and safety of care. This research highlights the importance of getting input from the healthcare providers regarding the quality and safety of care rather than relying only on traditional measures about patient outcomes.
本研究的目的是了解医疗服务提供者对门诊手术环境中患者安全的看法。采用了两种方法从医疗服务提供者那里收集数据：（1）针对患者护理过程的六个预定义阶段提出开放式问题的问卷；（2）封闭式问题的调查。通过第一种方法，护理的主要质量和安全问题涉及与患者的沟通、报告和表格的协调、患者和工作人员的时间压力以及护理标准。门诊手术过程的前两个阶段，即手术前一天的患者检查以及手术当天的患者入院和准备，产生的评论比其他四个阶段多得多。结构化问卷的结果表明，总体而言，医疗服务提供者报告他们自己提供的护理质量很高（98%），他们的手术中心的护理质量也很高（96%）。在患者安全方面（即手术取消、患者安全问题和严重失误），医生与护士及其他工作人员报告的看法存在明显差异。护士和其他工作人员比医生更有可能报告患者安全问题。初始问卷的定性数据与结构化问卷的定量数据相结合，较为完整地展现了门诊手术工作人员对护理质量和安全的看法。这项研究强调了从医疗服务提供者那里获取有关护理质量和安全的意见的重要性，而不是仅仅依赖于关于患者结局的传统指标。
