Centre for Clinical Governance Research, Australian Institute of Health Innovation, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
Int J Qual Health Care. 2011 Feb;23(1):8-14. doi: 10.1093/intqhc/mzq069. Epub 2010 Nov 16.
Motivated staff are needed to improve quality and safety in healthcare organizations. Stimulating and engaging staff to participate in accreditation processes is a considerable challenge. The purpose of this study was to explore the experiences of health executives, managers and frontline clinicians who participated in organizational accreditation processes: what motivated them to engage, and what benefits accrued?
DESIGN/PARTICIPANTS: The setting was a large public teaching hospital undergoing a planned review of its accreditation status. A research protocol was employed to conduct semi-structured interviews with a purposive sample of 30 staff with varied organizational roles, from different professions, to discuss their involvement in accreditation. Thematic analysis of the data was undertaken.
The analysis identified three categories, each with sub-themes: accreditation response (reactions to accreditation and the value of surveys); survey issues (participation in the survey, learning through interactions and constraints) and documentation issues (self-assessment report, survey report and recommendations). Participants' occupational role focuses their attention to prioritize aspects of the accreditation process. Their motivations to participate and the benefits that accrue to them can be positively self-reinforcing. Participants have a desire to engage collaboratively with colleagues to learn and validate their efforts to improve.
Participation in the accreditation process promoted a quality and safety culture that crossed organizational boundaries. The insights into worker motivation can be applied to engage staff to promote learning, overcome organizational boundaries and improve services. The findings can be applied to enhance involvement with accreditation and, more broadly, to other quality and safety activities.
需要激励员工以提高医疗机构的质量和安全性。激励和吸引员工参与认证过程是一项艰巨的挑战。本研究的目的是探讨参与组织认证过程的卫生行政人员、管理人员和一线临床医生的经验：他们的参与动机是什么，以及获得了哪些收益？
设计/参与者：该研究的背景是一家大型公立教学医院，正在计划对其认证状态进行审查。采用研究方案，对来自不同专业、具有不同组织角色的 30 名员工进行了半结构化访谈，以讨论他们参与认证的情况。对数据进行了主题分析。
分析确定了三个类别，每个类别都有子主题：认证反应（对认证的反应和调查的价值）；调查问题（参与调查、通过互动学习和约束）和文件问题（自我评估报告、调查报告和建议）。参与者的职业角色将他们的注意力集中在优先考虑认证过程的各个方面。他们参与的动机和获得的收益可以自我强化。参与者有与同事合作学习和验证他们改进努力的愿望。
参与认证过程促进了跨越组织边界的质量和安全文化。对工人动机的深入了解可以用于激励员工，以促进学习、克服组织障碍和改进服务。这些发现可用于加强与认证的参与，更广泛地用于其他质量和安全活动。
