The University of Western Ontario, London, Canada.
BMJ Qual Saf. 2011 Apr;20(4):338-43. doi: 10.1136/bmjqs.2010.040964. Epub 2011 Feb 8.
A growing body of peer-reviewed studies demonstrate the importance of safety culture in healthcare safety improvement, but little attention has focused on developing a common set of definitions, dimensions and measures.
Specific objectives of this literature review include: summarising definitions of safety culture and safety climate, identifying theories, dimensions and measures of safety culture in healthcare, and reviewing progress in improving safety culture.
Peer-reviewed, English-language articles published from 1980 to 2009 pertaining to safety culture in healthcare were reviewed. One hundred and thirty-nine studies were included in this review.
Results suggest that there is disagreement among researchers as to how safety culture should be defined, as well as whether or not safety culture is intrinsically diverse from the concept of safety climate. This variance extends into the dimensions and measurement of safety culture, and interventions to influence culture change.
Most studies utilise quantitative surveys to measure safety culture, and propose improvements in safety by implementing multifaceted interventions targeting several dimensions. Conversely, very few studies made their theoretical underpinnings explicit. Moving forward, a common set of definitions and dimensions will enable researchers to better share information and strategies to improve safety culture in healthcare, building momentum in this rapidly expanding field. Advancing the measurement of safety culture to include both quantitative and qualitative methods should be further explored. Using the expertise of traditional culture experts, anthropologists, more in-depth observational and longitudinal research is needed to move research in this area forward.
越来越多的同行评议研究表明安全文化在改善医疗保健安全方面的重要性，但很少关注开发一套通用的定义、维度和测量方法。
本次文献综述的具体目标包括：总结安全文化和安全氛围的定义，确定医疗保健中安全文化的理论、维度和测量方法，并回顾改善安全文化的进展。
对 1980 年至 2009 年期间发表的与医疗保健安全文化相关的同行评议、英文文章进行了回顾。本综述共纳入了 139 项研究。
研究结果表明，研究人员对于如何定义安全文化以及安全文化是否与安全氛围的概念本质上不同存在分歧。这种差异延伸到安全文化的维度和测量以及影响文化变革的干预措施。
大多数研究使用定量调查来衡量安全文化，并通过针对多个维度的多方面干预措施来提出提高安全性的建议。相反，很少有研究明确其理论基础。展望未来，一套通用的定义和维度将使研究人员能够更好地共享信息和策略，以改善医疗保健中的安全文化，在这个快速发展的领域中积累动力。进一步探索将安全文化的衡量纳入定量和定性方法。利用传统文化专家、人类学家的专业知识，进行更深入的观察性和纵向研究，以推动该领域的研究向前发展。
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