Department of Anaesthesiology, Baystate Medical Center, Tufts University School of Medicine, 759 Chestnut Street, Springfield, MA 01199, USA.
BMJ Qual Saf. 2012 Jul;21(7):617-20. doi: 10.1136/bmjqs-2011-000608. Epub 2012 Apr 4.
The world is not flat. Hierarchy is a fact of life in society and in healthcare institutions. National, specialty-specific and institutional cultures may play an important role in shaping today's patient-safety climate. The influence of power distance on safety interventions is under-studied. Checklists may make power distance-hampered negotiations easier by providing a standardised aviation-like framework for communications and by democratising the environment. By using surveys and simulation, we might discover patterns of potentially hidden yet problematic interactions that might foster maintenance of the error swamp. We need to understand how people interact as members of a group as this is crucial for the development of generalisable safety interventions.
世界并非是平的。层级关系是社会和医疗机构中的一个事实。国家、专业和机构文化可能在塑造当今患者安全氛围方面发挥着重要作用。权力距离对安全干预的影响还没有得到充分的研究。清单可以通过为沟通提供标准化的航空式框架，并使环境民主化，使权力距离受到阻碍的谈判变得更容易。通过使用调查和模拟，我们可能会发现潜在隐藏但有问题的交互模式，这些模式可能会助长错误沼泽的维持。我们需要了解人们作为群体成员如何相互作用，因为这对于发展可推广的安全干预措施至关重要。
