Balding Cathy
School of Public Health, La Trobe University.
Healthc Pap. 2013;13(1):55-9; discussion 78-82. doi: 10.12927/hcpap.2013.23344.
Healthcare has failed to make the same progress as other high-risk industries when it comes to creating safety - despite over a decade of research, education and implementation of safety systems in health services. Safe care is created by systems and standardization, and also by proactive, thinking staff working in partnership with consumers and each other; but the healthcare industry appears to struggle to reconcile these concepts. Even with our evolved knowledge of how human beings operate in organizations, and the best intentions, the dominant change paradigm in healthcare is still hierarchical, based on top-down policies implemented by managers and staff. Although the power spread in health services is being tested through generational change, we have a long way to go before proactivity and initiative at the front line are universally fostered and welcomed by healthcare managers and senior clinicians. "Front Line Ownership: Generating a Cure Mindset for Patient Safety," by Zimmerman et al., presents a persuasive example of how staff ownership of improving consumer safety is a powerful tool for change, one that deserves its place at the front line of safety and quality improvement methods.
在创造安全方面,医疗保健行业未能像其他高风险行业那样取得同样的进展——尽管在卫生服务领域进行了十多年的研究、教育和安全系统实施。安全护理是由系统和标准化创造的,也是由积极主动、善于思考的工作人员与消费者以及彼此合作创造的;但医疗保健行业似乎难以协调这些概念。即使我们对人类在组织中的运作方式有了更深入的了解,并且怀着最美好的意图,医疗保健领域占主导地位的变革模式仍然是等级制的,基于管理者和员工实施的自上而下的政策。尽管卫生服务中的权力分配正在通过代际变化进行检验,但在一线的积极性和主动性得到医疗保健管理者和资深临床医生的普遍培养和欢迎之前,我们还有很长的路要走。齐默尔曼等人所著的《一线自主权:为患者安全培养治愈心态》给出了一个有说服力的例子,说明员工对提高消费者安全的自主权是一种强大的变革工具,它在安全和质量改进方法的前沿理应占有一席之地。