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急症医院一线工作人员对患者安全氛围(PSC)的认知:探究报告便利性、科室开放规范及参与式领导的作用

Patient safety climate (PSC) perceptions of frontline staff in acute care hospitals: examining the role of ease of reporting, unit norms of openness, and participative leadership.

作者信息

Zaheer Shahram, Ginsburg Liane, Chuang You-Ta, Grace Sherry L

机构信息

Shahram Zaheer, MSc, is a PhD Candidate, School of Health Policy and Management, York University, Canada. Liane Ginsburg, PhD, is Associate Professor, School of Health Policy and Management, York University, Canada. E-mail:

出版信息

Health Care Manage Rev. 2015 Jan-Mar;40(1):13-23. doi: 10.1097/HMR.0000000000000005.

Abstract

BACKGROUND

Increased awareness regarding the importance of patient safety issues has led to the proliferation of theoretical conceptualizations, frameworks, and articles that apply safety experiences from high-reliability industries to medical settings. However, empirical research on patient safety and patient safety climate in medical settings still lags far behind the theoretical literature on these topics.

PURPOSE

The broader organizational literature suggests that ease of reporting, unit norms of openness, and participative leadership might be important variables for improving patient safety. The aim of this empirical study is to examine in detail how these three variables influence frontline staff perceptions of patient safety climate within health care organizations.

METHODOLOGY

A cross-sectional study design was used. Data were collected using a questionnaire composed of previously validated scales.

FINDINGS

The results of the study show that ease of reporting, unit norms of openness, and participative leadership are positively related to staff perceptions of patient safety climate.

PRACTICE IMPLICATIONS

Health care management needs to involve frontline staff during the development and implementation stages of an error reporting system to ensure staff perceive error reporting to be easy and efficient. Senior and supervisory leaders at health care organizations must be provided with learning opportunities to improve their participative leadership skills so they can better integrate frontline staff ideas and concerns while making safety-related decisions. Finally, health care management must ensure that frontline staff are able to freely communicate safety concerns without fear of being punished or ridiculed by others.

摘要

背景

对患者安全问题重要性的认识不断提高,导致了将高可靠性行业的安全经验应用于医疗环境的理论概念、框架和文章大量涌现。然而,关于医疗环境中患者安全和患者安全氛围的实证研究仍远远落后于这些主题的理论文献。

目的

更广泛的组织文献表明,报告的便利性、开放的单位规范和参与式领导可能是改善患者安全的重要变量。这项实证研究的目的是详细考察这三个变量如何影响医疗保健组织中一线员工对患者安全氛围的认知。

方法

采用横断面研究设计。使用由先前验证过的量表组成的问卷收集数据。

结果

研究结果表明,报告的便利性、开放的单位规范和参与式领导与员工对患者安全氛围的认知呈正相关。

实践意义

医疗保健管理需要在错误报告系统的开发和实施阶段让一线员工参与进来,以确保员工认为错误报告既简单又高效。必须为医疗保健组织的高级和监督领导提供学习机会,以提高他们的参与式领导技能,以便他们在做出与安全相关的决策时能够更好地整合一线员工的想法和关切。最后,医疗保健管理必须确保一线员工能够自由地交流安全问题,而不必担心受到他人的惩罚或嘲笑。

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