Shewchuk Richard M, Carlson Greg L, Klosterman Matt, Cullen Stephen, Qu Haiyan
Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham (Drs Shewchuk and Qu); Division of Health Services Administration, Beacom School of Business, University of South Dakota, Vermillion (Dr Carlson); San Juan Regional Medical Center, Farmington, New Mexico (Mr Klosterman); HealthSynergy LLC, Birmingham, Alabama (Drs Shewchuk, Carlson, and Qu and Mr Klosterman); and Integrated Medical Systems, Birmingham, Alabama (Mr Cullen).
Qual Manag Health Care. 2014 Jul-Sep;23(3):188-200. doi: 10.1097/QMH.0000000000000038.
The quality of the relationship between the sterile processing department (SPD) and the operating room (OR) is an important determinant of OR safety and performance. In this article, the concept of "friction" refers to the SPD behaviors and attributes that can negatively affect OR performance. Panels of SPD professionals initially were asked to identify and operationally define different ways in which behaviors of a hospital's SPD could compromise OR performance. A national convenience sample of OR nurses (N=291) rated 14 frictions in terms of their agreement or disagreement that each had a negative effect on OR performance in their hospital. Overall, more than 50% of the entire sample agreed that 2 frictions, "SPD does not communicate effectively with the OR" (55%) and "SPD inventories are insufficient for surgical volume" (52%), had negative effect on OR performance. However, a latent class analysis revealed 3 distinct classes of nurses who varied with respect to their level of agreement that SPD-OR frictions negatively affected OR performance. The observed heterogeneity in how different groups of nurses viewed different frictions suggests that effective efforts aimed at reducing performance-limiting frictions should be customized so that resources can be used where they are most needed.
消毒供应部门（SPD）与手术室（OR）之间关系的质量是手术室安全和绩效的重要决定因素。在本文中，“摩擦”的概念是指可能对手术室绩效产生负面影响的消毒供应部门的行为和属性。最初要求消毒供应部门专业人员小组确定并从操作上定义医院消毒供应部门的行为可能损害手术室绩效的不同方式。一个全国性的便利样本的手术室护士（N = 291）就他们是否同意每种摩擦对其所在医院的手术室绩效有负面影响对14种摩擦进行了评分。总体而言，超过50%的整个样本同意两种摩擦，即“消毒供应部门与手术室沟通不畅”（55%）和“消毒供应部门的库存不足以满足手术量”（52%），对手术室绩效有负面影响。然而，一项潜在类别分析揭示了3类不同的护士，他们在认为消毒供应部门与手术室之间的摩擦对手术室绩效有负面影响的认同程度上存在差异。不同组护士对不同摩擦看法的异质性表明，旨在减少限制绩效的摩擦的有效努力应该量身定制，以便能够在最需要的地方使用资源。
