Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina, USA.
Duke Patient Safety Center, Duke University Health System, Durham, North Carolina, USA.
BMJ Qual Saf. 2018 Apr;27(4):261-270. doi: 10.1136/bmjqs-2016-006399. Epub 2017 Oct 9.
There is a poorly understood relationship between Leadership WalkRounds (WR) and domains such as safety culture, employee engagement, burnout and work-life balance.
This cross-sectional survey study evaluated associations between receiving feedback about actions taken as a result of WR and healthcare worker assessments of patient safety culture, employee engagement, burnout and work-life balance, across 829 work settings.
16 797 of 23 853 administered surveys were returned (70.4%). 5497 (32.7% of total) reported that they had participated in WR, and 4074 (24.3%) reported that they participated in WR with feedback. Work settings reporting more WR with feedback had substantially higher safety culture domain scores (first vs fourth quartile Cohen's range: 0.34-0.84; % increase range: 15-27) and significantly higher engagement scores for four of its six domains (first vs fourth quartile Cohen's range: 0.02-0.76; % increase range: 0.48-0.70).
This WR study of patient safety and organisational outcomes tested relationships with a comprehensive set of safety culture and engagement metrics in the largest sample of hospitals and respondents to date. Beyond measuring simply WRs occur, we examine WR with feedback, as WR being . We suggest that when WRs are conducted, acted on, and the results are to those involved, the work setting is a better place to deliver and receive care as assessed across a broad range of metrics, including teamwork, safety, leadership, growth opportunities, participation in decision-making and the emotional exhaustion component of burnout. Whether WR with feedback is a manifestation of better norms, or a cause of these norms, is unknown, but the link is demonstrably potent.
领导力查房(WR)与安全文化、员工敬业度、倦怠和工作与生活平衡等领域之间的关系尚未被充分理解。
本横断面调查研究评估了在 829 个工作场所中,由于 WR 而采取行动的反馈与医疗保健工作者对患者安全文化、员工敬业度、倦怠和工作与生活平衡的评估之间的关联。
在 23853 份管理调查问卷中,有 16797 份(70.4%)被收回。5497 人(占总数的 32.7%)报告他们参加了 WR,其中 4074 人(24.3%)报告他们参加了带反馈的 WR。报告更多带反馈 WR 的工作场所具有明显更高的安全文化领域得分(第一四分位与第四四分位之间的 Cohen's 范围:0.34-0.84;增加幅度范围:15-27%),且其六个领域中的四个领域的敬业度得分也显著更高(第一四分位与第四四分位之间的 Cohen's 范围:0.02-0.76;增加幅度范围:0.48-0.70)。
在迄今最大规模的医院和受访者样本中,本项关于患者安全和组织结果的 WR 研究检验了与一套全面的安全文化和敬业度指标的关系。除了简单地衡量 WR 的发生,我们还考察了带反馈的 WR,因为 WR 是一种 。我们建议,当 WR 被执行、被采取行动,并将结果 给相关人员时,工作场所将成为一个更好的提供和接收护理的地方,这可以通过广泛的指标进行评估,包括团队合作、安全、领导力、发展机会、参与决策以及倦怠的情绪耗竭部分。反馈性 WR 是更好规范的表现,还是这些规范的原因,目前尚不清楚,但这种联系显然是有力的。