Sine David M, Paull Doug
Veterans Health Administration's Office of Quality Safety (Washington, DC).
University of Michigan and Georgetown University Schools of Medicine (Washington, DC).
J Healthc Risk Manag. 2018 Jan;37(3):14-17. doi: 10.1002/jhrm.21285. Epub 2017 Nov 1.
The structure of an organization is important, and structure has a profound influence on the way people work and what gets done. Where work units and individuals in an organization are placed, to whom they report, and with whom they are grouped signals power, prestige, and privilege. It also divides workers into groups with common interests and motivations. The question is, where should patient safety be placed in a health care organization? Such a question can be answered only within a framework of understanding that gives a clear definition to patient safety. We define safety, as do safety professionals from other industries, as the reduction of risk. This definition is also in concert with the risk management model that identifies claims management, risk financing, and loss control as its foundational triad.
组织架构很重要，它对人们的工作方式以及工作成果有着深远影响。组织中的工作单元和个人所处的位置、向谁汇报工作以及与谁归为一组，这些都标志着权力、威望和特权。它还将员工划分成具有共同利益和动机的群体。问题在于，在医疗保健组织中，患者安全应处于何种位置？只有在一个能对患者安全给出明确定义的理解框架内，才能回答这样的问题。我们如同其他行业的安全专业人员一样，将安全定义为风险的降低。这个定义也与风险管理模型相一致，该模型将索赔管理、风险融资和损失控制视为其基本的三大要素。
