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医疗机构医护人员参与根本原因分析与患者安全文化

Involvement in Root Cause Analysis and Patient Safety Culture Among Hospital Care Providers.

机构信息

Service de Biostatistique, Hospices Civils de Lyon, Laboratoire de Biométrie et Biologie Evolutive, UMR 5558 CNRS, Lyon.

Department of Political Science, Institute of Political Studies.

出版信息

J Patient Saf. 2021 Dec 1;17(8):e1194-e1201. doi: 10.1097/PTS.0000000000000456.

Abstract

BACKGROUND

The experience feedback committee (EFC) is a tool designed to involve medical teams in patient safety management, through root cause analysis within the team.

OBJECTIVE

The aim of the study was to determine whether patient safety culture, as measured by the Hospital Survey on Patient Safety Culture (HSOPS), differed regarding care provider involvement in EFC activities.

METHODS

Using the original data from a cross-sectional survey of 5064 employees at a single university hospital in France, we analyzed the differences in HSOPS dimension scores according involvement in EFC activities.

RESULTS

Of 5064 eligible employees, 3888 (76.8%) participated in the study. Among the respondents, 440 (11.3%) participated in EFC activities. Experience feedback committee participants had a more developed patient safety culture, with 9 of the 12 HSOPS dimension scores significantly higher than EFC nonparticipants (overall effect size = 0.31, 95% confidence interval = 0.21 to 0.41, P < 0.001). A multivariate analysis of variance indicated that all 12 dimension scores, taken together, were significantly different between EFC participants and nonparticipants (P < 0.0001), independently of sex, hospital department, and healthcare profession category. The largest differences in scores related to the "feedback and communication about error," "organizational learning," and "Nonpunitive response to error" dimensions. The analysis of the subgroup of professionals who worked in a department with a productive EFC, defined as an EFC implementing at least five actions per year, showed a higher patient safety culture level for seven of the 12 HSOPS dimensions (overall effect size = 0.19, 95% confidence interval = 0.10 to 0.27, P < 0.001).

DISCUSSION AND CONCLUSIONS

Participation in EFC activities was associated with higher patient safety culture scores. The findings suggest that root cause analysis in the team's routine may improve patient safety culture.

摘要

背景

经验反馈委员会(EFC)是一种工具,旨在通过团队内部的根本原因分析,让医疗团队参与到患者安全管理中。

目的

本研究旨在确定患者安全文化是否因医护人员参与 EFC 活动而有所不同,这是通过《医院患者安全文化调查》(HSOPS)来衡量的。

方法

利用法国某大学附属医院横断面调查的原始数据,我们分析了 EFC 活动参与情况与 HSOPS 维度得分差异之间的关系。

结果

在符合条件的 5064 名员工中,有 3888 人(76.8%)参与了研究。在受访者中,有 440 人(11.3%)参与了 EFC 活动。经验反馈委员会参与者的患者安全文化更为成熟,12 个 HSOPS 维度得分中有 9 个显著高于 EFC 非参与者(总效应量=0.31,95%置信区间=0.21 至 0.41,P<0.001)。方差分析表明,EFC 参与者和非参与者之间的 12 个维度得分总和存在显著差异(P<0.0001),且与性别、医院科室和医疗保健专业类别无关。得分差异最大的维度与“错误的反馈和沟通”、“组织学习”和“对错误的非惩罚性反应”有关。对在有生产力的 EFC 部门工作的专业人员亚组(定义为每年至少实施五项行动的 EFC)进行分析后发现,12 个 HSOPS 维度中有 7 个维度的患者安全文化水平更高(总效应量=0.19,95%置信区间=0.10 至 0.27,P<0.001)。

讨论与结论

参与 EFC 活动与更高的患者安全文化得分相关。这些发现表明,团队日常中的根本原因分析可能会改善患者安全文化。

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