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组织文化与从“公正文化”培训中获益的能力之间的关系。

The Association Between Organizational Culture and the Ability to Benefit From "Just Culture" Training.

机构信息

From the Department of Quality and Patient Safety, Universal Health Services, Temecula, CA.

出版信息

J Patient Saf. 2019 Mar;15(1):e3-e7. doi: 10.1097/PTS.0000000000000561.

Abstract

OBJECTIVE

This study aimed to determine whether there was an association between the organizational culture and the hospital's readiness to benefit from "Just Culture" training.

METHODS

The "Just Culture" Assessment Tool and the Competing Values Framework surveys were administered before and 6 weeks after a structured "Just Culture" training session to 172 care providers and administrators on similar units at two community for-profit hospitals of compatible size and offering comparable services in suburban communities. Data were analyzed for significance using IBM SPSS software.

RESULTS

At baseline, there was a significantly higher percentage of problematic responses (PPRs) for hospital 1 as compared with hospital 2. Administrators and managers reported significantly fewer PPRs than frontline staff. In addition, the archetypal organizational culture for hospital 1 was found to be more hierarchical, whereas the culture for hospital 2 was found to be more group oriented. Six weeks after the completion of "Just Culture" training, there was a 0.02% overall reduction in PPRs at hospital 1 as compared with a 62.01% overall reduction in PPRs at hospital 2. There was also a significant increase in the Group Culture Score, a significant decrease in both the Hierarchical Culture and Rational Culture scores for hospital 2 as compared with hospital 1.

CONCLUSIONS

There was a significantly greater reduction in PPR on the "Just Culture" Assessment Tool in the hospital with the more group-oriented organizational culture. Given the cost and effort required to conduct "Just Culture" training in an organization, it seems to be important to address the organizational culture before the implementation of this type of training.

摘要

目的

本研究旨在确定组织文化与医院是否准备从“公正文化”培训中受益之间是否存在关联。

方法

在结构“公正文化”培训课程前后,对两家规模相当且在郊区社区提供类似服务的社区盈利性医院的类似单位的 172 名护理人员和管理人员进行了“公正文化”评估工具和竞争价值观框架调查。使用 IBM SPSS 软件分析数据的显著性。

结果

在基线时,与医院 2 相比,医院 1 的问题反应比例(PPR)明显更高。管理人员和经理的 PPR 明显少于一线员工。此外,发现医院 1 的典型组织文化更加等级化,而医院 2 的文化更加面向群体。完成“公正文化”培训 6 周后,与医院 2 相比,医院 1 的 PPR 总体减少了 0.02%,医院 2 的 PPR 总体减少了 62.01%。医院 2 的群体文化评分显著增加,等级文化和理性文化评分均显著下降,而医院 1 的群体文化评分则显著增加。

结论

在更具群体导向的组织文化的医院中,“公正文化”评估工具上的 PPR 减少幅度明显更大。鉴于在组织中进行“公正文化”培训所需的成本和精力,在实施此类培训之前,解决组织文化问题似乎很重要。

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