Babitsch Birgit, Bretz Lisa, Mansholt Hilke, Götz Nina-Alexandra
Osnabrück University, Department of New Public Health, Osnabrück, Germany.
GMS J Med Educ. 2020 Mar 16;37(2):Doc14. doi: 10.3205/zma001307. eCollection 2020.
The society and consequently also the health system have become increasingly culturally diverse which applies to both - patients and professionals. Studies indicate an influence of the ethnicity on the care context. With regard to this, considerably more knowledge is available regarding diversity among patients than among professionals, for example considering the effect of cultural diversity in teams. The impact of cultural diversity on patient safety has barely been investigated which means that potential effects as well as required measures and competencies cannot currently be specified. As part of the project "Gestaltungskompetenz als Innovator für hochzuverlässige Organisationen im Gesundheitssystem" (abbreviation: GIO, "Gestaltungskompetenz as an Innovator for High Reliability Organisations in the Healthcare System") these questions are investigated in the context of a case study. Therefore, a CIRS data analysis was carried out to identify specific problem areas to derive competencies for the safe handling of cultural diversity between employees. On this basis and adjusted to the target group, an interactive learning management system will be developed for the advanced training of professionals. For the topic of cultural diversity, an analysis of the patient safety cases reported in CIRSmedical (Critical Incident Reporting System) was carried out followed by a qualitative summarising content analysis. The systematic search in CIRS was based on previously defined search terms as well as inclusion and exclusion criteria. 45 cases were included in the analysis. The results can be classed into two categories: "(Unsuccessful) communication" and "Unsuccessful adaptation to patient needs". Cultural diversity was not usually named as a primary or explicit cause but usually a combination of several factors was given as the reason for the occurrence of an undesirable event. The analysis of CIRS data identified concrete challenges resulting from the intercultural composition of teams and in the care context. The approaches for improvement should include both, organisational and personnel measures. In case of the latter, it is essential that competency requirements are identified resulting in suited offers for the competence development in the course of initial and professional development training for medical and nursing staff in ethnically diverse teams.
社会乃至卫生系统的文化多样性日益增加，这在患者和专业人员中均有体现。研究表明种族对护理环境有影响。就此而言，关于患者之间的多样性的知识比专业人员之间的更多，例如考虑团队中文化多样性的影响。文化多样性对患者安全的影响几乎未被研究，这意味着目前无法明确潜在影响以及所需措施和能力。作为“Gestaltungskompetenz als Innovator für hochzuverlässige Organisationen im Gesundheitssystem”（缩写：GIO，“设计能力作为医疗系统中高可靠性组织的创新者”）项目的一部分，这些问题在一个案例研究的背景下进行了调查。因此，进行了CIRS数据分析，以确定具体的问题领域，从而得出员工安全处理文化多样性的能力要求。在此基础上并针对目标群体进行调整，将开发一个交互式学习管理系统，用于专业人员的进阶培训。对于文化多样性主题，对CIRSmedical（关键事件报告系统）中报告的患者安全案例进行了分析，随后进行了定性的内容总结分析。在CIRS中的系统搜索基于先前定义的搜索词以及纳入和排除标准。45个案例被纳入分析。结果可分为两类：“（不成功的）沟通”和“未成功适应患者需求”。文化多样性通常未被列为主要或明确原因，但通常给出几个因素的组合作为不良事件发生的原因。对CIRS数据的分析确定了团队跨文化构成和护理环境中产生的具体挑战。改进方法应包括组织措施和人员措施。就后者而言，至关重要的是确定能力要求，从而为多民族团队中的医护人员在初始和专业发展培训过程中的能力发展提供合适的培训内容。
