Ravi Dhurjati, Tawfik Daniel S, Sexton J Bryan, Profit Jochen
Perinatal Epidemiology and Health Outcomes Research Unit, Division of Neonatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
California Perinatal Quality Care Collaborative, Palo Alto, CA, USA.
J Perinatol. 2021 Oct;41(10):2552-2560. doi: 10.1038/s41372-020-00839-0. Epub 2020 Oct 6.
Safety culture, an aspect of organizational culture, that reflects work place norms toward safety, is foundational to high-quality care. Improvements in safety culture are associated with improved operational and clinical outcomes. In the neonatal intensive care unit (NICU), where fragile infants receive complex, coordinated care over prolonged time periods, it is critically important that unit norms reflect the high priority placed on safety. Changing the safety culture of the NICU involves a systematic process of measurement, identifying strengths and weaknesses, deploying targeted interventions, and learning from the results, to set the stage for an iterative process of improvement. Successful change efforts require: effective partnerships with key stakeholders including management, clinicians, staff, and families; using data to make the case for improvement; and leadership actions that motivate change, channel resources, and support active problem- solving. Sustainable change requires buy-in from NICU staff and management, resources, and long-term institutional commitment.
安全文化作为组织文化的一个方面，反映了工作场所对安全的规范，是高质量医疗护理的基础。安全文化的改善与运营和临床结果的改善相关。在新生儿重症监护病房（NICU），脆弱的婴儿需要长时间接受复杂、协调的护理，该病房的规范高度重视安全至关重要。改变NICU的安全文化涉及一个系统的过程，包括测量、识别优势和劣势、部署有针对性的干预措施以及从结果中学习，为迭代改进过程奠定基础。成功的变革努力需要：与包括管理层、临床医生、工作人员和家庭在内的关键利益相关者建立有效的伙伴关系；利用数据来证明改进的必要性；以及采取激励变革、调配资源和支持积极解决问题的领导行动。可持续的变革需要NICU工作人员和管理层的认可、资源以及长期的机构承诺。
