Department of Industrial Engineering and Economics, School of Engineering, Tokyo Institute of Technology, Tokyo, Japan.
Int J Health Plann Manage. 2021 Jul;36(4):1153-1165. doi: 10.1002/hpm.3162. Epub 2021 Apr 1.
To extract the organizational climate factors that contribute to safe and effective inter-unit patient handoffs, as well as to capture their crucial characteristics in the context of current Japanese hospitals.
A questionnaire survey was conducted among nursing staff in 31 general hospitals, collecting a total of 5117 valid responses (69% response rate).
A five-factor model was established to determine the inter-unit handoff climate within hospitals. This comprised information and responsibility-related risk, role understanding, communication, handoff environment, and guidelines and process. Based on nursing staff perceptions, the inter-unit handoff climate in Japanese hospitals were generally found to be moderate or moderate-to-high levels across all five of the factors. Nursing staff's perceptions of all five climate factors differed significantly across hospitals and work units, rather than working conditions (full-time vs. part-time) or professions (nurse vs. nurse assistant). All five handoff factors were verified their significant impacts on patient safety awareness and handoff quality. Furthermore, in hospitals where staff perceptions of handoff climate were more positive, information was transferred more effectively.
An inter-unit handoff climate structure was extracted and verified its impact on handoff quality and safety. Due to moderate climate levels in Japanese hospitals, as well as background factors such as low risk awareness among staff and busy situations, promoting a more positive organizational culture is suggested for creating safer and more effective inter-unit handoffs. Improving the current handoff guidelines and processes in hospitals and using non-licensed assistive staff more effectively are also recommended.
提取有助于安全有效单元间患者交接的组织氛围因素，并在当前日本医院的背景下捕捉其关键特征。
对 31 家综合医院的护理人员进行问卷调查，共收集到 5117 份有效回复（69%的回复率）。
建立了一个五因素模型来确定医院内单元间交接的氛围。这包括与信息和责任相关的风险、角色理解、沟通、交接环境以及指南和流程。根据护理人员的感知，日本医院的单元间交接氛围在所有五个因素上普遍处于中等或中高水平。护理人员对所有五个气候因素的看法在医院和工作单位之间存在显著差异，而不是工作条件（全职与兼职）或职业（护士与护士助理）。所有五个交接因素都验证了它们对患者安全意识和交接质量的显著影响。此外，在员工对手头交接氛围的看法更为积极的医院中，信息的传递更为有效。
提取了单元间交接氛围结构，并验证了其对交接质量和安全的影响。由于日本医院的氛围水平中等，以及员工风险意识低和工作繁忙等背景因素，建议营造更积极的组织文化，以实现更安全、更有效的单元间交接。还建议改善医院现行的交接指南和流程，并更有效地利用非持牌辅助人员。
