Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, Level 6, 75 Talavera Road, NSW, Sydney, Australia.
Université de Nantes, LEMNA, F-44000, Nantes, France.
BMC Health Serv Res. 2021 Nov 20;21(1):1256. doi: 10.1186/s12913-021-07275-6.
Hospitals are perceived as fast-paced and complex environments in which a missed or incorrect diagnosis or misread chart has the potential to lead to patient harm. However, to date, limited attention has been paid to studying how hospital sociotemporal norms may be associated with staff wellbeing or patient safety. The aim of this study was to use novel network analysis, in conjunction with well-established statistical methods, to investigate and untangle the complex interplay of relationships between hospital staff perceived sociotemporal structures, staff safety attitudes and work-related well-being.
Cross-sectional survey data of hospital staff (n = 314) was collected from four major hospitals in Australia. The survey included subscales from the Organizational Temporality Scale (OTS), two previously established scales of safety attitudes (teamwork climate and safety climate) and measures of staff-related wellbeing (job satisfaction, emotional exhaustion, depersonalisation).
Using confirmatory factor analysis, we first tested a 19-item version of the OTS for use in future studies of hospital temporality (the OTS-H). Novel psychological network analysis techniques were then employed, which identified that "pace" (the tempo or rate of hospital activity) occupies the central position in understanding the complex relationship between temporality, safety attitudes and staff wellbeing. Using a path analysis approach, serial mediation further identified that pace has an indirect relationship with safety attitudes through wellbeing factors, that is, pace impacts on staff wellbeing, which in turn affects hospital safety attitudes.
The findings of this study are important in revealing that staff wellbeing and safety attitudes can be significantly improved by placing more focus on temporal norms, and in particular hospital pace. There are implications for increasing levels of trust and providing staff with opportunities to exercise greater levels of control over their work.
医院被认为是快节奏且复杂的环境，在这种环境中，误诊或错误的诊断或读错图表都有可能导致患者受到伤害。然而，迄今为止，人们对研究医院社会时间规范如何与员工的幸福感或患者安全相关的关注有限。本研究的目的是使用新颖的网络分析，结合成熟的统计方法，调查和理清医院工作人员感知的社会时间结构、员工安全态度和与工作相关的幸福感之间复杂的相互关系。
从澳大利亚的四家大医院收集了医院工作人员（n=314）的横断面调查数据。该调查包括组织时间性量表（OTS）的子量表、两个先前建立的安全态度量表（团队合作氛围和安全氛围）以及与员工相关的幸福感（工作满意度、情绪疲惫、去个性化）的测量。
我们首先使用验证性因素分析，对用于未来医院时间性研究的 OTS 的 19 项版本（OTS-H）进行了测试。然后采用新颖的心理网络分析技术，确定“节奏”（医院活动的节奏或速度）在理解时间性、安全态度和员工幸福感之间复杂关系方面占据中心位置。使用路径分析方法，序列中介进一步确定节奏通过幸福感因素与安全态度呈间接关系，即节奏对员工幸福感有影响，而员工幸福感又会影响医院的安全态度。
这项研究的结果很重要，它揭示了通过更加关注时间规范，特别是医院节奏，可以显著提高员工的幸福感和安全态度。这意味着可以提高信任水平，并为员工提供更多机会来控制自己的工作。
