QualiREL Santé, Hôpital Saint Jacques, 85 rue Saint Jacques, 44093, Nantes, France.
Public Health Department, University Hospital of Nantes, 85 rue Saint-Jacques, 44093, Nantes Cedex 1, France.
BMC Health Serv Res. 2021 Dec 11;21(1):1332. doi: 10.1186/s12913-021-07336-w.
French nursing homes (NHs) are in the early stages of implementing their risk management approach. The latter includes the development of a safety culture (SC) among professionals. A training package to support NHs in implementing a risk management strategy has been designed by QualiREL Santé, a regional body that provides support in quality and risk management. The aim is to improve SC. No data are available about the level of SC in French NHs. This study evaluates the level of SC and identifies predictors of SC scores in NHs that will subsequently benefit from the training package.
The study was proposed to NHs who are members of QualiREL Santé in 2 French departments. Inclusion criteria were voluntary participation, the commitment of top management to benefit from the training package, and the absence of previous risk management support provided by QualiREL Santé. The NHSOPS-F questionnaire (22 items measuring 7 dimensions of SC) was administered to professionals between January and March 2016. 14 variables related to the structural profile of the NHs and the strategic choices of top management in terms of healthcare safety were recorded. Scores for 7 dimensions were calculated for all of the included NHs. Further modelling identified predictive factors.
58 NHs were included. The response rate for the NHSOPS-F (n = 1946 professionals) was 64% (Q1-Q3 = [49.4;79.0]). Staffing was the least-developed dimension (11.8%), while scores were highest for Feedback and communication about incidents (84.8%). Being attached to a public hospital was associated with poorer perceptions of SC, notably for the dimension "Overall perceptions of resident safety and organizational learning" (β = - 19.59;p-value< 0.001). A less-developed SC was also significantly linked to existing Quality initiatives.
Overall, French NHs must prioritise issues of staffing, teamwork and compliance with procedures. The role of human factors within teams should be exploited by top management. Our initial findings will help to adapt improvement approaches and are particularly relevant to local and national policies during the ongoing pandemic.
法国养老院（NH）正处于实施风险管理方法的早期阶段。后者包括在专业人员中发展安全文化（SC）。为了支持 NH 实施风险管理策略，由提供质量和风险管理支持的区域机构 QualiREL Santé 设计了一套培训包。目的是提高 SC。目前还没有关于法国 NH 中 SC 水平的数据。本研究评估了 SC 的水平，并确定了将从培训包中受益的 NH 中 SC 得分的预测因素。
该研究提议在法国 2 个省的 QualiREL Santé 成员 NH 中进行。纳入标准为自愿参与、高层管理人员承诺从培训包中受益，以及之前没有由 QualiREL Santé 提供的风险管理支持。NHSOPS-F 问卷（22 个项目，测量 SC 的 7 个维度）于 2016 年 1 月至 3 月期间分发给专业人员。记录了与 NH 结构概况和高层管理人员在医疗保健安全方面的战略选择相关的 14 个变量。为所有纳入的 NH 计算了 7 个维度的得分。进一步建模确定了预测因素。
共纳入 58 家 NH。NHSOPS-F 的应答率（n=1946 名专业人员）为 64%（Q1-Q3=[49.4；79.0]）。人员配备是最不发达的维度（11.8%），而对事件的反馈和沟通得分最高（84.8%）。与公立医院有关联与 SC 的看法较差有关，特别是对“居民安全和组织学习的总体看法”维度（β=-19.59；p 值<0.001）。SC 发展较差也与现有的质量倡议显著相关。
总体而言，法国 NH 必须优先考虑人员配备、团队合作和遵守程序的问题。高层管理人员应利用团队中的人为因素。我们的初步发现将有助于调整改进方法，在当前大流行期间，对地方和国家政策特别相关。
