From the Departments of Research.
Development, Region Västra Götaland, South Älvsborg Hospital.
J Patient Saf. 2022 Jan 1;18(1):e18-e25. doi: 10.1097/PTS.0000000000000685.
The Green Cross (GC) method is a visual method for health service staff to recognize risks and preventable adverse events (PAEs) on a daily basis. The aim was to compare patient safety culture and the number of reported PAEs in units using the GC method with units that do not.
This study has a retrospective cross-sectional design in the setting of psychiatric and somatic care departments in a Swedish hospital. In total, 1476 staff members from 62 different units participate in the study.
Units who had implemented the GC method scored higher than non-GC units in overall quality. The dimensions Feedback and communication about error, Nonpunitive response to errors, Organizational learning-continuous improvement, Handoffs and transitions between units and shifts, and Teamwork within units scored significantly higher in GC units. More risks were reported in the incident reporting system in GC units than in non-GC units, but the number of PAEs was similar. Units with nursing staff who used the GC method scored higher on patient safety culture than those who did not use the method. This difference was not seen in physician units.
The implementation of the GC method has a positive impact on patient safety culture and PAE reporting. However, the method does not seem to have the same impact in physician units as in units with nursing staff, which calls for further investigation.
绿十字（GC）方法是一种供卫生服务人员日常识别风险和可预防不良事件（PAE）的视觉方法。目的是比较使用 GC 方法的单位与不使用该方法的单位的患者安全文化和报告的 PAE 数量。
本研究采用瑞典医院精神科和躯体科护理部门的回顾性横断面设计。共有来自 62 个不同单位的 1476 名工作人员参与了这项研究。
实施 GC 方法的单位在整体质量方面的得分高于非 GC 单位。GC 单位在反馈和错误沟通、对错误的非惩罚性反应、组织学习-持续改进、单位之间和轮班之间的交接和过渡以及单位内部的团队合作等维度上的得分显著更高。GC 单位在事件报告系统中报告的风险更多，但 PAE 的数量相似。使用 GC 方法的护理人员所在单位的患者安全文化得分高于未使用该方法的单位。在医师单位中，没有观察到这种差异。
GC 方法的实施对患者安全文化和 PAE 报告有积极影响。然而，该方法在医师单位的影响似乎不如在有护理人员的单位那么大，这需要进一步调查。
