Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
BMC Emerg Med. 2024 Feb 16;24(1):29. doi: 10.1186/s12873-024-00943-w.
Workplace violence (WPV) in healthcare is a growing challenge posing significant risks to patient care and employee well-being. Existing metrics to measure WPV in healthcare settings often fail to provide decision-makers with an adequate reflection of WPV due to the complexity of the issue. This increases the difficulty for decision-makers to evaluate WPV in healthcare settings and implement interventions that can produce sustained improvements.
This study aims to identify and compile a list of quality indicators that have previously been utilized to measure WPV in healthcare settings. The identified quality indicators serve as tools, providing leadership with the necessary information on the state of WPV within their organization or the impact of WPV prevention interventions. This information provides leadership with a foundation for planning and decision making related to addressing WPV.
Ovid databases were used to identify articles relevant to violence in healthcare settings, from which 43 publications were included for data extraction. Data extraction produced a total of 229 quality indicators that were sorted into three indicator categories using the Donabedian model: structure, process, and outcome.
A majority of the articles (93%) contained at least 1 quality indicator that possessed the potential to be operationalized at an organizational level. In addition, several articles (40%) contained valuable questionnaires or survey instruments for measuring WPV. In total, the rapid review process identified 84 structural quality indicators, 121 process quality indicators, 24 outcome quality indicators, 57 survey-type questions and 17 survey instruments.
This study provides a foundation for healthcare organizations to address WPV through systematic approaches informed by quality indicators. The utilization of indicators showed promise for characterizing WPV and measuring the efficacy of interventions. Caution must be exercised to ensure indicators are not discriminatory and are suited to specific organizational needs. While the findings of this review are promising, further investigation is needed to rigorously evaluate existing literature to expand the list of quality indicators for WPV.
工作场所暴力(WPV)在医疗保健领域是一个日益严峻的挑战,对患者护理和员工福祉构成重大风险。现有的医疗保健环境中 WPV 衡量指标往往无法为决策者提供对 WPV 的充分反映,因为问题的复杂性增加了决策者评估医疗保健环境中的 WPV 并实施可以产生持续改进的干预措施的难度。
本研究旨在确定并编制一份先前用于衡量医疗保健环境中 WPV 的质量指标清单。所确定的质量指标可作为工具,为领导层提供有关其组织内 WPV 状况或 WPV 预防干预措施影响的必要信息。这些信息为领导层提供了与解决 WPV 相关的规划和决策的基础。
使用 Ovid 数据库确定与医疗保健环境中的暴力相关的文章,从中纳入了 43 篇用于数据提取的出版物。数据提取共产生了 229 个质量指标,这些指标使用 Donabedian 模型分为结构、过程和结果三个指标类别。
大多数文章(93%)至少包含 1 个有潜力在组织层面实施的质量指标。此外,有几篇文章(40%)包含了用于衡量 WPV 的有价值的问卷或调查工具。总共,快速审查过程确定了 84 个结构性质量指标、121 个过程质量指标、24 个结果质量指标、57 个调查型问题和 17 个调查工具。
本研究为医疗保健组织提供了通过质量指标为指导的系统方法来解决 WPV 的基础。指标的使用有望用于描述 WPV 和衡量干预措施的效果。必须谨慎行事,以确保指标不具有歧视性且适合特定的组织需求。虽然本综述的结果很有希望,但需要进一步调查以严格评估现有文献,以扩大 WPV 的质量指标清单。