Zhang Chi, Wilson-Sheehan Sena, Ruch Brianna, Wagler Josiah, Abidali Ali, Lim Elisabeth S, Chang Yu-Hui, Fowler Christopher, Douglas David D, Mathur Amit K
Transplant Center, Mayo Clinic, Phoenix, AZ, United States.
Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, United States.
Front Transplant. 2023 Sep 26;2:1208916. doi: 10.3389/frtra.2023.1208916. eCollection 2023.
We sought to understand how safety culture may evolve during disruption, by using the COVID-19 pandemic as an example, to identify vulnerabilities in the system that could impact patient outcomes.
A cross-sectional analysis of transplant personnel at a high-volume transplant center was conducted using the Safety Attitudes Questionnaire (SAQ). Survey responses were scaled and evaluated pre- and post-COVID-19 (2019 and 2021).
Two-hundred and thirty-eight responses were collected (134 pre-pandemic and 104 post-pandemic). Represented organ groups included: kidney ( = 89;38%), heart ( = 18;8%), liver ( = 54;23%), multiple ( = 66;28%), and other ( = 10;4%). Responders primarily included nurses ( = 75;34%), administration ( = 50;23%), and physicians ( = 24;11%). Workers had high safety, job satisfaction, stress recognition, and working conditions satisfaction (score >75) both before and after the pandemic with overlapping responses across both timepoints. Stress recognition, safety, and working conditions improved post-COVID-19, but teamwork, job satisfaction, and perceptions of management were somewhat negatively impacted (all > 0.05).
Despite the serious health care disruptions induced by the pandemic, high domain ratings were notable and largely maintained in a high-volume transplant center. The SAQ is a valuable tool for healthcare units and can be used in longitudinal assessments of transplant culture of safety as a component of quality assurance and performance improvement initiatives.
我们试图以2019冠状病毒病大流行为例，了解安全文化在混乱期间如何演变，以识别可能影响患者预后的系统漏洞。
使用安全态度问卷（SAQ）对一家大型移植中心的移植人员进行横断面分析。对2019年（新冠疫情前）和2021年（新冠疫情后）的调查回复进行评分和评估。
共收集到238份回复（疫情前134份，疫情后104份）。所代表的器官组包括：肾脏（=89；38%）、心脏（=18；8%）、肝脏（=54；23%）、多个器官（=66；28%）和其他（=10；4%）。回复者主要包括护士（=75；34%）、行政人员（=50；23%）和医生（=24；11%）。疫情前后，工作人员的安全、工作满意度、压力认知和工作条件满意度都很高（得分>75），两个时间点的回复有重叠。新冠疫情后，压力认知、安全和工作条件有所改善，但团队合作、工作满意度和对管理层的看法受到了一定的负面影响（所有P>0.05）。
尽管疫情给医疗保健带来了严重干扰，但在一家大型移植中心，高领域评分值得注意且基本保持。SAQ是医疗单位的一个有价值的工具，可作为质量保证和绩效改进举措的一部分，用于移植安全文化的纵向评估。
