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医疗行业安全氛围的组织和个体影响因素——贝叶斯网络预测建模方法。

Organizational and Individual Contributing Factors to Safety Climate in Healthcare Industries-Bayesian Network Predictive Modeling Approach.

机构信息

From the University of Georgia, Athens, Georgia (Y.H.); Kansas State University, Manhattan, Kansas (J.L.); Oregon Health & Science University, Portland, Oregon (Y.-H.H.); and National Chengchi University, Taipei, Taiwan (C.H.).

出版信息

J Occup Environ Med. 2024 Nov 1;66(11):908-918. doi: 10.1097/JOM.0000000000003208. Epub 2024 Aug 16.

Abstract

OBJECTIVES

The current study aims to identify individual and joint drivers that significantly influence the safety climate in healthcare industries by using Bayesian network (BN) simulations for an in-depth analysis.

METHODS

Survey data were collected from 452 employees from two branches of one hospital in China for a study about workplace safety. The original English surveys were translated into Chinese using the back-translation procedure recommended by Brislin. Employees were asked to complete two online surveys with 1 month in between each administration. The sample was 42% doctors and 58% nurses. A BN model, based on theory, was updated and complemented with expert knowledge. A graphical model based on expert knowledge and data-driven machine learning approaches was used to refine the BN structure, representing interrelationships among all studied variables. The BN model was employed to identify the best key drivers and joint strategies for safety climate improvement.

RESULTS

The BN model demonstrated a good overall fit. The Euclidean distance metric was used to assess the influence between connected variables, with interpersonal trust and locus of control having the strongest independent effects on safety climate among the five contributing factors. Joint strategies, particularly joint optimization of error disclosure culture and interpersonal trust, as well as error disclosure culture and self-efficacy, were most effective in promoting a safe climate.

CONCLUSIONS

The findings suggest that hospital safety climate can be improved by providing a psychologically safe error disclosure culture and enhancing interpersonal trust among employees and their self-efficacy.

摘要

目的

本研究旨在通过贝叶斯网络(BN)模拟对医疗保健行业的安全氛围进行深入分析,确定对其具有显著影响的个体和共同驱动因素。

方法

从中国一家医院的两个分支机构中抽取 452 名员工进行了一项关于工作场所安全的研究,共收集了他们的调查数据。原始英文调查问卷通过 Brislin 推荐的回译程序翻译成中文。员工被要求在两次在线调查之间间隔一个月的时间填写两次在线调查问卷。该样本中,医生占 42%,护士占 58%。基于理论,构建了 BN 模型,并结合专家知识进行了更新和补充。使用基于专家知识和数据驱动机器学习方法的图形模型来改进 BN 结构,以表示所有研究变量之间的相互关系。该 BN 模型用于识别改善安全氛围的最佳关键驱动因素和联合策略。

结果

BN 模型表现出良好的整体拟合度。欧几里得距离度量用于评估连接变量之间的影响,在五个促成因素中,人际信任和控制源对安全氛围具有最强的独立影响。联合策略,特别是错误披露文化和人际信任的联合优化以及错误披露文化和自我效能的联合优化,在促进安全氛围方面最为有效。

结论

研究结果表明,通过提供心理安全的错误披露文化并增强员工之间的人际信任和自我效能感,可以改善医院的安全氛围。

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