Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Division of Occupational Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan; Department of Nursing, Fooyin University. Kaohsiung, Taiwan.
Department of Medical Quality, E-Da Hospital, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
J Formos Med Assoc. 2024 Nov;123 Suppl 3:S200-S206. doi: 10.1016/j.jfma.2024.09.035. Epub 2024 Oct 11.
The COVID-19 global pandemic exposed healthcare system vulnerabilities, further endangering patient safety. This article explores perspectives on resilience and patient safety among healthcare workers using data from the Taiwan Patient Safety Culture Survey (TPSCS) and implementing Patient Safety Leadership Walkrounds (PSLWs) at E-Da Hospital. In 2021 and 2022, 1340 and 1114 staff members from clinical departments completed TPSCS questionnaires, respectively. 89 leaders from clinical departments participated in PSLWs in 2022. Among the four job categories, scores of Safety Attitude Questionnaire (SAQ) were lower among nurses and medical technicians, while perceptions of resilience and work-life balance were lowest among nurses. Between the two-year surveys, nurses exhibited significant decreases in SAQ in 2022 compared to 2021, while perceptions of work condition and work-life balance significantly declined among pharmacists. Resilience perception significantly decreased among all job categories except physicians during the pandemic. Mediation analyses showed teamwork climate, job satisfaction, management, work condition, and work-life balance were directly associated with safety climate, while resilience acts as a mediator, indirectly potentiating these relationships. Through PSLWs, we identified concerns about patient safety, including workforce, systems, processes, equipment, and work environment. Among these, workforce shortages and unsatisfactory pay emerged as the most pressing challenges. Strong leadership was recognized as a crucial factor in enhancing resilience and patient safety. This study suggests that TPSCS and PSLWs are worth regularly promoting among hospital institutions. Additionally, our findings highlight the urgency of healthcare organizations and governmental agencies to undertake policy reforms to improve healthcare workers' well-being.
新冠疫情全球大流行暴露了医疗体系的脆弱性，进一步危及患者安全。本文探讨了医疗工作者在弹性和患者安全方面的观点，使用了来自台湾患者安全文化调查（TPSCS）的数据，并在义大医院实施了患者安全领导力巡访（PSLWs）。2021 年和 2022 年，临床部门的 1340 名和 1114 名员工分别完成了 TPSCS 问卷。2022 年，89 名临床部门领导参加了 PSLWs。在四个工作类别中，安全态度问卷（SAQ）的分数在护士和医疗技术人员中较低，而护士的弹性和工作生活平衡的看法最低。在两年的调查中，与 2021 年相比，护士在 2022 年的 SAQ 显著下降，而药剂师的工作条件和工作生活平衡的看法显著下降。在疫情期间，除了医生外，所有工作类别的弹性感知都显著下降。中介分析表明，团队合作氛围、工作满意度、管理、工作条件和工作生活平衡与安全氛围直接相关，而弹性则作为中介，间接增强了这些关系。通过 PSLWs，我们确定了一些与患者安全相关的问题，包括劳动力、系统、流程、设备和工作环境。在这些问题中，劳动力短缺和薪酬不满意是最紧迫的挑战。强有力的领导被认为是增强弹性和患者安全的关键因素。本研究表明，TPSCS 和 PSLWs 在医院机构中值得定期推广。此外，我们的研究结果强调了医疗保健组织和政府机构采取政策改革以改善医疗保健工作者福祉的紧迫性。
