识别和衡量医院医生和行政领导人所经历的行政伤害
Marisha Burden1, Gopi Astik2, Andrew Auerbach3
1Division of Hospital Medicine, University of Colorado School of Medicine, Aurora.
JAMA internal medicine
|June 24, 2024
概括
行政损害 (AH) 在医疗保健中很常见,影响工作流程和患者护理. 这项研究发现,医疗机构缺乏有效的方法来识别,测量和解决AH,尽管它的普遍性.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 组织行为 组织行为
背景情况:
- 行政损害 (AH) 被定义为影响医疗保健工作结构,流程和计划的行政决策的不利后果.
- AH在医学中是普遍存在的,但仍然不太了解和描述.
- 现有的文献缺乏对临床医生和领导者之间的AH经验的全面探索.
研究的目的:
- 探索医院临床医生和行政领导者之间常见的行政伤害 (AH) 经验.
- 了解在医疗保健系统内识别和测量AH的挑战.
- 为了确定潜在的策略来缓解AH.
主要方法:
- 通过调查和半结构化的虚拟焦点小组进行了定性混合方法研究.
- 参与者包括医院临床医生,研究人员,行政领导人和患者/家庭顾问.
- 采用了快速定性方法,包括模板摘要和矩阵分析.
主要成果:
- 81%的参与者报告说他们个人参与了导致AH的决策,但只有6%的人对这个术语非常熟悉.
- 出现了三个关键主题:AH在所有领导层中普遍存在,由于心理安全和不清楚所有权等问题,组织缺乏AH识别/测量机制,以及组织压力导致AH.
- 参与者强调了管理员-临床医生合作在减少AH方面发挥的关键作用.
结论:
- 行政损害 (AH) 是一个广泛的问题,在医疗保健组织中产生重大影响.
- 目前的医疗保健系统缺乏强大的机制来识别,测量和解决AH.
- 制定有效的缓解AH策略需要解决系统性问题并促进合作.
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