从报告到改进:团队中的根本原因分析如何塑造患者安全文化
Christos Tsamasiotis1, Gaelle Fiard2, Pierre Bouzat3
1Department of Clinical Epidemiology, Grenoble-Alps University Hospital; Laboratory TIMC-IMAG, UMR 5525 Joint Research Unit, National Center for Scientific Research, Faculty of Medicine, Grenoble Alps University, Grenoble, France.
Risk management and healthcare policy
|July 29, 2024
概括
参与发病率和死亡率会议 (MMCs) 和经验反委员会 (EFCs) 显著提高了患者安全文化. 与个人参与或不参与相比,参与这两项计划在安全文化方面取得了更大的改善.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 提高质量 提高质量
背景情况:
- 持续质量改进计划 (QIP) 对患者安全至关重要.
- 发病率和死亡率会议 (MMC) 和经验反委员会 (EFC) 是提高安全文化的关键QIP.
- 了解这些计划对医疗保健专业人员对安全感知的影响至关重要.
研究的目的:
- 根据医疗保健提供者参与MMC和EFC的情况,确定患者安全文化是否有所不同.
- 量化参与MMC和EFC对患者安全文化特定维度的影响.
主要方法:
- 在2022年进行了一项跨部门仅在网上进行的调查.
- 关于患者安全文化的医院调查 (HSOPS) 针对法国一所大学附属医院的4780名员工进行.
- 用多变量分析差异和科恩d效应大小来分析基于MMC和EFC参与的HSOPS维度得分的差异.
主要成果:
- 1457名员工 (30.5%) 参与,其中571人 (39.2%) 参与了MMC或EFC.
- 在12个HSOPS维度中的6个维度中,MMC或EFC的参与者报告得分明显更高,特别是"对错误的非惩罚性反应"",对错误的反和沟通"和"组织学习" (效果大小=0.14).
- 参与MMC和EFC显示,患者安全文化的改善比单独参与或不参与更大,尽管"人员"和"医院管理支持"等维度不受影响.
结论:
- 参与MMC和EFC与增强的患者安全文化有积极的相关性.
- 这些项目培养了有利于学习,沟通和非惩罚性错误响应的环境.
- 解决超越MMC和EFC的更广泛的系统问题是全面改善患者安全的必要条件.
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