Error disclosure: a new domain for safety culture assessment.
Error disclosure: a new domain for safety culture assessment.
复制标题
错误披露：安全文化评估的新领域。
DOI：
10.1136/bmjqs-2011-000530
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发表时间：
2012
影响因子：
5.4
通讯作者：
Thomas,EricJ
中科院分区：
文献类型：
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作者：
Etchegaray,JasonM;Gallagher,ThomasH;Bell,SigallK;Dunlap,Ben;Thomas,EricJ
目的（1）编制和检验差错披露文化的测量项目，（2）检验差错披露文化、团队文化和安全文化之间的关系，（3）建立差错披露文化测量项目的预测效度（四所医学院，一间癌症中心及一间健康科学中心）在德克萨斯大学系统被邀请匿名完成一项电子调查，其中包括有关安全文化和错误的问题结果发现错误披露文化的两个测量因素：一个是关注错误披露的一般文化，另一个是关注信任。这两个错误披露文化因素是独特的安全文化和团队合作文化（相关性小于r=0.85）。此外，错误披露一般文化和错误披露信任文化预测了向患者披露假设错误的意图（分别为r=0.25，p<0.001和r=0.16，p<0.001），而团队合作和安全文化没有预测这种意图（r=0.09，p=NS和r=0.12，p=NS）。那些接受过错误披露培训的人报告了更高水平的错误披露一般文化（t=3.7，p<0.05）和错误披露信任culture.ConclusionsThe作者创建并验证了一个新的错误披露文化，预测意图披露错误比其他措施的医疗文化。这一措施填补了组织评估中的现有空白，评估了医疗差错后的透明沟通，这是文化的一个重要方面。
ObjectiveTo (1) develop and test survey items that measure error disclosure culture, (2) examine relationships among error disclosure culture, teamwork culture and safety culture and (3) establish predictive validity for survey items measuring error disclosure culture.MethodAll clinical faculty from six health institutions (four medical schools, one cancer centre and one health science centre) in The University of Texas System were invited to anonymously complete an electronic survey containing questions about safety culture and error disclosure.ResultsThe authors found two factors to measure error disclosure culture: one factor is focused on the general culture of error disclosure and the second factor is focused on trust. Both error disclosure culture factors were unique from safety culture and teamwork culture (correlations were less than r=0.85). Also, error disclosure general culture and error disclosure trust culture predicted intent to disclose a hypothetical error to a patient (r=0.25, p<0.001 and r=0.16, p<0.001, respectively) while teamwork and safety culture did not predict such an intent (r=0.09, p=NS and r=0.12, p=NS). Those who received prior error disclosure training reported significantly higher levels of error disclosure general culture (t=3.7, p<0.05) and error disclosure trust culture (t=2.9, p<0.05).ConclusionsThe authors created and validated a new measure of error disclosure culture that predicts intent to disclose an error better than other measures of healthcare culture. This measure fills an existing gap in organisational assessments by assessing transparent communication after medical error, an important aspect of culture.