Comparing safety climate in naval aviation and hospitals: implications for improving patient safety.
Comparing safety climate in naval aviation and hospitals: implications for improving patient safety.
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比较海军航空和医院的安全氛围：对改善患者安全的影响。
DOI：
10.1097/hmr.0b013e3181c8b20c
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发表时间：
2010
影响因子：
2.5
通讯作者：
Gaba,DavidM
中科院分区：
文献类型：
--
作者：
Singer,SaraJ;Rosen,Amy;Zhao,Shibei;Ciavarelli,AnthonyP;Gaba,DavidM
背景：安全气候变化的证据表明，至少在一些医院中需要改进。然而，仅在医院之间进行比较可能会低估所需的改善。医院与类似行业的比较，可能会提供一个更广泛的视角对我国hospitals.Purpose的安全状况：本研究的目的是比较医院工作人员与人员之间的安全气候从海军航空，一个组织，具有高可靠性，尽管固有的危险conditions.Methodology：我们调查了一个随机样本的医疗保健工作者在67家美国医院，并为概括性，30退伍军人事务医院使用的问题，提出了在大约相同的时间（2007年），以人口普查的人员从35个中队的美国海军飞行员。我们在美国医院收到了13，841份（41%）完成的调查，在退伍军人事务医院收到了5，511份（50%）完成的调查，在海军飞行员中收到了14，854份（82%）完成的调查。我们研究了受访者的安全气候的看法在他们的机构整体和16个单独的items.Findings的差异：安全气候是三倍，平均之间的海军飞行员比医院人员。海军飞行员认为一个更安全的气候（高达7倍的安全）比医院人员就16个调查项目。与医院管理者相比，海军指挥官对气候的感知更接近前线人员。当对比海军飞行员与医院工作人员在危险区域，安全气候差异增加，而不是减少。一个单独的医院，以及海军航空平均，至少有一家医院优于海军基准，但三个单独的调查items.Practice影响：结果表明，医院没有充分创造一个统一的优先安全。然而，如果每家医院的表现都能与每个领域中表现最好的医院一样好，那么医院就可以达到与海军航空兵相当的安全气候水平。继续需要采取重大干预措施来加强医院安全环境，以改善患者安全。
Background:Evidence of variation in safety climate suggests the need for improvement among at least some hospitals. However, comparisons only among hospitals may underestimate the improvement required. Comparison of hospitals with analogous industries may provide a broader perspective on the safety status of our nation's hospitals.Purpose:The purpose of this study was to compare safety climate among hospital workers with personnel from naval aviation, an organization that operates with high reliability despite intrinsically hazardous conditions.Methodology:We surveyed a random sample of health care workers in 67 US hospitals and, for generalizability, 30 veterans affairs hospitals using questions comparable with those posed at approximately the same time (2007) to a census of personnel from 35 squadrons of US naval aviators. We received 13,841 (41%) completed surveys in US hospitals, 5,511 (50%) in veterans affairs hospitals, and 14,854 (82%) among naval aviators. We examined differences in respondents' perceptions of safety climate at their institution overall and for 16 individual items.Findings:Safety climate was three times better on average among naval aviators than among hospital personnel. Naval aviators perceived a safer climate (up to seven times safer) than hospital personnel with respect to each of the 16 survey items. Compared with hospital managers, naval commanders perceived climate more like frontline personnel did. When contrasting naval aviators with hospital personnel working in comparably hazardous areas, safety climate discrepancies increased rather than decreased. One individual hospital performed as well as naval aviation on average, and at least one hospital outperformed the Navy benchmark for all but three individual survey items.Practice Implications:Results suggest that hospitals have not sufficiently created a uniform priority of safety. However, if each hospital performed as well as the top-performing hospital in each area measured, hospitals could achieve safety climate levels comparable with naval aviation. Major interventions to bolster hospital safety climate continue to be required to improve patient safety.