The culture of safety: results of an organization-wide survey in 15 California hospitals
The culture of safety: results of an organization-wide survey in 15 California hospitals
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DOI：
10.1136/qhc.12.2.112
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发表时间：
2003-04-01
影响因子：
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通讯作者：
Park, KC
中科院分区：
文献类型：
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作者：
Singer, SJ;Gaba, DM;Park, KC
目的：了解对患者安全文化的基本态度和态度因医院、工作类别和临床状态而异的方式：使用封闭式调查，受访者被问及16个重要的主题，在医疗保健或其他行业的安全文化加上人口统计信息。这项调查是通过美国邮件进行的（可选择通过互联网回复），从2001年4月起6个月内，通过三封邮件进行。设置：参加加州患者安全联盟的15家医院。受试者：样本包括6312名员工，通常包括医院所有主治医生、所有高级管理人员（定义为部门主管或以上），以及所有其他医院人员的10%随机样本。总体应答率为47.4%，不包括医生的应答率为62%。在适当的情况下，响应加权，以允许参与医院和工作类型之间的准确比较，并纠正non-response.Main结果measures：频率的响应表明没有安全文化（“有问题的反应”的调查问题）和频率的“中立”的反应，这也可能意味着缺乏安全文化。根据医院，工作类，临床status.Results：平均整体有问题的反应是18%，另外18%的受访者给出了中立的反应，每个问题的反应整体记录。各参与机构对问题的答复差别很大。临床医生，特别是护士，给了更多的问题比非临床医生的反应，和一线工人给了更多的高级manager.Conclusion：安全文化可能不强，是一个高可靠性的组织所希望的。这种文化不仅在医院之间存在显著差异，而且在各个机构内的临床状态和工作类别之间也存在显著差异。结果提供了最完整的可用信息的态度和经验的工人在医院的安全文化和方式，安全文化的看法不同的医院和不同类型的人员。需要进一步的研究来证实这些结果，并确定高级管理人员如何成功地将他们对安全的承诺传递到临床工作场所。
Objective: To understand fundamental attitudes towards patient safety culture and ways in which attitudes vary by hospital, job class, and clinical status.Design: Using a closed ended survey, respondents were questioned on 16 topics important to a culture of safety in health care or other industries plus demographic information. The survey was conducted by US mail ( with an option to respond by Internet) over a 6 month period from April 2001 in three mailings.Setting: 15 hospitals participating in the California Patient Safety Consortium.Subjects: A sample of 6312 employees generally comprising all the hospital's attending physicians, all the senior executives ( defined as department head or above), and a 10% random sample of all other hospital personnel. The response rate was 47.4% overall, 62% excluding physicians. Where appropriate, responses were weighted to allow an accurate comparison between participating hospitals and job types and to correct for non-response.Main outcome measures: Frequency of responses suggesting an absence of safety culture ("problematic responses" to survey questions) and the frequency of "neutral" responses which might also imply a lack of safety culture. Responses to each question overall were recorded according to hospital, job class, and clinician status.Results: The mean overall problematic response was 18% and a further 18% of respondents gave neutral responses. Problematic responses varied widely between participating institutions. Clinicians, especially nurses, gave more problematic responses than non-clinicians, and front line workers gave more than senior managers.Conclusion: Safety culture may not be as strong as is desirable of a high reliability organization. The culture differed significantly, not only between hospitals, but also by clinical status and job class within individual institutions. The results provide the most complete available information on the attitudes and experiences of workers about safety culture in hospitals and ways in which perceptions of safety culture differ among hospitals and between types of personnel. Further research is needed to confirm these results and to determine how senior managers can successfully transmit their commitment to safety to the clinical workplace.