保障医疗服务质量是医院管理的重要任务。理论上，医院安全文化影响着医务人员的态度、认知和行为；临床指南/路径的目的是促进医疗服务的合理性和有效性，缩小诊疗的差异性。我国国家卫生和计划生育委员会也将临床指南/路径作为改善医疗服务效果和效率的重要策略。虽然我国一些公立医院已强化了安全文化，实施了相应的部分临床指南/路径，但我国尚未建立一个适用于评价国内医院安全文化、具有良好信度和效度的测评工具，对我国不同地区、不同等级公立医院的安全文化、临床指南/路径具体实施现况及它们对医疗质量的影响缺乏系统研究。 本项目拟通过实证调查（包括公立医院调查、员工问卷调查和病案调查等），构建我国公立医院安全文化、临床指南/路径实施、医疗质量的关联机制模型，提出以改善医疗质量为目的、以规范医务人员行为为途径的公立医院安全文化建设方向，促进我国公立医院把握改善医疗质量的重点策略和重点环节，促进我国公立医院可持续发展。

The important task of hospital management is to ensure quality of medical care. Theoretically, hospital safety culture affects attitudes, recognition and behaviors of medical professionals, and clinical guidelines and clinical pathways are intended to provide appropriate and effective health care and to reduce variation in practice. National Health and Family Planning Commission of the People's Republic of China also perceives clinical guidelines and clinical pathways as an important strategy to improve effectiveness and efficiency of medical care. Although some public hospitals in China have enhanced safety culture and implement clinical guidelines and clinical pathways, there is no adequate tool for the assessment of hospital safety culture with good reliability and validity in China, and there is no systematical research on safety culture, clinical guidelines and clinical pathways, and their effects on medical quality in public hospitals in different areas and at different levels in China. This study is to construct a model of correlation mechanism among organizational safety culture, clinical guidelines/pathways and medical quality through empirical study (including questionnaire surveys of public hospitals and staff, and audit charts), and is to indicate the direction of safety culture construction in public hospitals of China with the aim of improving medical quality and the way of regulating professional behaviors. The study will facilitate the public hospitals of China to have focused strategies and elements to improve medical care quality and to have sustainable development.