Evangelia Tsiga , Efharis Panagopoulou , Anthony Montgomery
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引用次数: 29
Abstract
Background
The aim of this cross-sectional study was to develop an evidence-based systematic Medical Error Checklist (MEC) for self-reporting of medical errors. In addition the study examined the comparative influence of individual, structural, and organizational factors on the frequency of self-reported medical errors.
Research design
A three-step process was followed in order to develop three checklists, for internists, surgeons and pediatricians respectively. The Maslach Burnout Inventory (MBI), the Utrecht Work Engagement Scale (UWES) and the teamwork-subscale of the Hospital Survey on Patient Safety Culture (AHRQ) were used in order to measure physicians’ levels of burnout, job engagement and teamwork respectively. A total of 231 doctors working in a large teaching hospital in Greece participated in the study (response rate: 49.8%).
Results
Internal reliability coefficients were high for all three checklists. Gender, age, clinical experience, and working hours were not related to medical errors in any of the medical specialties. In surgeons, medical errors were negatively related to engagement (R2 = 0.210, p = 0.004), while teamwork and depersonalization were the only predictive factors of frequency of medical errors, in both pediatricians and internists (R2 = 0.306 p < 0.001).
Conclusions
The Medical Error Checklists developed in this study advance the study of medical errors by proposing a comprehensive, valid and reliable self-assessment tool. The results highlight the importance of hospital organizational factors in preventing medical errors.
背景:本横断面研究的目的是开发一个基于证据的系统医疗错误清单(MEC),用于医疗错误的自我报告。此外,该研究还考察了个人、结构和组织因素对自我报告医疗差错频率的比较影响。研究设计遵循三步流程,分别为内科医生、外科医生和儿科医生制定了三份检查清单。采用马斯拉克职业倦怠量表(MBI)、乌得勒支工作投入量表(UWES)和医院患者安全文化调查(AHRQ)团队工作子量表分别测量医生的职业倦怠、工作投入和团队合作水平。在希腊一家大型教学医院工作的231名医生参与了这项研究(回复率:49.8%)。结果三种检查表的内部信度系数均较高。性别、年龄、临床经验和工作时间与任何医学专业的医疗差错无关。在外科医生中,医疗差错与敬业度呈负相关(R2 = 0.210, p = 0.004),而在儿科医生和内科医生中,团队合作和人格解体是医疗差错发生频率的唯一预测因素(R2 = 0.306 p <0.001)。结论本研究开发的医疗差错清单为医疗差错研究提供了一种全面、有效、可靠的自我评估工具。结果突出了医院组织因素在预防医疗差错中的重要性。