乌克兰和美国医疗机构患者安全文化动态对比分析--建立安全医院环境的参考文献

О. P. Yavorovsky, Yu. M. Skaletsky, R. Brukhno, Оlexandr V. Ivanko, Sergіy V. Kravchenko, Valentin I. Bugro, Andriy V. Shkurba, T.O. Zinchenko, N. D. Kozak
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引用次数: 0

摘要

导言。世卫组织广泛呼吁国际社会关注安全文化,将其作为确保医院环境安全的有效基础。然而,世卫组织警告说,"改变文化比引入新的结构和组织机制更加困难"。因此,目前许多国家广泛使用医院患者安全文化评估系统。 本研究的目的分析和比较乌克兰和美国医疗机构患者安全文化的动态。 材料和方法。研究采用了文献学、统计学和社会学研究方法。研究材料包括 2016 年对医务人员进行的患者安全文化问卷调查(来自 3 家医疗机构的 163 份调查问卷)和 2023 年进行的问卷调查(来自 4 家医疗机构的 174 份调查问卷)。2014年和2021年美国医院患者安全文化监测结果用于对比。对医务人员的调查采用了 AHRQ 领导力问卷。 结果显示2023年,我们在国内医疗机构调查的12个患者安全文化特征中,5个特征的正面回答比例明显低于2016年。国内医疗机构患者安全文化出现这种消极趋势的主要原因可以归结为 COVID-19 大流行和俄罗斯的军事侵略,但首要原因在于缺乏改善这种文化的全面战略。在过去 8 年中,愿意披露自己在职业活动中的失误、同事的失误和其他事件,而不担心自己的失误和事件报告会对自己造成伤害的受访者比例基本保持不变。尽管美国医院对患者安全文化指标给予了极大的关注,但其改善趋势微弱,这表明我们在形成积极安全文化的过程中面临着挑战。 结论。国内医疗领域普遍存在的被动安全文化,加上缺乏积极的变革,阻碍了现代安全战略在医疗领域的实施。我们自己的研究数据和科学文献突出表明,迫切需要对国内医疗机构的患者安全文化状况进行深入研究,并根据国际标准制定评估医疗机构安全文化的方法框架。形成积极的民族文化,特别是医疗机构的安全文化,应被视为战后国家重建和融入文明、经济发达的国际社会的重要先决条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COMPARATIVE ANALYSIS OF PATIENT SAFETY CULTURE DYNAMICS IN UKRAINE AND THE USA HEALTHCARE FACILITIES REFERENCE TO ESTABLISHING SAFE HOSPITAL ENVIRONMENT
Introduction. WHO widely draws the attention of the world community to safety culture as an effective basis for ensuring safety in the hospital environment. However, WHO warns that "changing culture is more difficult than introducing new structural and organizational mechanisms". Therefore, systems for assessing patient safety culture in hospitals are widely used in many countries today. The aim of the study. To analyze and compare the dynamics of patient safety culture in Ukraine and the USA healthcare facilities. Materials and methods. The study utilized bibliographic, statistical, and sociological research methods. The research material consisted of a questionnaire survey of medical personnel on patient safety culture in 2016 (163 surveys from 3 healthcare facilities) and a questionnaire survey conducted in 2023 (174 surveys from 4 healthcare facilities). Results of patient safety culture monitoring in US hospitals for 2014 and 2021 were used for comparison. The survey of medical personnel was conducted using the AHRQ leadership questionnaire. Results. The percentage of positive responses for 5 out of the 12 characteristics of patient safety culture that we investigated in domestic healthcare facilities in 2023 was significantly lower than in 2016. The main reason for this negative trend in patient safety culture within domestic healthcare facilities can be attributed to the COVID-19 pandemic and Russia's military aggression, but the primary cause lies in the absence of a comprehensive strategy for improving this culture. Over the past 8 years, the proportion of respondents willing to disclose errors in their professional activities, as well as the mistakes of their colleagues and other incidents, without fearing that their mistakes and incident reports will harm them, has remained largely unchanged. The slight trend toward improvement in patient safety culture indicators in US hospitals, despite significant attention to it, indicates the challenges we face in the journey towards forming a positive safety culture. Conclusions. The prevailing reactive safety culture in domestic healthcare, along with the lack of positive changes, hinders the implementation of modern safety strategies in the medical field. The data from our own research and scientific literature highlight the urgent need for in-depth examination of the state of patient safety culture in domestic healthcare facilities and the development of a methodological framework adapted to international standards for evaluating safety culture in medical institutions. The formation of a positive national culture in general, and safety culture within healthcare facilities in particular, should be regarded as a crucial prerequisite for the post-war reconstruction of the country and its integration into the civilized, economically developed global community.
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