促進醫院安全風氣－－由安全領導層面探討

Promoting Hospital Safety Culture: The Perspective of Safety Leadership

在安全的文化中，對零傷害目標以及實現該目標所需的持續改進和創新有著堅定的承諾。然而目前在許多健康照護組織，安全往往是被疏忽且事後才想到的，或者充其量只是一個遙遠的次要問題，沒有承諾感亦無零傷害的目標。本文首先簡述安全文化的起源與定義、安全文化的組成、以及安全文化金字塔；其次是談論醫院安全風氣的定義、重要性與影響作用、以及醫院安全風氣的評估工具；最後則是引介國外許多促進醫院安全風氣的領導實務指引，可供國內健康照護組織之參考與應用。病人安全是一種動態而複雜的現象，因此，建議每兩到三年進行一次研究和調查醫院安全風氣，以確保病人安全的最佳實踐，實現病人安全和醫院安全風氣的持續改進需要各層級領導。同時，需要在整個健康照護系統中灌輸全面安全文化，領導層和管理層的承諾對於建立和維護一個安全的、以人為本的環境至關重要。

Cultures of safety share a strong commitment to the goal of achieving zero harm and to continuously implementing the improvements and innovations necessary to achieve this goal. However, in some healthcare organizations today, safety is often undervalued and considered only after the occurrence of safety incidents, with no sense of commitment and no goal of zero harm. This article first briefly introduces the origin and definition of safety culture, the composition of safety culture, and the safety culture pyramid. Secondly, the definition, importance, and impact of hospital safety culture as well as the assessment tools for hospital safety culture are discussed. Finally, many practical leadership guidelines used in other countries to promote hospital safety culture are introduced as references for domestic healthcare organizations. Because patient safety is a dynamic and complex phenomenon, research and surveys of hospital safety culture conducted every two to three years are recommended to ensure best practices in patient safety. Achieving continuous improvement in patient safety and hospital safety culture requires leadership at all levels. In tandem, a total safety culture must be instilled throughout the health system. Commitment from leadership and management is critical to establishing and maintaining a safe, people-centered environment.