探討醫院改制後醫療從業人員對病人安全文化態度的影響

Explore theImpactofHospital RestructuringMedicalPractitioners ofPatient Safety CultureAttitudes

本研究旨在瞭解醫院改制轉型過程中醫療從業人員對病人安全文化態度的影響，未來可供醫院領導者在推動病人安全目標與時之參考，並作為管理領導之方針。以北部某地區教學醫院醫療從業人員為研究對象，以二年二次抽測方式由受試者以電腦線上填答，本橫斷性問卷採用美國德州大學發展的安全態度量表（Safety Attitudes Questionnaire, SAQ）六個構面，及美國保健政策研究機構（Agency for Healthcare Research and Quality, AHRQ）病安文化問卷三個構面，共九個構面41題項，經由調查資料了解不同體制之領導風格與制度規範下對院內醫療從業人員所呈現的影響。2011年共發放問卷164份，有效問卷回收率為72.56 %。2012年共發放問卷171份，有效問卷回收率為68.42%。對問卷回收的有效樣本採用獨立樣本t檢驗的方法進行資料分析，結果發現在Q7如果我是病人，我認為在這裡會受到十分安全的照護（p＜.01），Q13本單位的文化會讓人很容易從別人的錯誤中汲取教訓（p＜.05）Q28本院有做好新進人員訓練工作（p＜.01）等均呈現出顯著差異。本研究醫院改制轉型時間尚未達一年，改制過程中領導者以融入文化、循序漸進方式帶領醫療從業人員轉型，醫療從業人員對病人安全文化的態度受醫院改制的影響不明顯，但對於病人在本院受到照護的安全程度、新人培訓工作滿意度、對組織文化是否很容易從別人的錯誤中汲取教訓的功能等三題項，醫療從業人員的態度反而產生負向變化，是否因改制而造成人員流動尚未平穩，有待後續進一步探討。

Thepurposeofthis studyistounderstandtheimpactofhospital restructuringinthetransitionprocessto medical practitionersonpatient safety cultureattitudes, toavailablereferencehospitalleaderstopromotepatient safetyobjectives and strategiesastheprinciplesofmanagement and leadership. Northernregionalteaching hospitalmedicalpractitioners, computeronlinetothetwosecondarysample waybythesubjects, thecross-sectionalquestionnairedevelopmentoftheUniversity of TexasSafety Attitudes Questionnaire(SAQ)six dimensions, and the U.S.health-care policyresearch organization (Agency for Healthcare Research and Quality,AHRQ)patient safetyculturequestionnairethreedimensions, 41itemsforatotalofninedimensions, through thesurvey datatounderstandthedifferent systemsleadership styleand therules and normsofthehospitalmedicalpractitionerspresented. 2011issued a total of164questionnaireswerevalid questionnairesEffective response rateof72.56%. 2012a total of171questionnairesweredistributed, theEffective response rateof68.42%. Theeffective samplequestionnairerecycledData were analyzedusingindependent samplest-testwas foundintheQ7If I were apatient, I think it will behereverysafetyofcare(p <.01) Q13cultureoftheunitwillmakethepeople are veryeasytolearn a lessonfromthemistakes of others(p <.05) Q28hospitalhavegoodnew stafftraining(p <.01)all showsasignificant difference. Conclusion:In this study,the hospitalrestructuringin transitiontimeless thanone year, theleaderoftherestructuring processtointegrate into theculture, step-by-stepto leadthetransformationofmedical practitioners, medicalpractitionersobviousimpactofhospital restructuringandtheattitudeofthepatient safety culture, but forpatientsbythedegreeofsecurityofcarein our hospital, anew trainingjob satisfaction, organizational cultureisveryeasy tolearn a lessonfromthemistakes of othersfunctionitems, theattitudeofmedicalpractitionersbuthaveanegativechange.