利用資料探勘於病人安全文化的復原力研究──以中部某區域教學醫院為例

A Data Mining Approach to Study the Effects of Emotional Exhaustion of Medical Staffs on Patient Safety-Case Study on a Teaching Hospital in Central Taiwan

目的：醫療人員面對高度工作壓力，職業倦怠容易造成工作效率降低、工作滿意度降低，並且會對醫療照護品質有負面的影響，進而導致醫療錯誤。方法：本研究採用2014年新版的病人安全文化當中的復原力構面，以中部某區域教學醫院內部的醫療相關人員為對象，問卷總共793份，有效問卷為680份問卷，利用資料探勘當中的分群分析將復原力構面的九題問項當成投入變數，將 680 位人員的問卷結果進行分群，計算各集群的平均值，了解有哪幾個集群高於平均值或低於平均值，再透過統計各個集群的人口統計變數來分析每個集群的特性。結果：有四個集群在復原力每題平均分數皆高於平均值，表示這些人員在工作上較不容易感到疲倦。以醫師為主，年紀主要集中在31-40歲、院工作年資在11至20年、在直接接觸病人的程度相對也較低。兩個集群在復原力每題平均分數皆低於平均值，表示這些人員在工作上感到疲倦的程度較高。以護理人員為主，年紀以31-40歲為主、院工作年資在11至20年、常常直接接觸病人的程度較高。結論：可針對年紀集中在31-40歲且院工作年資在11至20年之間的護理人員、藥劑人員以及復健人員進行觀察以及訪談，進一步了解他們在工作上所遇到的問題或困難，並進行改善輔導。醫院可透過營造更具人性化工作環境，多關懷醫療相關人員、協助其紓解情緒壓力，進而增加醫療服務的品質及病人的安全。

Purposes: Medical staffs experience extensive work stress that eventually leads to a burnout. This can result in lower efficiency, reduced job satisfaction, a negative impact on healthcare quality, and a high number of medical errors. Methods: This study uses the emotional exhaustion dimension of the new Chinese version of safety attitudes questionnaire in 2014 with the medical staffs of a regional teaching hospital in central Taiwan. A total of 793 questionnaires were received; however, only 680 questionnaires are valid. Cluster analysis is applied by clustering the inputs of 680 medical staffs on nine questions from the emotional exhaustion dimension. Compute the average values of the clusters and then identify the clusters with the average values higher or lower than the grand averages by summing up their demographic information. Results: Four clusters were identified with all of the average values of emotional exhaustion dimension higher than the grand average values, which indicate that these staffs are less likely to experience fatigue. The major demographic characteristics of the staffs are that they are physicians aged between 31 to 40 years with 11 to 20 years of experience in the hospital, and they have limited direct contact with the patients. Two clusters with all of the average values lower than the grand average values show that these medical staffs experience a higher degree of exhaustion. The characteristics of the staffs are that they are nurses aged between 31 to 40 years with 11 to 20 years of experience in the hospital, and they often deal with patients directly. Conclusions: The hospital should focus on nurses, pharmacists, and rehabilitation staff members between the ages of 31 to 40 years with 11 to 20 years of experience in the hospital. Through observations and interviews, the hospital management can identify their problems and provide training courses to improve the current situation. Moreover, the hospital management can create a more employee-centric environment and pay attention to the emotional health of staffs to relieve their stress, which, in turn, will enhance the healthcare quality and patient safety