IPA模式調查病人安全文化──台南某區域醫院經驗

Using IPA Model to Investigate Patient Safety Culture--Experience of a Regional Hospital in Tainan

病人安全文化是病人安全的關鍵，透過安全文化調查是病人安全改變的起點。因消費者意識高漲及醫療糾紛層出不窮，醫療環境趨向緊張化，故台灣在2014年發展全國性病人安全文化網路調查系統中增加「工作生活平衡」、「復原力」兩大構面。本研究旨在探討醫院員工對病人安全文化認知重要程度及滿意程度關係，並運用重要性-表現程度分析探討病人安全風險主要關鍵因素，供醫院管理階層投入適當資源改善策略參考。以問卷調查法收集資料，研究對象為南部某區域醫院員工，共發放669份，回收有效問卷605份，有效問卷回收率為90.4%。研究結果顯示員工最重視「團隊合作」構面；最不滿意為「工作生活平衡」，亦是主要改善構面。優先改善為：「本單位的臨床人力配置足以處理病人工作量」、「工作準時下班」、「睡眠品質」、「夜間睡眠時間」。依據研究結果，對醫院管理者依序提出改善建議，做為提升病人安全文化之參考。 Patient safety culture is the key to patient safety. Investigation of patient safety serves as the start of change. Due to the rise of customers' awareness and numerous medical conflicts, the tension in medical environments gradually escalated. In 2014, Taiwan's survey questionnaires developed an online survey system investigating patient safety culture had two dimensions added to the system: ''work-life balance'' and ''resilience''. Thus, the new version consists of eight major dimensions. The research aims to explore the relationship between the importance and satisfaction of medical practitioner's awareness of patient safety. The Importance-Performance Analysis (IPA) was adopted to explore the key factors. The research is expected to provide executive members of hospitals with suggestions about how to improve and refine management strategies. The data were collected through questionnaire survey, and total 605 out of 669 valid responses were received for further statistical analyses. The valid response rate is 90.4%. Data is analyzed by using Importance-Performance Analysis. The results show that medical practitioners to suppose ''group cooperation'' is most important. The most satisfied dimension is ''safety climate''; the least satisfied dimension is ''work-life balance''. The other dimensions requiring improvement are ranked as ''sleeping quality'', ''sleeping time at night'', ''being punctually off work'' and ''perceptions of management''. The study is expected to offer improvement suggestions in management strategies to elevate patient safety culture.