A multilevel model of organizational culture, patient safety culture and patient safety performance

• Main Authors: I-Chi Chen, 陳依琪
• Other Authors: 李弘暉
• Format: Others
• Language: zh-TW
• Published: 2010
• Online Access: http://ndltd.ncl.edu.tw/handle/29368149204962749079

博士 === 元智大學 === 管理學院博士班 === 99 === Objective：Patient safety in health care organization has received much attention following the Institute of Medicine report “To Err Is Human: Building a Safer Health System” (IOM, 1999). The patient safety movement was rooted in the mid 1970s and 1980s, when medical malpractice claims were both high in number and severity (Johnson & Hudson, 2004). In Taiwan, the healthcare organization authorities, government and media initiated some attention to patient safety since 2002. Those several medical adverse events forced healthcare organizations and clinical manger started some movement including the recognition of healthcare risk management as a profession, adoption by health care leaders of continuous quality improvement principles, and advancement of the role of the hospital setting. Background：Patient safety culture as the product of individual and group values, attitudes, perceptions, competencies and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s safety management. An organization with a ‘safety culture’ is open and fair with staff when incidents happen, learning from mistakes and, rather than blaming individuals, looking at what went wrong in the system. Through those actitives couls avoid unnecessary harm of patient and cost of healthcare organizations. The previous studies lacked systematic research on patient safety culture, therefore, it is important for health care organizations to assess their culture regarding patient safety in order to improve patient safety within the health care process. Methodology：The authors measured organizational culture (bureaucratic, supportive and innovative culture), patient safety culture and performance from 788 hospital workers among 42 hospitals in Taiwan. Multilevel analysis was applied to explore the relationship between organizational culture (group level) and patient safety culture and patient safety performance (individual level). In this research, the authors used SPSS 14.0 for Windows, Amos 7.0 and HLM 6.06 tools to estimate and evaluate the relationship among those variables. Conclusion： Overall, organizational culture plays an important role in patient safety activities. Safety performance of hospital staffs are influenced by the prevailing cultural norms in their organizations and work groups, building a safety culture for healthcare system which might understand the how organizations shaping their culture and how its work in safety issue. Constructed patient priority from management commitment to leadership is necessary, learning from and holding an open mind about mistake. For academic and management implications, research on patient safety should consider safety perception and consequence of hospital staffs, and furthermore consider those aspects in patient side. These factors are important for understanding the barriers and the possibilities embedded in patient safety.