推動國際醫院評鑑對醫師的病人安全文化態度之影響

Impact of the Implementation of Joint Commission International Accreditation on Physician Attitudes towards Patient Safety Culture

張嘉芳(Chia-Fang Chang) ； 郭彥宏(Yen-Hung Kuo) ； 張怡萱(Yi-Hsuan Chang) ； 陳綾穗(Ling-Sui Chen) ； 蕭世槐(Shih-Huai Hsiao)

《醫務管理期刊》 22卷2期 (2021/06) Pp. 151-170

https://doi.org/10.6174/JHM.202106_22(2).151

摘要

目的：醫師作為確保醫療照護品質與病人安全之關鍵角色，本研究旨在探討其參與國際醫院評鑑前後對病人安全文化態度之差異，做為協助醫療機構相關政策發展與改善病人安全文化認知之依據。方法：以南部某醫學中心全體醫師為研究對象，考量匿名調查之限制，透過兩年度橫斷式問卷調查法，以該醫院於2015年參與國際醫院評鑑前與2017年評鑑後之資料進行分析，有效樣本數為463人與514人。結果：於國際醫院評鑑後，醫師在壓力的認知、復原力與工作生活平衡上呈現統計顯著高於評鑑前，單位安全風氣、對管理的感受與工作狀況雖無統計顯著差異，但正向回答平均分較評鑑前略高。結論：在首次接受國際醫院評鑑下，醫師的病人安全文化有部分正向提升效益，然評鑑規範的落實與病人安全文化的塑造須要時間累積，建議可持續參與以評估其醫院整體之助益。

關鍵字

國際醫院評鑑 ； 病人安全文化 ； 復原力 ； 工作生活平衡

並列摘要

Objectives: As a key role for physicians to ensure the quality of medical care and patient safety, this study aims to explore the differences in physician attitudes towards patient safety before and after participating in the Joint Commission International Accreditation, as a basis for assisting medical institutions to develop relevant policies and improve patient safety culture awareness. Methods: Taking all physicians in a medical center in Southern Taiwan as the research object, considering the limitations of anonymous surveys, through the cross-sectional questionnaire survey, the hospital was analyzed in 2015 and 2017 before and after the Joint Commission International Accreditation. The effective number of samples is 463 and 514. Results: After implementation of the International Hospital Accreditation, the physicians scored statistically higher in such aspects as stress recognition, resilience and work-life balance than before the accreditation. Although there was no statistically significant difference between the safety climate, perception of management, and working conditions, the average score is slightly higher than before accreditation. Conclusions: Under the first accreditation of the Joint Commission International, physicians' patient safety culture is partially improvement. However, the implementation of the accreditation standards and the shaping of patient safety culture will take time. It is recommended to participate continuously in the accreditation and patient safety culture survey to evaluate their help to the hospital as a whole.

並列關鍵字

International Hospital Accreditation ； Patient Safety Culture ； Resilience ； Life Balance

參考文獻

王嵩竑、林筱芸、林晉鋒、杜貞儀、鄭鈺樺（2011）‧醫院員工個人特質與病人安全文化關係之研究‧北市醫學雜誌，8(2)，116-125。https://doi. org/10.6200/TCMJ.2011.8.2.03。

石崇良、蘇喜（2004）‧運用資訊提升病人安全‧台灣醫學， 8 (6)，807-816。https://doi.org/10.6320/FJM.2004.8(6).09。

李偉強、簡淑芬、陳玉枝、黃東波、李建賢、李壽東（2008）‧中文版病人安全態度問卷信效度分析‧臺灣公共衛生雜誌，27(3)，214-222。https://doi.org/10.6288/TJPH2008-27-03-03。

何清幼（ 2010 ） ‧醫療工作人員的病人安全認知、態度與行為間關係之探討 —以台北某醫院為例（碩士論文）‧國立台灣大學，台北市。 https://doi.org/10.6342/NTU.2010.00446。

邱文達、李友專、朱子斌、呂嵐欽、許淳森、連吉時、楊哲銘（2007）‧以國際醫院評鑑提升醫療品質-以萬芳醫院為例‧醫務管理期刊，8(2)，160-171。https://doi.org/10.6174/JHM2007.8(2).160。