運用IPGA探索病人安全文化改善策略之研究

目的：我國2014年將全國性病人安全文化網路調查問卷，增加「工作生活平衡」、「復原力」兩大構面，供各醫院自我調查，以營造醫院病人安全文化。本研究在探討病人安全文化主要缺口關鍵因素。方法：採用問卷調查法收集資料，研究對象為北部某地區醫院員工，排除到職未滿一個月員工及外包人員，共發放276份，有效問卷回收率為96.7%；並以重要性－績效缺口分析法進行分析。結果：顯示員工最重視「團隊合作」構面，最不滿意為「復原力」。依據IPGA理論模式加以排序，結果顯示首要改善構面為「對管理的感受」，其後依序「團隊合作」、「單位安全風氣」。主要待改善關鍵項目依序「夜間睡眠時間」、「本單位工作士氣很高」、「在照護病人時，我可以充分得到所需的支援」等。結論：經IPGA理論研究方法，幫助醫院找出病人安全認知改善關鍵因素以及改善先後順序，此研究結果建議政府機關及醫院管理階層進行提升復原力改善策略，以提升病人安全文化。

關鍵字

病人安全文化；新版病人安全文化調查；重要－績效缺口分析；關鍵改善因素

並列摘要

Objectives: Taiwan has developed an online survey system investigating patient safety culture. The survey questionnaires have two dimensions added to the system in 2014: ＂work-life balance＂ and ＂resilience＂. The research aims to explore key factors of the gap between the importance and satisfaction of medical practitioner's awareness of patient safety. Methods: The data were collected through questionnaire survey. Of 276 questionnaires distributed to medical practitioners except those who were working less than one month and freelancers. The valid response rate was 96.7%. Data were analyzed by using Importance-Performance Gap Analysis. Results: The results show the most satisfied dimension is ＂safety climate＂; the least satisfied dimension is ＂resilience＂. The other dimensions requiring improvement are ranked as ＂perception of management＂, ＂teamwork climate＂ and ＂safety climate＂. The items requiring improvement are ranked as ＂sleeping time at night＂, ＂high morale of the unit＂, and ＂sufficient support in patient care＂ etc. Conclusions: The Importance-Performance Gap Analysis (IPGA) effectively investigated and helped hospitals find key factors of patient safety culture cognition. The study is expected to offer improvement suggestions in management strategies.

並列關鍵字

Patient Safety Culture ； New-Safety Attidudes Questionnaire (New-SAQ) ； Importance-Performance Gap Analysis (IPGA) ； Key Improvement Factors

參考文獻

陳怡甄、郭素娥、阮祺文（2017）。護理人員的病人安全文化對工作生活平衡之影響復原力之調節效果。弘光學報，80，13-26。doi: 10.6615/HAR.201709.80.02

羅建銘、張斐綾、廖薰香（2008）。病人安全文化分析。醫療品質雜誌，2(4)，68-73。doi: 10.30160/JHQ.200807.0016

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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。doi: 10.6200/TCMJ.2011.8.2.03

駱俊宏、許秀月（2009）。病人安全文化於臨床護理之應用。高雄護理雜誌，26(1)，99-110。doi: 10.6692/KJN-2009-26-1-9

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運用IPGA探索病人安全文化改善策略之研究

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