病人安全文化與組織公民行為相關因素探討-以衛生署中南區聯盟為例

The Exploration of The Relationship between Patient safety culture and organization citizen behavior - a case for Central Region Hospital Alliance﹐Department of Health﹐Executive Yuan

張秋月(Chen-yeu Chang)

指導教授 ： 賴志松 ； 鄭安欽

朝陽科技大學/管理學院/企業管理系/碩士(2009年)

摘要

醫院運作的體系中，組織扮演了多重角色。公立醫院身兼政府機構和救濟機構，此種複雜的體質形成了特有的組織文化。員工對醫院組織文化認同高，才能使醫院於競爭的醫療環境中，處於不敗之地，而優良組織文化風氣，有助於提升組織公民行為。以往研究也發現，組織公民行為是一種利他行為，對部門有正向力量。
病人安全為近年來各界相當關注的議題，目前已有許多有關病人安全後因模型研究，但欠缺前因模型探討。本研究擬探討組織公民行為是否影響病人安全文化，故以衛生署中南區區域聯盟十家醫院為研究對象，探討醫療人員之組織公民行為與病人安全文化之認知態度之相關性，並深究組織公民行為是否影響病人安全文化，以作為管理者日後加強醫療安全努力的成效指標與政策參考。
本研究為一橫斷性研究(cross-sectional study)，研究工具為「病人安全文化問卷」與「組織公民行為調查表」。研究結果顯示，組織公民行為與病人安全之間確實互為相關。組織公民行為五構面中，以「組織認同」對病人安全文化之影響最大，其他依序為「道德良心」、「協助他人」、「人際合諧」、「組織資源」，但公民行為會反向影響「病人安全文化」中壓力認知構面。研究中發現「是否擔任主管」、「工作年資」、「年齡」、「教育程度」等四項因素對組織公民行為有顯著影響，並影響病人安全文化。針對年資、教育程度之人力素質訓練，建議醫院主管在選才、育才、用才上，應對組織新進人員進行「病人安全」教育訓練，且在一年內有資深人員引導，並鼓勵醫療人員在職進修，對於在職進修者提供協助，可提升員工之公民行為提升病人安全文化。

關鍵字

中南區聯盟醫院 ； 病人安全文化 ； 組織公民行為

並列摘要

Hospital plays multiple roles under the current medical system. The public hospitals, for example, are both governmental and medical institution at the same time. Under such a circumstance, a specific characteristic organizational culture is formed. And, it is critically essential to have staff’s high identification of the organizational culture in order to make the institution competitive. And the excellent organizational culture would be beneficial to the organization citizenship behaviors. Many studies revealed that Altruism in the organizational citizenship behavior has positive influence.
Patient-safety has become quite a focused issue in recent years, and there are many retro-active model researches instead of proactive ones. This study, aims at determining whether the organizational citizenship behavior would influence the patient safety culture, has conducted a survey of hospital personnel’s identification and attitudes toward organizational citizenship behavior and patient safety culture from ten institutions of Central Hospital Alliance, Department of Health. The study also probes into the relevance of two topics, and thereby providing an indicator for the personnel’s attitude on safety culture, and organization citizenship behavior as hospital management’s performance benchmark and policy-making reference specifically for the medical safety.
This research is a cross-sectional study with investigative tools of Patient-safety Culture Survey, and Organizational Citizenship Behavior Questionnaire. The study reveals that there is a significant relevance between organizational citizenship behavior and patient safety. There are five main perspectives of organizational citizenship behavior, and “organizational identification” is the most influential one. Others in descendent are “Morality and Ethic”, “Assistance to others”, “Interpersonal Harmony”, and “Organizational Resources”. Yet, citizenship behavior would negatively influence pressure identification perspective of “patient safety culture”. Moreover, the study finds that factors “whether at managerial role”, “total working tenure”, “age”, and “education background” are significant relevance to organizational citizen behaviors, and influential to patient safety culture. Therefore, it is suggested that hospitals should carry out “patient-safety” training for new recruiters, and guided by those who with one year or longer tenures. Further, to provide on-job training to those who graduate from vocational schools in order to promote personnel’s citizenship behavior and patient safety culture.

並列關鍵字

Central Hospital Alliance ； Organizational Citizenship Behavior ； Patient’s Safety Culture

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