Požiūrio į pacientų saugą ir gero valdymo principų įgyvendinimo vertinimas x asmens sveikatos priežiūros įstaigoje

Abstract

Aim of the study: To evaluate the attitude of personal health care professionals to patient safety and implementation of principles of good management. Objectives: 1. Identify personal health care professionals' attitudes towards patient safety. 2. Identify the approach of personal health care professionals to the implementation of principles of good governance. 3. Identify the links between the approach of personal health care professionals to the implementation of the principles of good governance and the approach to patient safety. Methods. An anonymous questionnaire was conducted by a personal health care institution specialists using a combined Patient Safety Culture (HSOPS) and Good Governance Principle Questionnaire. The one-minute anonymous study was conducted in 2018. January - February. 538 questionnaires were distributed, suitable for data analysis - 341 questionnaires: 57 doctors (16.7 %), 203 nurses (59.5 %), 43 nurses assistants (12.6 %) and 38 other specialists (11.1 %). Response rate - 63.4 percent. Microsoft Office Excel 2010 and IBM SPSS 22.0 software packages were used for statistical data analysis. The study was conducted with the consent of the head of the X health care institution and the permission of the Bioethics Center of the Lithuanian University of Health Sciences 2017-12-01 Nr. BEC - VSV (M) – 37. Results. Almost half of the personal health care professionals consider the level of patient safety in the institution as very good. According to specialists, patient safety is determined by teamwork, feedback and error communication, manager's expectations and actions to promote safety. Specialists, who work for more than 10 years are more likely to have a positive attitude towards the influence of management on patient safety and reports of adverse events. Employees that work more than 40 hours per week more often positively appreciates the handoffs and transitions of a shift. 72.5 percent respondents have not reported any adverse events during the past one year. The evaluation of the principles of good governance implemented in a personal health care facility was distributed as follows: effectiveness/ efficiency (3.88 ± 0.7 points), transparency (3.81 ± 0.8 points), participation (3.76 ± 0.8 points), reporting of patient responses (3.75 ± 0.8 points), impartiality/ equity (3.58 ± 0.8 points), reporting (3.40 ± 0.8 points). Managers, unlike other employees, place more emphasis on the implementation of the principles of transparency and accountability in good health care management. Assessing the links between the approach of personal health care professionals to the implementation of good governance principles and the approach to patient safety, the implementation of the principles of impartiality, participation and transparency enhances the positive attitude of health professionals: the occurrence report and discussion; the impact of teamwork, leadership actions, learning and improvement benefits, shift handoffs and transitions effects, the importance of communication, and the impact of personnel on patient safety; as well as safety management, ensuring this patient need. Only accountability to management reduces the positive attitude of the research participants to the report on adverse events and their discussion; to overall perceptions of patient safety. There was also a weak positive link between the principles of good governance and respondents' opinion of the level of patient safety in their workplace. Conclusions. 1. Two thirds of health care professionals personal consider the level of patients safety in their workplace as very positive (very good or excellent), but the management of adverse events in a personal health care facility is not efficient enough, reported by only 27.5 percent of respondents during the current year. The most important factors in ensuring patient safety are specialist teamwork, feedback and communication about adverse events, manager's expectations / actions to promote safety. The weakest areas of patient health care in a personal health care facility are the wrong response to a mistake; teamwork between departments; openness of communication. 2. The implementation of the principles of good governance, except for reporting, is considered very good in a personal health care institution. The most important principles of good governance are efficiency and transparency. 3. The level of implementation of the principles of good governance shall indicate the assessment of the safety of the patients in the personal health care facility in their units. The positive attitude of healthcare workers to a patient safety culture is particularly enhanced by the implementation of good governance principles such as impartiality, participation, and transparency. The exception is the implementation of the principle of accountability, which reduces the positive attitude of the staff twice towards the occurrence of adverse events and the overall perception of patient safety.