Abstract：
Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.
摘要：
设计和开发安全系统一直是医疗保健领域的持续挑战，特别是在手术环境中。为了促进安全，安全文化,即，关于安全管理的共同价值观，被认为是高质量的关键驱动力，安全的医疗保健交付。然而,改变组织文化，使其强调和促进安全往往是一个难以捉摸的目标。安全手术清单是提高安全文化和手术护理安全性的创新工具，但是关于安全手术检查表有效性的证据好坏参半。我们研究了在实施安全手术检查表期间管理实践的变化与感知安全文化的变化之间的关系。采用前测后设计和调查方法，我们在一个领先的医院网络中的42家普通急性护理医院的全国样本中评估了安全手术检查表的实施情况.我们使用世界管理调查衡量了管理者(n=99)的感知管理实践。我们使用安全手术实践调查测量了临床手术室人员的术前安全性和安全文化（N=2,380（2016）;N=1,433（2017））。我们连续两年收集数据。多变量线性回归分析表明，在实施安全手术清单后，管理实践的变化与整体安全文化和感知的团队合作之间存在显着关系。
