Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
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Effect of Leadership WalkRounds Convergence to Establish a Patient Safety Culture

환자안전문화 정착을 위한 리더십 워크라운드(Leadership WalkRounds)의 융복합적 적용 효과

  • Received : 2015.02.26
  • Accepted : 2015.06.20
  • Published : 2015.06.28
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Abstract

This study aims to study the change in the level of awareness of medical personnels regarding the patient safety culture(PSC) before and after the Leadership WalkRounds(LWR). The LWR in this study was based on the IHI and the models of the Patient Safety Rounds(PSRs) at University of Michigan, emphasizing the 5 steps of Preparation--Scheduling--Conducting--Reporting--Resolving. After the LWR the scores for the level of awareness showed a statistically significant increase from 2.63 to 3.36(p<.001). Among the participants, those who are pharmaceutists, women, 30.0~39.9 years old, or had work experience of a year or less showed particularly notable increase in awareness. The effect was significant across all categories of PSC, especially in Safety Accident Reporting(p<.001), then in Communication(p<.001). Therefore the LWR proved an convergent concept for applying new leadership skill and the concept of patient safety management as an method to elevate the frontline staffs' awareness of PSC.

본 연구는 일 대학병원의 환자안전문화 정착을 위해 리더십 워크라운드(Leadership WalkrRounds, LWR) 프로그램을 개발 적용한 후 의료직의 환자안전문화 인식정도를 비교한 것이다. 리더십 워크라운드는 미국 의료질향상 연구소(IHI)의 도구와 미시건 대학의 환자안전 라운드(Patient Safety Rounds, PSRs)를 기반으로 준비-일정계획-운영-보고-문제해결 5단계로 구성하였다. 대상자의 평균 연령은 30.9세, 방사선사가 55.2%, 간호사가 26.0%, 약무직이 18.8%였다. 중재 후 환자안전문화 인식 총점은 2.63점에서 3.36점으로 유의하게 증가하였다(p<.001). 약무직, 여자, 30대 및 근무경력 1년 이하 그룹에서 인식정도가 가장 많이 상승하였다. 환자안전문화의 모든 영역에서 인식정도가 유의하게 상승했는데(p<.001), 특히 안전사고보고영역(p<.001), 의사소통영역(p<.001)이 가장 많이 상승하였다. 새로운 형태의 리더십과 환자안전관리 개념의 융합으로 의료 질관리에 새로운 관리방안을 시도한 리더십 워크라운드는 의료인의 환자안전문화 인식 향상에 유용한 프로그램으로 활용할 수 있을 것이다.

Keywords

References

  1. H. Y. Kim, E. S. Lee, Effects of perceived patient safety cultures on safety care activities among nurses in general hospitals. Journal of East-West Nursing Research, Vol. 19, No. 1, pp.46-54, 2013. DOI: http://dx.doi.org/10.14370/jewnr.2013.19.1.046
  2. A. Frankel, S. P. Grillo, M. Pittman, Patient Safety Leadership $WalkRounds^{TM}$ Guide. Chicago: Health Research and Education Trust. 2006.
  3. J. S. Hwan, S. Y. Lee, Y. J. Jeon, H. O. Lee, Y. N. Kwak, J. O. Lee, A descriptive study of military nurses' perception on patient safety culture and their performance on patient safety nursing. Journal of Military Nursing Research, Vol. 43, No. 1, pp.92-104, 2014.
  4. J. Timmel, P. S. Kent, C. G. Holzmueller, L. Paine, R. D. Schulick, P. J. Pronovost, Impact of the comprehensive unit-based safety program (CUSP) on safety culture in a surgical inpatient unit. The Joint Commission Journal on Quality and Patient Safety, Vol. 36, No. 6, pp. 252-260, 2010. https://doi.org/10.1016/S1553-7250(10)36040-5
  5. S. K. Kim, H. J. Lee, & E. G. Oh, Perceived level and associated factors of patient safety culture among health care providers in an operating room. Journal of Korean Clinical Nursing Research, Vol. 16, No. 2, pp. 57-67, 2010.
  6. V. F. Nieva, J. Sorra. Safety culture assessment: A tool for improving patient safety in healthcare organization. Quality and Safety in Health Care, Vol. 12, Supp. 12, pp. ii17-ii23, 2003. DOI: http://dx.doi.org/10.1136/qhc.12.suppl_2.ii17
  7. H. W. Cho, J. H Yang, Relationship between perceived patient safety culture and patient safety management activities among health personnel. Journal of Fundamentals of Nursing, Vol. 19, No. 1, pp. 35-45, 2012. DOI: http://dx.doi.org/10.7739/jkafn.2012.19.1.035
  8. J. E. Kim, M. A. Kang, K. E. An, Y. H. Sung, A survey of nurse's perception of patient safety related to hospital culture and reports of medical errors. Clinical Nursing Research, Vol. 13, No. 3, pp. 169-179, 2007.
  9. N. G. Castel, K. E. Sonon, A culture of patient safety in nursing homes. Quality & Safety in Health Care, Vol. 15, No. 6, pp. 405-409, 2006. DOI: http://dx.doi.org/10.1136/qshc.2006.018424
  10. D. A. Campbell, M. Thompson, Patient safety rounds: description of an inexpensive but important strategy to improve the safety culture. American Journal of Medical Quality, Vol. 22, pp. 26-33, 2007. DOI: http://dx.doi.org/10.1177/1062860606295619
  11. Y. Kim, E. S. Lee, E. Y. Choi. Perception of patient safety culture of hospital nurses. Korean Journal of Hospital Management, Vol. 18, No. 3, pp. 27-42, 2013.
  12. K. H. Lee, Y. S. Lee, H. K. Park, J. O. Rhu, I. S. Byun. The influences of the awareness of patient safety culture on safety care activities among operating room nurses. Journal of Korean Clinical Nursing Research, Vol. 17, No. 2, pp. 204-214, 2011.
  13. Y. M. Lee, Safety accident occurrence to perceptions of patient safety culture of hospital nurses. Journal of Korea Academia-Industrial Cooperation Society, Vol. 13, No. 1, pp. 117-124, 2012. DOI: http://dx.doi.org/10.5762/kais.2012.13.1.117
  14. H. Y. Kim, H. S. Kim, Effects of perceived patient safety culture on safety nursing activities in the general hospital nurse's. Journal of Korean Academy of Nursing Administration, Vol. 17, No. 4, pp. 413-422, 2011. DOI: http://dx.doi.org/10.11111/jkana.2011.17.4.413
  15. N. J. Lee, J. H. Kim, Perception of patient safety culture and sfety care activity among nurses in small-medium sized general hospitals. Journal of Korean Academy of Nursing Administration, Vol. 17, No. 4, pp. 462-473, 2011. DOI: http://dx.doi.org/10.11111/jkana.2011.17.4.462
  16. Y. H. Kim, H. J. Kim, W. H. Cho, H. J. Lee, C. Y. Park, S. H. Lee, A study on the interrelation of influential factors in organizational conflict and organizational commitment. Korean Journal of Hospital Management, Vol. 7, No. 1, pp. 41-63, 2002.
  17. K. J. Kim, Development of website-based patient safety culture promotion program. Journal of Korean Clinical Nursing Research, Vol. 19, No. 1, pp. 152-167, 2013. https://doi.org/10.22650/JKCNR.2013.19.1.152
  18. Institude for Healthcare Improvement (IHI), Leadership guide to patient safety, Accessed January, 15, 2014. Available at http://www.ihi.org/resources/Pages/IHIWhitePapers/LeadershipGuidetoPatientSafetyWhitePaper.aspx
  19. A. Frankel, S. P. Grillo, M. Pittman, E. J. Thomas, L. Horowitz, M. Page, S. Bryanl, Revealing and resolving patient safety defects : the impact of Leadership WalkRounds on frontile caregiver assessments of patient safety. Health Service Research, Vol. 43, No. 6, pp. 2050-2066, 2008. DOI: http://dx.doi.org/10.1111/j.1475-6773.2008.00878.x
  20. J. B. Sexton, P. J. Sharek, E. J. Thomas, J. B. Gould, C. C. Nisbet, A. B. Amspoker, M. A. Kowalkowski, R. Schewendimann, J. Profit. Exposure to Leadership Walkrounds in neonatal intensive care units is associated with a better patient safety culture and less caregiver burnout. BMJ Quality & Safety. Vol. 23, pp. 814-822, 2013. DOI: http://dx.doi.org/10.1136/bmjqs-2013-002042
  21. G. Budrevics, C. O'Neill, Changing a culture with patient safety walkrounds. Healthcare Quarterly, Vol. 8, special issue, pp. 20-25, 2005.
  22. S. P. Feitelberg, Patient safety executive walkrounds. The Permanente Journal, Vol. 10, No. 2, pp. 29-36, 2006.
  23. R. T. Morrello, J. A. Lowthian, A. L. Barker, R. McGinnes, D. Dunt, C. Brand, Strategies for improving patient safety culture in hospitals : a systematic review. BMJ Quality & Safety, Vol. 22, No. 1, 11-18, 2013. DOI: http://dx.doi.org/10.1136/bmjqs-2011-000582
  24. E. J. Thomas, J. B. Sexton, T. B. Neilands, A. Frankel, R. L. Helmreich, The effect of executive walk rounds on nurse safety climate attitudes : a randomized trial of clinical units. BMC Health Services Research, Vol. 5, No. 28, pp. 1-9, 2005. DOI: http://dx.doi.org/10.1186/1472-6963-5-28
  25. R. Zimmerman, I. Ip, C. Daniels, T. Smith, J. Shaver, An evaluation of patient safety leadership walkrounds. Healthcare Quarterly, Vol. 11, special issue, pp. 16-20, 2008.
  26. National Healthcare System (NHS), Patient safety first launches Leadership WalkRounds "How to Guide". Accessed January, 30, 2015. Available at http://www.patientsafetyfirst.nhs.uk/Content.aspx?path=/Campaign-news/current/Leadership-Walkrounds-HTGuide/
  27. K. J. Kim, J. S. Han, M. S. Seo, B. H. Jang, M. M. Park, H. M. Ham, M. S. Yoo, Relationship between intra-organizational communication satisfaction and safety attitude of nurses. Journal of Korean Academy of Nursing Administration, Vol. 18, No. 2, pp. 213-221, 2012. DOI: http://dx.doi.org/10.11111/jkana.2012.18.2.213
  28. E. Y. Yu, S. J. Jung, Analysis of doctors' cognition of patient safety at general hospitals. Journal of Korea Academia-Industrial cooperation Society, Vol. 13, No. 6, pp. 2607-2616, 2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.6.2607
  29. Y. R. Yeun, The impact of healthcare accreditation on patient safety and quality, job satisfaction and organizational commtment: about a general hospital. Journal of the Academia-Indusyrial cooperation Society, Vol. 14, No. 4, pp. 1820-1829, 2013. DOI: http://dx.doi.org/10.5762/KAIS.2013.14.4.1820