DEVELOPING A CULTURE OF SAFETY IN THE INFORMATION AGE

Yu-Chun Wang、Chien-Hui Hung、Hong-Ling Li 、Tsang-Ju Chen 、Jung-Chun Chang

Department of Medical Quality, China Medical University Hospital (TAIWAN)

Introduction : Our hospital began to promote patient safety operations in 2003, cooperate with the annual patient safety goals and strategies of the highest health authority in Taiwan, and comprehensive and continuous implementation. However, the overall environment is undergoing unprecedented rapid changes, including globalization, aging, informatization and intelligence. Under the new situation, with the deepening of health reform and development, the modernization of hospitals urgently needs a stable and safe environment, and a positive safety culture is the core basis for implementing patient safety operations.

Method : In recent years, the specific actions of our hospital in improving patient safety culture are as follows:
1.Adopt multiple improvements of "resilience" including: a) set up an employee health promotion center, establish an employee care mechanism and systematize work processes. b) establish preventive intervention measures, employees fill out the "Fatigue Scale" and "Employee Health Promotion Management Questionnaire" during the annual health examination, special stuff from the Occupational Safety Office proactively contact high-risk employees and provide timely care. c) Matching the use of school sports and leisure space, and conducting physical and mental related courses (such as communication skills, stress reduction and resilience courses, etc.)
2.Set up hospital quality consultant physicians and quality promoters for each department to assist in the implementation of quality and patient safety policies.
3.Advanceing the quality internal audit system, implementing the routine evaluation benchmarks through walking around and Patient Focused Method (PFM) methods.
4.Participate in the disease care certification of domestic health authorities, and provide stable quality and operational effectiveness through external inspection of the hospital's specific disease team's horizontal communication, teamwork and care continuity.
5.In line with the application of artificial intelligence, carry out the promotion of medical quality projects. Construct a system quality care cloud and introduce Business Intelligence (BI) to grasp indicators and intervene immediately to improve management efficiency, and at the same time publish the results in domestic or international conferences to enhance self-achievement and value.

Results : In the past two years, under the influence of the epidemic, the hospital's medical quality and patient safety operations have continued to improve of information technology and intelligence. The hospital is gradually improving the patient safety culture, especially in the aspect of "Teamwork" increased from 59.4% in 2020 years to 62.2% in 2021 years (4.7% increase), "Ethos of workplace safety" increased from 55.5% in 2020 to 59.0% in 2021 (6.3% increase), "resilience" increased from 18.9% in 2020 to 20.3% in 2021 (7.9% increase), all three aspects fall into the participating institutions (peer value) P75, as shown in the table below.

Conclusions : "Patients first, staff first, hospital pride" is the core value of our hospital. Based on the survey results of patient safety culture every year, we also review the monitoring results of medical quality and patient safety related indicators in the hospital, formulate improvement strategies for patient safety risk items, take feasible and effective measures, and implement the PDCA improvement cycle. The creation of a patient safety culture definitely requires internal changes and accumulation over time. However, it is precisely this process that provides nutrients for the cohesion of the safety culture and improves the overall positive patient safety culture of the hospital.