Table_1_Safety management in times of crisis: Lessons learned from a nationwide status-analysis on German intensive care units during the COVID-19 pandemic.pdf

BackgroundThe status of Safety Management is highly relevant to evaluate an organization's ability to deal with unexpected events or errors, especially in times of crisis. However, it remains unclear to what extent Safety Management was developed and sufficiently implemented within the healthcare system during the COVID-19 pandemic. Providing insights of potential for improvement is expected to be directional for ongoing Safety Management efforts, in times of crisis and beyond.
MethodA nationwide survey study was conducted among healthcare professionals and auxiliary staff on German Intensive Care Units (ICUs) evaluating their experiences during the first wave of the COVID-19 pandemic. Error Management and Patient Safety Culture (PSC) measures served to operationalize Safety Management. Data were analyzed descriptively and by using quantitative content analysis (QCA).
ResultsResults for n = 588 participants from 53 hospitals show that there is a gap between errors occurred, reported, documented, and addressed. QCA revealed that low quality of safety culture (27.8%) was the most mentioned reason for errors not being addressed. Overall, ratings of PSC ranged from 26.7 to 57.9% positive response with Staffing being the worst and Teamwork Within Units being the best rated dimension. While assessments showed a similar pattern, medical staff rated PSC on ICUs more positively in comparison to nursing staff.
ConclusionThe status-analysis of Safety Management in times of crisis revealed relevant potential for improvement. Human Factor plays a crucial role in the occurrence and the way errors are dealt with on ICUs, but systemic factors should not be underestimated. Further intensified efforts specifically in the fields of staffing and error reporting, documentation and communication are needed to improve Safety Management on ICUs. These findings might also be applicable across nations and sectors beyond the medical field.

研究背景：安全管理（Safety Management）的现状与组织应对突发状况或失误的能力息息相关，尤其在危机时期更为关键。然而目前学界尚不清楚，在新冠疫情（COVID-19 pandemic）期间，医疗系统内的安全管理发展程度与落实充分性究竟如何。本研究旨在明确其改进潜力，为危机时期乃至后疫情时代的安全管理工作提供针对性指导方向。
研究方法：本研究针对德国境内重症监护病房（Intensive Care Units，简称ICUs）的医疗专业人员与辅助人员开展全国性调查研究，调研其在新冠疫情第一波冲击期间的工作体验。研究以失误管理与患者安全文化（Patient Safety Culture，简称PSC）作为安全管理的操作化测评维度，并采用描述性统计与定量内容分析（Quantitative Content Analysis，简称QCA）对数据进行分析。
研究结果：本次研究共纳入来自53家医院的588名受访者，结果显示，失误的发生、上报、记录与处置环节之间存在明显脱节。QCA结果显示，27.8%的受访者提及安全文化质量低下是失误未得到处置的最主要原因。整体而言，患者安全文化的正向应答率介于26.7%至57.9%之间，其中人员配置维度得分最低，科室内部团队协作维度得分最高。尽管评估结果整体趋势一致，但相较于护理人员，医疗人员对ICU患者安全文化的评分更为积极。
研究结论：本次危机时期安全管理现状分析显示，当前仍存在较大的改进空间。人为因素（Human Factor）在ICU失误的发生与处置流程中发挥着关键作用，但系统性因素同样不容忽视。未来需进一步强化人员配置、失误上报、记录与沟通等领域的工作，以提升ICU的安全管理水平。本研究结论或可推广至医疗领域之外的其他国家与行业。