Analyse des dimensions organisationnelles clés déterminant la culture de sécurité-patient du personnel infirmier: analyse comparée entre six services médicaux

Abstract

Over time, industrial companies were facing many disasters and industrial accidents. Progressively, technical issues no longer explained accidents or improve safety and so, the concepts of human error and organizational factors appeared. After the nuclear environment, the healthcare sector was inspired by industrial methods and the human and organizational factors approach to improve the quality and safety of care. In addition, in hospitals, many adverse events are reported each year during the hospitalization of patients. However, most of them could be avoided and so, adverse events can no longer be considered as secondary. First developed in the nuclear sector, the concept of safety culture is now well established in the healthcare sector. Developing a patient safety culture would ensure that safety is a priority for hospital staff. The study aims at analyzing five organizational factors in six medical services in a Belgian hospital. These factors are: communication, incompatibles goals, organization, training and procedures. Our objective is to determine which factors are developed into these services or on the contrary must be improved. To do so, we submitted a questionnaire to ninety nurses from these services within the hospital. The first part of this master’s thesis will be dedicated to clarifying the different concepts that will be used in this study, such as safety culture, patient safety culture and the human and organizational factors. The Swiss Cheese Model (Reason, 1997) and the Tripod Delta method were used to understand the basic principles of organizational accidents and defenses set up in the services participating in the study. Once these theoretical concepts are in place, the second part will be dedicated to the description of the methodology. After that, we will expose the results of the survey and we will concluded with a comparison of the service’s organizational factors. At the end of this analysis, we will see that the six services have not reached the same level for each factor and that there are still improvements to be made. Following these analyses, a few recommendations will be provided.