AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton's Safety At...AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton's Safety Attitudes Questionnaire(SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork(TW) and collaboration(CO) as endogenous variables. The exogenous variables are effective communication(EC), safety culture(SC), job satisfaction(JS), work pressure(PR), and work climate(WC). The measure-ment instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW(0.81), CO(0.76), EC(0.70), SC(0.83), JS(0.91), WP(0.85), and WC(0.78). Confirmatory factor analysis was performed for each of these constructs. RESULTS: Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork(R2 = 0.59) and in collaboration(R2 = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork(β = 0.26) and collaboration(β = 0.88). A relatively weak positive(β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled.CONCLUSION: Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive to intra-organizational collaboration.展开更多
目的:探讨慢性病病案管理模式对我国社区老年抑郁症患者疗效的影响。方法:采用随机对照研究方法,将年龄≥60岁,符合美国《精神障碍诊断与统计手册》(Diagnostic and Statistical Manual of Mental Disorder,Fourthedition,DSM-Ⅳ)抑郁...目的:探讨慢性病病案管理模式对我国社区老年抑郁症患者疗效的影响。方法:采用随机对照研究方法,将年龄≥60岁,符合美国《精神障碍诊断与统计手册》(Diagnostic and Statistical Manual of Mental Disorder,Fourthedition,DSM-Ⅳ)抑郁症诊断标准的120例老年抑郁症患者,随机分成干预组(N=60)和对照组(N=60)。干预组实行慢性病病案管理模式,即精神科医生、社区医生和病案管理员共同对老年抑郁症患者实施综合治疗方案,如健康教育、心理治疗和药物治疗等;对照组按照目前社区日常的医学方式进行。在治疗前,治疗第2、4、6、8、12周末分别应用汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD-17)、临床疗效总评量表(ClinicalGlobalImpression,CGI)、治疗副反应量表(Treatment Emergent Symptom Scale,TESS)对两组患者的疗效和药物不良反应进行评定。结果:在治疗12周末,干预组患者HAMD-17总分[(14.19±7.66)vs.(24.93±5.86)]和CGI-GI评分[(1.61±0.92)vs.(3.43±1.42)]均低于对照组(均P<0.01);干预组有效率(83.1%vs.39.3%)、临床治愈率(27.1%vs.5.4%)高于对照组(均P<0.01);干预组患者坚持服药率高于对照组(98.3%vs.35%,P<0.01);两组患者药物不良反应轻微,且差异无统计学意义(P>0.05)。结论:应用慢性病病案管理模式可以有效地减轻抑郁症状,增加抗抑郁药的使用,提高治疗效果。展开更多
基金Supported by the Taipei Veterans General Hospital
文摘AIM: To understand how work climate and related factors influence teamwork and collaboration in a large medical center. METHODS: A survey of 3462 employees was conducted to generate responses to Sexton's Safety Attitudes Questionnaire(SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork(TW) and collaboration(CO) as endogenous variables. The exogenous variables are effective communication(EC), safety culture(SC), job satisfaction(JS), work pressure(PR), and work climate(WC). The measure-ment instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW(0.81), CO(0.76), EC(0.70), SC(0.83), JS(0.91), WP(0.85), and WC(0.78). Confirmatory factor analysis was performed for each of these constructs. RESULTS: Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork(R2 = 0.59) and in collaboration(R2 = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork(β = 0.26) and collaboration(β = 0.88). A relatively weak positive(β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled.CONCLUSION: Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive to intra-organizational collaboration.
