부산대학교 도서관

Byline: Bruna Babic [brb2019@med.cornell.edu] (a,e,*), Anita Ayrandjian Volpe (a), Stephen Merola (a,e), Elizabeth Mauer (b), Yaniv Cozacov (a), Clifford Y. Ko (c,d), Fabrizio Michelassi (e), Pierre Saldinger (a,e) Keywords Surgical quality improvement; Patient safety; Patient quality improvement; Culture; NSQIP Highlights * A culture of surgical safety has taken priority for both patient outcomes and institutional values. * After initiation of a change in culture, there was a significant change in surgical patient outcomes. * The foundation for improved surgical outcomes needs to be a culture of patient safety. Abstract Background A focus on the culture of safety and patient outcomes continues to grow in importance. Several initiatives targeted at individual deficits have been described but few institutions have shown the effect of a global change in culture on patient outcomes. Methods Patient care perception was assessed using Safety Attitudes Questionnaire (SAQ) by Pascal Metrics.sup.[R]. A change in culture was initiated, followed by implementation of initiatives targeting communication and patient safety. ACS-NSQIP data was analyzed to assess outcomes during the period of improved culture. Results Our institution had poor outcomes as measured by ACS-NSQIP data and several deficiencies in our culture score. Both statistically improved after initiative implementation. A difference in mean culture score across time (p < 0.001 = .031) was seen from 2013 to 2015, while NSQIP odds ratios falling in the 'exemplary' category increased. Conclusion Our results demonstrate an improvement in both culture and outcomes from 2013 to 2015, suggesting a correlation between culture and surgical outcomes. Author Affiliation: (a) Department of Surgery, New York Presbyterian-Queens, Flushing, NY, USA (b) Division of Biostatistics and Epidemiology, Department of Healthcare Policy and Research, New York-Presbyterian/Weill Cornell Medical Center, New York, NY, USA (c) Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA (d) Division of Research and Optimal Patient Care, American College of Surgeons, Chicago, IL, USA (e) Department of Surgery, Weill Cornell Medicine, New York, NY, USA * Corresponding author. 56-45 Main Street, 5 South, Department of Surgery, Flushing, NY 11355, USA. Article History: Received 19 December 2017; Revised 30 January 2018; Accepted 7 February 2018