Psychological safety in the perioperative environment: a cost-consequence analysis.

IF 1.7 Q3 HEALTH CARE SCIENCES & SERVICES BMJ Leader Pub Date : 2024-03-12 DOI:10.1136/leader-2023-000935
Franklyn P Cladis, Mark Hudson, Joel Goh
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Abstract

Introduction: Psychologically unsafe healthcare environments can lead to high levels of staff turnover, and unwanted financial burden. In this study, we investigate the hypothesis that lower levels of psychological safety are associated with higher levels of turnover, within an anaesthesiology department and we estimate the cost attributable to low psychological safety, driven by turnover costs.

Methods: Psychological safety was measured in one academic department. The psychological safety score was correlated with 'intention to leave' using linear regression and Pearson correlation and a cost-consequence analysis was performed.

Results: One hundred and thirty-eight physician anaesthesiologists (MDs) and 282 certified registered nurse anaesthetists (CRNAs) were surveyed. The response rate was 67.4% (93/138) for MDs and 60.6% (171/282) for CRNAs. There was an inverse relationship between psychological safety and turnover intent for both MDs (Pearson correlation -0.373, p value <0.0002) and CRNAs (Pearson correlation -0.486, p value <0.0002). The OR of intent to turn over in the presence of low psychological safety was 6.86 (95% CI 1.38 to 34.05) for MDs and 8.93 (95% CI 4.27 to 18.68) for CRNAs. The cost-consequence analysis demonstrated the cost of low psychological safety related to turnover per year was $337, 428 for MDs and $14, 024, 279 for CRNAs. Reducing low psychological safety in CRNAs from 31.6% to 20% reduces the potential cost of low psychological to $8 876 126.03.

Conclusion: There is a cost relationship between low psychological safety and turnover. Low psychological safety in an academic anaesthesiology department may result in staff turnover, and potentially high financial costs.

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围手术期环境中的心理安全:成本-后果分析。
导言:心理不安全的医疗环境会导致员工的高流失率和不必要的经济负担。在这项研究中,我们探讨了一个假设,即在一个麻醉科内,较低的心理安全水平与较高的人员流动水平相关联:方法:在一个学术部门对心理安全进行了测量。采用线性回归和皮尔逊相关法将心理安全得分与 "离职意向 "相关联,并进行了成本-后果分析:结果:138 名麻醉医师(MD)和 282 名注册麻醉师(CRNA)接受了调查。医学博士的回复率为 67.4%(93/138),注册麻醉师的回复率为 60.6%(171/282)。两位医学博士的心理安全与离职意向之间呈反比关系(Pearson 相关性-0.373,P 值 结论:低心理安全感与离职之间存在成本关系。学术麻醉科的低心理安全度可能会导致员工流失,并可能产生高昂的经济成本。
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来源期刊
BMJ Leader
BMJ Leader Nursing-Leadership and Management
CiteScore
3.00
自引率
7.40%
发文量
57
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