病人安全文化、內部行銷對異常事件發生的影響

台灣醫療產業在經營管理上，因為病人意識的抬頭使得醫療服務化，政府對病人安全及異常事件的要求也越趨嚴格；在這樣的嚴峻狀況下醫院管理階層意識到必需要積極網羅人才、培育員工，改善員工的服務品質等內部行銷作為，才能維持醫院人力運作並提高醫院的競爭力。 依據文獻回顧及政府醫療管理規章，本研究探討醫院病人安全文化、內部行銷作為與異常事件發生的關係。本研究調查了一家醫學中心及兩家區域教學等三家個案醫院，問卷填寫對象為個案醫院的員工。採橫斷面結構式問卷，共發放629份問卷，回收535份，回收率為85.0%，其中75份判定為無效問卷，有效問卷為460份，有效率為86%。經SPSS 30.0版統計套裝軟體進行信度檢定分析，信度係數Cronbach α值為0.919。 本研究發現病人安全文化對於內部行銷作為顯示正相關，病人安全文化對於異常事件發生則顯示負相關。醫院管理者可以經由內部行銷作為來強化病人安全文化，完善的內部行銷活動可以加強病人安全文化的落實；醫院越重視病人安全文化，異常事件越不容易發生，異常事件的發生率越低，越能提升醫院的病人安全文化的塑造。建議醫院管理者可以使用內部行銷的方法來對具有不同人格特徵的醫院員工進行教育訓練，以提升員工對病人安全文化的重視，進而減少異常事件的發生。

In the management of Taiwan medical industry, patients are more aware of their medical service where patient safety and environment safety are highly evaluated. Under such a high demanding condition, the managerial department must train their staffs, and improve medical service quality. So that the hospital can maintain their workforce, thereby, competitivity. According to the literature review and the government's medical management regulations, this study explored the relationship between hospital patient safety culture and internal marketing and medical adverse event. This study surveyed three hospitals, including one medical center and two regional teaching hospitals. The questionnaires were filled out by the staff of these hospitals. With a total of 629 questionnaires distributed, 535 questionnaires were returned. We had 85% returning rate (535/629) where the effective rate was 86% (460/535). We applied 30.0 ver. SPSS for the analysis and had Cronbach a value was 0.919. This study discovers patient safety culture has a positive impact on internal marketing and negative impact on medical adverse event. It suggests patient safety culture can be strengthen through the internal marketing. An internal campaign can fulfill the act of internal marketing. If the hospital values patient safety culture, the medical adverse events would become less likely. In another words, the less the medical adverse events in a hospital can promote patient safety culture. At the same time, it promotes hospital reputation. This study suggests hospital management can carry out education and training awareness to different employees in the different departments through internal marketing. Therefore, brings attentions to patient safety culture to the employees. In future, we hope hospital personnel can value patient safety culture and bring down the occurrence of medical adverse event.