基于Reason奶酪模型的卫生应急工作机制运行障碍关键影响因素研究  

Study on the Key Influencing Factors of Barriers to Operation of Health Emergency Work Mechanisms Based on Swiss Cheese Model

作　　者：王群凯 孟楠 马云霞 吴群红[1,2] Wang Qunkai(Health Management College of Harbin Medical University,Harbin,P.R.China)

机构地区：[1]哈尔滨医科大学卫生管理学院,黑龙江哈尔滨150081 [2]哈尔滨医科大学公共卫生学院

出　　处：《中国卫生事业管理》2024年第8期884-890,共7页Chinese Health Service Management

基　　金：国家自然科学基金项目“复杂网络视域下中俄两国医疗浪涌应对系统理论建模、仿真及能力建设研究”(72361137562);黑龙江省公共健康安全及医改策略高端智库研究项目(ZKWT1013)。

摘　　要：目的:研究探索影响卫生应急工作机制高效运行的关键因素,旨在及时、有效地应对突发新发公共卫生危机,为卫生应急工作机制运行效果优化提供参考和依据。方法:通过文献研究法梳理出影响卫生应急工作机制运行的相关因素,在瑞士奶酪模型的基础上采用Python软件应用DEMATEL方法析出卫生应急工作机制的关键影响因素。结果:应急沟通通畅度(中心度为27.48)、领导行动自觉性(中心度为27.35)等强原因因素对卫生应急工作的运行具有非常显著的影响,且对其他因素有较大的影响;决策指挥反馈能力(中心度为27.77)、应急协同联防联控能力(中心度为27.58)等属于强结果因素,且深受其他原因因素综合作用的影响。结论:应该重视卫生应急工作机制在系统环境、组织管理、资源保障以及执行行为层面的关键影响因素,建议提升领导行动自觉性,增强应急沟通效果,强化协同联防联控能力,加强社会动员力度等,破除阻碍卫生应急机制顺畅运行的壁垒,着力提升公共卫生应急能力。Objective To explore the key factors affecting the operation of health emergency response mechanism,provide ref-erence and basis for timely and effective response to new public health emergencies,and improve the operation effect of health e-mergency response mechanism.Methods The relevant factors affecting the operation of health emergency response mechanism were sorted out through the literature research method,and the key influencing factors of health emergency response mechanism were analyzed by using the DEMATEL method in Python software on the basis of Swiss cheese model.Results Strong causal factors of smooth emergency communication(centrality of 27.48)and conscientiousness of leadership action(centrality of 27.35)had a very significant impact on the operation of health emergency response,and had a greater impact on other factors.Decision-mak-ing and commanding feedback ability(centrality of 27.77)and emergency cooperation and joint prevention and control ability(centrality of 27.58)were strong result factors,which were deeply affected by the combined effect of other causal factors.Conclu-sion It is suggested to pay attention to the key influencing factors of health emergency response mechanism at the levels of system environment,organizational management,resource guarantee and implementation behaviour,improve the conscientiousness of the leadership,enhance the effect of emergency response communication,intensify the ability of collaborative joint prevention and con-trol,and strengthen the social mobilization,in order to break down the barriers that impede the smooth functioning of health emer-gency response mechanism,and strive to enhance the capacity of public health emergency response.

关 键 词：卫生应急工作机制 DEMATEL方法 影响因素 

分 类 号：R197.1[医药卫生—卫生事业管理]