Through The eyes of The Workforce - National Patient Safety ...

THROUGH THE EYES OF THE WORKFORCECreating Joy, Meaning, and Safer Health CareThe American Association of Colleges of Nursing identifies insufficient staffing asraising nurses’ stress levels, impacting their job satisfaction and driving many nursesto leave the profession.Workforce safety in health care organizations tends to be considered and managedin silos often unconnected to the work of patient safety, with workers’ compensationissues typically overseen as an aspect of employee benefits under the HumanResources function, injury reports and claims managed by the Risk and EmployeeHealth department, workplace safety under the jurisdiction of EnvironmentalServices, and infection control responsibility distributed across multiple clinicaldepartments. What is uncommon is an integrated approach to workforce safety and,importantly, consideration of workforce safety as a quality indicator for the culture ofthe organization—the culture that provides the critical context for achieving patientsafety. The two are inextricably linked and grounded in the same safety science.However, a survey across the health care disciplines conducted by the AmericanSociety of Professionals in Patient Safety at the National Patient Safety Foundationfound that while 99% of the respondents agreed that there is a link between workforcesafety and patient safety, only 16.5% reported that workforce safety was a focusin their organization’s quality and safety initiatives. 50 A systems approach to establishingand ensuring a culture of safety would, by definition, argue for alignment, ifnot integration, of workforce safety efforts with patient safety efforts.Boards of trustees are usually unaware of these kinds of problems, often interpretingtheir fiduciary responsibility as limited to financial issues, although it is known thatgoverning board priorities have significant impact on quality performance. 51 Workforceinjuries are often not visible to, or a top priority of, CEOs and other hospitalleaders. At the same time, leaders are often unaware of or ill equipped to managedisruptive behavior. Budgeting processes could, but rarely do, make investments inworker safety a priority. 52 By this omission of attention and action, leaders of healthcare organizations are unknowingly condoning and enabling unsafe behaviors andunsafe workplaces.CURRENT STATE OF THE HEALTH CARE WORKPLACE • 11