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

THROUGH THE EYES OF THE WORKFORCECreating Joy, Meaning, and Safer Health CareHigh-reliability organizations are organized to anticipate and manage the unexpectedand exhibit five basic principles: a preoccupation with failure, a reluctance to simplifyinterpretations, a sensitivity to operations, a commitment to resilience, and adeference to expertise. 63 Through these, they create an error-tolerant culture in whicherrors are the catalyst for investigatingand addressing systemic failures. In such Can each person in the workforce answer yesa culture, errors are acknowledged, but to these three questions each day?violations of formal rules are not tolerated.64 Multidisciplinary teamwork is1. Am I treated with dignity and respect byeveryone?integral to the creation of a safe environment,and open communication, without 2. Do I have what I need so I can make athreat of negative repercussion, is integral contribution that gives meaning to my life?to teamwork. In such an environment, the 3. Am I recognized and thanked for what I do?safety of the workforce is paramount.The introduction of HRO performance in health care is emphasized in the Institute ofMedicine’s recently issued report Best Care at Lower Cost, which calls on health careorganizations to become learning organizations and pursue high reliability. 65 The JointCommission has also recently called on health care organizations to become HROs. 66Fulfilling the PreconditionsEffective organizations are those that care for their employees, are committed toreliability, and continuously meet preconditions. A precondition is an enduringrequirement that is not subject to annual priority and budget setting. The most fundamentalof these is workforce safety. Studies have correlated employee safety andpatient safety and have demonstrated how organizational climate impacts workers’health. 67–71 Other high-risk industries have found that an organizational climate ofsafety and workers’ perception of it are aligned with better safety outcomes. 72–74When health care organizations provide programs aimed at improving worker healthand safety—such as employee wellness programs, influenza vaccinations, safe instrumentand sharps handling, and devices for lifting—patient outcomes improve andworkers feel cared for and safer. 75 The Occupational Safety and Health Administration(OSHA), the National Institute for Occupational Safety and Health (NIOSH),and The Joint Commission (TJC) have researched, developed, and promoted bestpractices for managing safety and aligning patient safety with workforce safety.In addition, physical safety measures put in place over the years have been informedby federal and state regulatory action, including the federal Needlestick Safety andPrevention Act, passed in 2000, and safe patient handling laws implemented at theWhat can be donE • 15