The Bureau of Labor Statistics reports that health care workers suffer more on-the-job injuries than professionals in most other industries, with more than two million lost workdays in 2011. The same year, a study in Professional Safety, the journal of the American Society of Safety Engineers, found that the relatively high rate of injuries in the health care industry totals about $13.1 billion.
Direct injury expenses in the health care industry are not a cost of doing business—since they are not intended to enhance the organization or generate revenue, they are losses. The indirect cost of injuries is four to five times higher than their direct cost, which impacts many areas of the business. Thus, there is a great need for the health care industry to develop sustainable safety solutions by using a multidisciplinary group of stakeholders to examine root issues linking employee and patient injuries.
Historically, professionals with clinical experience have been the most dominant leaders of safety programs in the health care industry, but clinical knowledge is not the only prerequisite for understanding and addressing safety and health exposures. Organizational leadership as a whole can play a major role in educating and motivating employees to perform their jobs safely and balance efforts to prevent employee injuries while also preventing patient harm.
“Resources and attention have historically been focused on the prevention of harm to patients at the cost of harm to health care employees,” said Colin J. Brigham, vice president of safety management and ergonomics at 1Source Safety and Health, Inc. “Care providers [are] willingly and unnecessarily putting themselves at risk of harm. As leaders, we need to reinforce living up to the health care oath of ‘Do No Harm’ from just care recipients to care recipients and providers. Protecting the care provider assures their availability to provide care.”
Leaders of health care organizations should emphasize that practitioners are not expected to sacrifice their own safety and health. Without collaborative efforts to protect both employees and patients, one or both will be at risk.
“For safety professionals to successfully integrate and lead safety programs in health care, it is essential to understand the culture of health care and health care professionals,” said Lynda Enos, a veteran nurse and ergonomics consultant at HumanFit, LLC. “Competing and constantly changing business, service and regulatory demands can make it challenging to maintain the sufficient organizational support for health care worker safety programs such as Safe Patient Handling. However, if such programs demonstrate a direct contribution to the achievement of health care organizations’ business objectives and stakeholder needs, they will be effective in reducing work injuries and facilitate an essential shift in culture where worker and patient safety are viewed with equal importance.”
The capabilities of health care workers also impact safety. These capabilities can either be enhanced or diminished by the work environment. Therefore, it is critical that the “built environment” approach to designing health care facilities encompasses early involvement of front line staff and risk management, environmental health and safety professionals, ergonomists, human factors engineers and experts from other pertinent disciplines in the design, budgeting and planning phases. This minimizes risks to patients and employees by considering hazards and workers’ capabilities from the start. If risk, safety and health are a post-construction afterthought, then problematic and expensive retrofits may ensue.
In addition, the fast-growing use of lean initiatives should also involve collaborations with professionals from a variety of disciplines to avoid unintentionally creating new worker safety and health issues.
Involving finance and risk management will help identify actual and potential sources of financial loss. This information can be used as the basis for setting measurable financial loss reduction goals to forecast returns on investment in interventions that involve expenses and/or capital expenditures.
Initial and ongoing training for health care workers should integrate clear objectives that impact patient and employee safety. The quality, delivery and testing of educational objectives will ultimately impact participants’ capabilities and motives to work safely. In some cases, sophisticated healthcare organizations have gone above and beyond “off-the-shelf” training solutions by using surveys to solicit the tacit knowledge of employees and feedback from care recipients. Survey results are then used to refine the educational program and its objectives.
Resources are widely available. For example, the Agency for Healthcare Research and Quality has survey resources on patient safety, and OSHA has a “Safety & Health Leadership Quiz” that can be used to capture key insights and improve training and educational efforts to align patient and employee safety. Internal, department-based champions and outside training coaches can also help to conduct on-site staff education, particularly for patient handling.
Solutions to widespread problems in health care are rarely simple, but safety starts with quality data that can be used to help make decisions and develop solutions. First, health care organizations can make use of tools and technologies to help identify sources of workers compensation, financial and productivity losses, like quality risk management information systems, human resources information systems and health care analytics. Second, organizations should address sources of loss, based on risk assessment and exposure, using a multidisciplinary team of stakeholders. Finally, they need to communicate how to measure progress and gauge the efficacy of interventions aimed at treating sources of loss and subsequent risks.
To accurately measure outcomes, the health care industry must engage and build trust to encourage consistent reporting of errors, incidents and injuries, and turn liabilities into learning assets. This offers an opportunity to correlate the relationship between patient safety and employee outcome. Using this three-tiered approach can serve as a springboard to increase capabilities, educate and motivate health care organizations to align patient and employee safety efforts.