Health systems must tackle workplace, patient safety in tandem, IHI says

ORLANDO, FLORIDA—A nationwide effort to improve and coordinate patient safety measures will strive to make a connection between workplace and patient safety.

The Institute for Healthcare Improvement (IHI) gave an update during its National Forum this week on the creation of a national patient safety plan intended to encourage better coordination of safety efforts. A key goal of the plan, expected to be released next year, was to emphasize the role of improving workforce safety.

“In our view, too many systems have a separation between workforce safety and patient safety and yet we know the two are connected,” said Derek Feeley, president and CEO of IHI, in a briefing with reporters Monday before the start of the forum in Orlando, Florida. “Patient safety incidents are much less likely to occur when workers feel safe.”

The steering committee developing the plan includes 27 organizations that range from patient advocates and professional societies to provider organizations and government representatives. The committee's plan hopes to target healthcare leaders and policymakers.

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Workers in healthcare settings such as hospitals or nursing homes are at serious risk for violence. From 2002 to 2013, the rate of serious workplace violence incidents that required workers to take time off was more than four times greater in the healthcare industry compared to private industry, according to data from the National Institute for Occupational Safety and Health.

“In fact, healthcare accounts for nearly as many serious violent injuries as all other industries combined,” the report from the institute said.

Physical dangers in the workforce aren’t the only thing the committee is focusing on, as physician and worker burnout is a major link to patient safety.

“We know if the workforce is burned out then the workforce has less empathy and trying to deliver on the point of care,” said Tejal Gandhi, IHI’s chief clinical and safety officer.

She added that many boards in healthcare are not looking at their data on workforce harm, so “it is not getting to that level of governance and oversight that we think needs to happen.”

Hospitals need to apply the same strategies that occur when a patient gets harmed in a hospital to a worker.

“If something fell and hit a patient and broke the patient’s foot, it would be a huge deal in a hospital,” Gandhi said. “If something falls on an employee and breaks the employee’s foot it is often not treated at that same level of urgency.”

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Some healthcare systems are making moves to improve workplace injuries and violence. The Virginia Commonwealth University Medical Center implemented a series of initiatives to improve on violence.

For instance, the facility adapted in spring 2019 its electronic medical record to flag patients that have been aggressive either verbally or physically.

The center experienced a 24.5% decrease in assault claims from 2018 to 2019, according to a copy of the study on display at the forum.

Healthcare organizations are also starting to address workplace safety as it begins to draw attention from federal and state lawmakers, who are considering putting in regulations and laws on workplace violence.

By creating their own initiatives, a facility can be proactive on the issue and seek assistance from policymakers, said Carl Schiessl, senior director for regulatory advocacy for the Connecticut Hospital Association, at the forum.