Engaging All Employees in Efforts to Achieve High Reliability

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DRAMATIC AND NUMEROUS advances in science, technology, and medicine provide new opportunities to keep people healthy as well as to diagnose, treat, and cure disease. Unfortunately, increasing complexity increases opportunities for mistakes and errors, particularly in healthcare organizations as they struggle to prevent patient harm (Chassin and Loeb 2011). Safety problems persist and harm to patients continues despite widespread attention to the need for improvement (Stelfox et al. 2006).

An engaged and empowered workforce is critical to improving the patient experience, improving health outcomes, and correcting unsafe conditions (Rathert and May 2007). However, all healthcare workers—nurses, physicians, security guards, chaplains, and so many others—are subject to the same stressors and system failures that lead to patient harm. This situation compromises the workforce’s ability to ensure care that is consistently excellent and safe. Patient harm events are further exacerbated by employee fatigue, disengagement, burnout, intimidation, bullying, and violence in the work place.

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