Interaction of Health Care Worker Health and Safety and Patient Health and Safety in the US Health Care System: Recommendations From the 2016 Summit

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Since the publication of the Institute of Medicine's groundbreaking report To Err is Human in 2000,1 patient safety has become a key health care issue, driving decision-making and policy formulation in virtually every sector of the health care system. In 2008, Berwick stated that the US health care system could only be improved if it focused on three aims: (1) improving the experience of patient care; (2) improving the health of populations; and (3) reducing per capita costs of health care.2
More recently, a new topic has begun to emerge: the health and safety of those who deliver health care—from physicians and nurses to administrative and service personnel—and how that can impact the health and safety of patients. It is becoming clear that workers in this high stress, demanding sector are themselves prone to a wide variety of health risks, ranging from musculoskeletal issues to depression and burnout. This burnout and dissatisfaction among health care workers compromises the goals of the triple aim. Therefore, there is a need to expand the triple aim into the quadruple aim, which includes the goal of improving the work life and well-being of health care providers.3
In the midst of these factors, health care leaders have begun to recognize the irony that the very places charged with addressing patient safety—America's hospitals, care clinics, and medical offices—face significant health and safety challenges of their own. For example, the incidence rate of total recordable injuries and illnesses for private hospitals and residential care facilities was 7.7 and 8.8 per 100 full time workers in 2007, respectively, as compared with 4.2 for private industry overall.4 There is growing agreement that the health and safety of patients is inextricably linked to the health and safety of those who care for them.5,6
Without a safe and healthy work environment for the millions of individuals who provide care for and support the needs of patients, the core goal of ensuring patient safety is placed at risk. Healthy and safe health care workers are more likely to provide care that leads to optimized patient health and safety.
Striving to address this fundamental obstacle to the provision of true patient safety requires a new way of thinking about, and talking about, the health care workplace. It requires a new vision and a culture shift in which health care employers put a new emphasis on ensuring the health and safety of their own workers as well as addressing issues of patient safety. It requires striving to achieve greater parity of resources, alignment of workplace incentives, commitment from health care organizations and standard-setting bodies, and a new focus on accountability for healthy and safe employee environments, beginning with senior leadership.
At the heart of this vision is a new and emerging concept of health care worker safety and wellness—a concept that includes a wide spectrum of components that contribute to an optimally functioning health care worker—physical and psychological safety, enhanced individual health, and the creation of well-designed, supportive working environments. The end goal is to create places where it is just as safe to work as it is to receive care. Healthy and safe workers are the gateway to healthy and safe patients. Thought leaders are beginning to construct models that promote this new vision for health worker safety and wellness.
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