Caregivers cannot meet the challenge of patient safety unless they feel safe and valued, and find a purpose in their work that brings joy and meaning to their lives. Research has shown a higher burnout rate among health care staff who spend less than 20 percent of their time in work that is personally meaningful to them.
The connection between patient safety and the day-to-day experience of caregivers was drawn clearly in a white paper recently released by the Lucian Leape Institute at the National Patient Safety Foundation. Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care outlines the physical and psychological harms that health care providers encounter on a daily basis in the course of their work. The premise of the paper is that although health care workers enter the field because they are drawn to finding joy and meaning in caring for others during times of increased vulnerability, the current environment in which they work is not designed to protect their emotional and physical well-being.
Caregivers suffer emotional harm from lack of respect, bullying, and demeaning behavior and physical harm from working in settings with suboptimal risk prevention.
In a stressful and unsupportive environment, caregivers are less able to find joy and meaning in work. They experience burnout and too often make the choice to leave or cut back on their professional work. They are also less able to attend to safety practices diligently-which has implications for both worker and patient safety. As the authors point out, "If we expect the health care workforce to care for patients, we need to care for the workforce."
The authors suggest that the solution to this safety issue is fostering an environment of mutual respect, which requires the development of an effective high-reliability organization in which worker well-being is a priority. Committed leadership is essential to the creation of such an organization.
The paper also outlines seven proposed action steps for improving health care by fostering greater joy and meaning in the workplace. The authors argue that to protect the physical and psychological well-being of caregivers and support patient safety, health care organizations must:
Develop and embody shared core values of mutual respect and civility; transparency and truth telling; safety of all workers and patients; and alignment and accountability from the boardroom through the front lines.
Adopt the explicit aim to eliminate harm to the workforce and to patients.
- Commit to creating a high-reliability organization (HRO) and demonstrate the discipline to achieve highly reliable performance.
- Create a learning and improvement system.
- Establish data capture, database, and performance metrics for accountability and improvement.
- Recognize and celebrate the work and accomplishments of the workforce, regularly and with high visibility.
- Support industry-wide research to design and conduct studies that will explore issues and conditions in health care that are harming our workforce and our patients.