Exploring Front-Line Hospital Workers' Contributions to Patient and Worker Safety

Abstract

Concerns about stubbornly persistent high rates both of error-related patient injuries and of occupational injuries among healthcare workers have generated intense exploration of etiologies, interventions, and the role of underlying safety culture. Much of this work has centered on the role of physicians and nurses in health care, and suggests common issues related to safety culture. However, the role of front-line health care workers, such as nursing assistants, ward clerks, environmental service workers, food workers and transportation workers, among others, has not been explored sufficiently. This article provides the background for a workshop held in Washington, D.C., to identify gaps and opportunities for integrating front-line hospital workers into safety efforts. It provides a brief review of available information, the results of a series of focus groups of front-line workers from a single urban hospital addressing the question, and a series of framing questions for the workshop itself.

Determinants of occupational injury for US home health aides reporting one or more work-related injuries

“…The sampling frame of 15 488 agencies was developed through three data sources1: the Centers for Medicare and Medicaid Services Providers of Services file of home health agencies and hospice2; state licensing lists of home health agencies of private organisations and3 the National Hospice and Palliative Care Organization file of hospices. The NHHAS was fielded to HHAs at a nationally represented subset of agencies (n=3377) participating in the 2007 NHHCS (n=955).…”

“…A total of 4836 workers were killed, and millions of others were injured by preventable injuries occurring at the workplace across all industries in 2015 1. This study defined occupational injury as any type of injury reported by a worker at the workplace that occurred during performing job-related responsibilities in a 12-month period 2. At the workplace, workers are at risk for exposure to hazards and occupational accidents that may lead to injury or illness.…”

“…Patients receiving home healthcare services with multiple of severe activities of daily living (ADLs) or instrumental activities of daily living (IADLs) needs are functionally limited and require a great deal of physical assistance. The most common and well-documented underlying risk factor of work-related injury among home-based HHAs is related to the manual handling of patients, which leads to injuries 2. HHAs continue to experience above average rates of injury at 4 per 100 full-time employees (FTE) and are ranked the second-highest occupation for work-related injuries 3–5.…”

“…The research questions for this study were1: what is the relationship between workplace environment (measured by workers’ perceptions of leadership style, work value, work design, time pressure and organisational culture) and the probability of reporting one or more work-related injuries? and2 what is the relationship between ergonomic workplace factors and the probability of reporting one or more work-related injuries? We hypothesised that (a) workplace conditions such as leadership support, work value, work design, time pressure and organisational culture and (b) ergonomic factors such as availability and consistent availability of devices would be associated with reporting work-related injuries.…”

“…The study sample consisted of a nationally represented sample of home health aides (n=3.377) with a 76.6% response rate. We used two scales 1 : a Work Environment Scale and 2 an Ergonomic Scale. Univariate and bivariate analyses were conducted to describe HHA work-related injury across individual, job and organisational factors.…”