By Paul Gallese, PT, MBA
Witnessing the harm or death of a patient caused by a medical error can be a traumatizing event to a healthcare worker. Unfortunately, the impact of adverse events on caregivers often goes unnoticed.
While the focus of efforts to enhance safety rightly centers on patients, workers involved in or exposed to adverse events also become victims. Being associated with a medical error that harms a patient can result in undue stress, burnout, loss of confidence, economic harm or other negative consequences (Holden and Card, 2019).
Hospital leaders can decrease adverse events and burnout while improving workers’ job satisfaction by engaging them in efforts to improve patient safety, according to recent communications from the Joint Commission and the Institute for Healthcare Improvement. These efforts have the added benefits of improving patient outcomes and satisfaction scores by reducing healthcare-acquired infections and conditions.
Safety cultures encourage the reporting of adverse events and unsafe conditions
A recent Joint Commission Sentinel Event Alert titled “Developing a Reporting Culture: Learning from Close Calls and Hazardous Conditions” explains how healthcare organizations can improve the identification and reporting of adverse events and unsafe conditions by establishing trust among their staff and eliminating the fear of punishment. Within a trusting and fair environment, or “just culture,” workers more readily report errors and unsafe conditions because they feel they are contributing to better patient safety rather than feeling they may be blamed or disciplined for their actions.
The Joint Commission alert provides several examples of how healthcare organizations are establishing trust, encouraging reporting, learning from close call reporting, and gaining leadership and staff engagement and accountability in relation to patient safety. The alert on reporting culture is a follow-up to another Joint Commission alert titled “The Essential Role of Leadership in Developing a Safety Culture,” which goes into detail about the tenets or attributes defining healthcare safety cultures.
A just and trusting culture can reduce burnout
An Institute for Healthcare Improvement blog article explains how a just and trusting culture can reduce burnout, which has been linked to adverse events. In “Just Culture as a Foundation for Joy in Work: The Impact of Leaders,” author Barbara Balik writes about the connection between burnout and patient safety risks and explains how hospital leaders can reduce these risks by establishing a just culture.
A long-time member of the National Patient Safety Foundation Board of Advisors and co-founder of Aefina Partners, Balik points out the correlation between burnout and errors (Shanafelt 2010), as well as how leaders can reduce burnout by engaging caregivers in patient safety initiatives and other activities that bring joy to work. Engaged employees are four times less likely to feel burnout at work, Gallup (2018) analytics show.
In response to the problem of burnout and the patient safety challenges it causes, Vitalacy has developed a patient safety platform that helps healthcare workers to perform their rounding activities more efficiently and safely. The platform has proved to reduce hospital-acquired infections through better hand hygiene (Nour-Omid, 2019) and helps nurses track shift duration, shift frequency and miles walked during rounding. A fatigue scoring algorithm notifies unit clerks and nurses managers when a caregiver experiences burnout symptoms. Vitalacy is also planning to introduce a meditation tool to its daily reporting to clients to help employees manage stress, burnout and fatigue.
An important intervention in any effort to improve patient safety is letting frontline healthcare workers know that their efforts are noticed and that they matter. These caregivers often pay a steep price – physically, emotionally and even financially – for the privilege of working in patient care. By understanding, addressing and fulfilling their needs, hospital leaders can create a positive cycle that results in healthier and happier workers, patients and communities.
Gallup Sharecare Well-Being Index. 2 remedies for reducing burnout among healthcare workers, March 27, 2018.
Holden J & Card AJ. Patient safety professionals as the third victims of adverse events. Journal of Patient Safety and Risk, June 11, 2019.
Nour-Omid J. A case study: will improvements in hand hygiene compliance reduce infections? Vitalacy Blog, June 4, 2019.
The Joint Commission. Sentinel Event Alert 57: The essential role of leadership in developing a safety culture, March 1, 2017.
The Joint Commission. Sentinel Event Alert 60: Developing a reporting culture: learning from close calls and hazardous conditions, Dec. 10, 2018.