Report Urges Emphasis on Joy, Meaning, and Workforce Safety in Health Care

The Lucian Leape Institute at the National Patient Safety Foundation has released a report focusing on the health and safety of the health care workforce and calling upon health care organizations to initiate broad organizational changes to reduce physical and psychological harm to health care workers. Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care contends that patient safety is inextricably linked to health care workers’ safety and well-being because caregivers who suffer disrespect, humiliation, or physical harm are more likely to make errors or fail to follow safety practices.

The report is the result of two Institute Roundtables on the topic. It represents the experiences and opinions of frontline practitioners, leaders of health care organizations, scholars, and representatives of government agencies and professional societies.

“The basic precondition of a safe workplace is protection of the physical and psychological safety of the workforce,” said Paul O’Neill, former US Treasury Secretary and chairman and CEO of Alcoa. “Most health care organizations have done little to support the common contention that ‘people are our most important asset.’”

Mr. O’Neill and fellow Leape Institute member Julianne Morath, RN, MS, chief quality and safety officer, Vanderbilt University Medical Center, led the roundtables on this topic and were instrumental in writing the report.

“The health care workforce is made up of caring, well-intentioned individuals, but unfortunately, many are subjected to bullying, harassment, disrespect, and even physical assault,” said Ms. Morath. “Health care workers suffer more injury—and disrespect—than workers of other industries.”

The report details vulnerabilities in the system and the costs of inaction:

  • Emotional abuse, bullying, and even physical threats are often accepted as “normal” conditions of the health care workplace.
  • Production and cost pressures in health care have reduced intimate, personal caregiving to a series of demanding tasks performed under severe time constraints, detracting from what should be joyful and meaningful work.
  • More full-time employee workdays are lost in health care each year (due to illness or injury) than in industries such as mining, machinery manufacturing, and construction.

Examples of workers’ experiences punctuate the report and bring the issue to life. The report concludes with examples of what a healthy and safe workplace looks like and recommends strategies to improve the environment.

“We are grateful to our roundtable experts who contributed to this report,” said Lucian Leape, MD, chairman of the Institute and a founder of the patient safety movement. “We believe it is essential for health care leaders to address these issues to move the patient safety efforts forward.”

This is the third in a series of reports on issues that the Leape Institute has identified as top priorities in ongoing efforts to improve patient safety. The first, Unmet Needs: Teaching Physicians to Provide Safe Patient Care (2010) addressed dysfunction in medical education. Last fall, the Institute published Order from Chaos: Accelerating Care Integration, which looked at the problems caused by fragmented care and possible solutions. Subsequent Institute initiatives will address the promotion of active consumer engagement in patient care and provision of fully transparent care.

The Lucian Leape Institute at the National Patient Safety Foundation gratefully acknowledges SEIU Healthcare for its generous support of the LLI Expert Roundtable on Joy, Meaning, and Workforce Safety.

Executive Summary

Through the Eyes of the Workforce: Creating Joy, Meaning, and Workplace Safety (full report PDF)