October 21, 2020

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Patient safety and health worker safety go hand in hand

Opinion

ANOTHER World Patient Safety Day has come and gone with great virtual fanfare. The theme for the World Patient Safety Day (Sept. 17) was one that should continue to resonate widely given the ongoing global pandemic: the important link between health worker safety and patient safety.

Health-care providers around the world are engaged in actions intended to enhance health, yet they regularly put themselves at risk in order to care for their patients. Working in stressful health-care environments can make this burden worse.

The COVID-19 pandemic brought these dangers to an entirely new level, revealing how risks to health workers risk patient health and safety in turn. Creating a safe space for health-care workers has never been more important.

Today, health workers worry about being infected with the novel coronavirus themselves and contributing to the spread of the virus at work, at home, or in their communities. This adds to the stress we all share of managing work, family and home-life commitments, particularly when child care and schools have been on hold or in flux, as well as elder care for aging parents.

Health workers have also had to work with limited access or adherence to personal protective equipment (PPE) and other infection-prevention and control measures. They’ve had to be flexible and resilient in the face of ever-changing and evolving work policies and practices. They’ve also had to bear the burden of being seen as responsible for sub-optimal care or errors which could potentially harm patients and fellow health workers.

Such stressors take a toll on the well-being and safety of our health providers. And that’s not good for patients.

Our health system is only as strong as our health workers.

Research has shown that organizational climate can significantly affect both patient and worker safety. A recent systematic review reveals a strong correlation between high levels of health-worker burnout, often caused by work overload and a lack of empowerment, and worsening patient experiences and outcomes.

Compromises in patient safety rooted in organizational structures and culture can also cause anxiety and distress amongst health workers. Consider the well-documented dilemmas faced by workers in long-term care, where worker-safety outcomes can be seen as an indicator of quality in nursing homes.

In many countries, including Canada, health-care providers are facing increased risks of infections, violence, mistakes, guilt, stigma, illness and even death.

What needs to happen to ensure patient and health-care worker safety? Improved investments in health-worker physical and psychological health and safety should be a national, provincial/territorial and organizational priority for improving patient safety outcomes.

In fact, the World Health Organization (WHO) has called on governments to commit to urgent and sustainable action to ensure health-worker safety and patient safety. Key suggested action areas include establishing synergies between health-worker safety and patient safety policies, and the development and implementation of national programs for better occupational health and safety of health workers, including peer-support programs.

The WHO also calls on governments to protect health workers from violence in the workplace, as well as for the improvement of mental health and psychological well-being of the health workforce. Finally, we need to protect health workers from physical and biological hazards.

In its recent speech from the throne, the federal government stated that we owe an immense debt to our health-care personnel. The pandemic has made clear why Canadians "need a resilient health care system." But for our health systems to stay resilient, we need to safeguard the health and well-being of our health workforce — from personal support workers to homecare aides to nurses and doctors, lab workers and beyond.

Our health system is only as strong as our health workers. It’s time to care for the workers who care for us.

Ivy Lynn Bourgeault is a professor of sociological and anthropological studies at the University of Ottawa and the lead of the Canadian Health Workforce Network. Chris Power is CEO of the Canadian Patient Safety Institute. Her journey in health care began at the bedside as a front-line nurse; since then, she has become one of the pre-eminent health care executives in Canada.

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