Lucian Leape Institute at National Patient Safety Foundation Releases Report Urging Emphasis on Joy, Meaning, and Workforce Safety in Health Care

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Links Patient Safety to Worker Safety and Recommends Seven Actions Organizations Must Take

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.

The Lucian Leape Institute at the National Patient Safety Foundation today 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.

Besides Dr. Leape, Mr. O’Neill, and Ms. Morath, current members of the Lucian Leape Institute include Carolyn M. Clancy, MD, director, Agency for Healthcare Research and Quality; Janet Corrigan, PhD, MBA, former president, National Quality Forum; Susan Edgman-Levitan, PA, executive director, John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital; Gary S. Kaplan, MD, FACMPE, Chairman and CEO, Virginia Mason Medical Center; Patricia A. McGaffigan, RN, MS, Interim President of the Leape Institute and the National Patient Safety Foundation; Dennis S. O’Leary, MD, President Emeritus, The Joint Commission; Diane C. Pinakiewicz, MBA, CPPS, Distinguished Advisor, National Patient Safety Foundation; and Robert M. Wachter, MD, associate chair, Department of Medicine, University of California at San Francisco.

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.

About the Lucian Leape Institute
The Lucian Leape Institute at NPSF, established in 2007, is charged with defining strategic paths and calls to action for the field of patient safety, offering vision and context for the many efforts under way within health care, and providing the leverage necessary for system-level change. Its members comprise national thought leaders with a common interest in patient safety whose expertise and influence are brought to bear as the Institute calls for the innovation necessary to expedite the work and create significant, sustainable improvements in culture, process, and outcomes critical to safer health care.

About National Patient Safety Foundation
The National Patient Safety Foundation (NPSF) has been pursuing one mission since its founding in 1997–to improve the safety of care provided to patients. As a central voice for patient safety, NPSF is committed to a collaborative, multistakeholder approach in all that it does. NPSF is an independent, not-for-profit 501(c)(3) organization. To learn more about the work of the National Patient Safety Foundation, please visit:

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Patricia McTiernan
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