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5 steps to improve health worker safety and patient safety Establish synergies between health worker safety and patient safety policies and strategies: Develop linkages between occupational health and safety, patient safety, quality improvement, and infection prevention and control programmes. Incorporate requirements for health worker and patient safety in health care licensing and accreditation standards. Integrate staff safety and patient safety incident reporting and learning systems. Develop and implement national programmes for occupational health and safety of health workers: Develop and implement national programmes for occupational health for health workers in line with national occupational health and safety policies. Review and upgrade, where necessary, national regulations and laws for occupational health and safety to ensure that all health workers have regulatory protection of their health and safety at work. Appoint responsible officers with authority for occupational health and safety for health workers at both the national and facility levels. Develop standards, guidelines, and codes of practice on occupational health and safety. Strengthen intersectoral collaboration on health worker and patient safety, with appropriate worker and management representation, including gender, diversity and all occupational groups. Protect health workers from violence in the workplace Adopt and implement in accordance with national law, relevant policies and mechanisms to prevent and eliminate violence in the health sector. Promote a culture of zero tolerance to violence against health workers Review labour laws and other legislation, and where appropriate the introduction of specific legislation, to prevent violence against health workers. Ensure that policies and regulations are implemented effectively to prevent violence and protect health workers. Establish relevant implementation mechanisms, such ombudspersons and helplines to enable free and confidential reporting and support for any health worker facing violence. Improve mental health and psychological well-being: Establish policies to ensure appropriate and fair duration of deployments, working hours, rest break and minimizing the administrative burden on health workers. Define and maintain appropriate safe staffing levels within health care facilities. Provide indemnity and insurance coverage for work-related risk, especially those working in high-risk areas. Establish a ‘blame-free’ and just working culture through open communication and including legal and administrative protection from punitive action on reporting adverse safety events. Provide access to mental well-being and social support services for health workers, including advice on work-life balance and risk assessment and mitigation. Protect health workers from physical and biological hazards Ensure the implementation of minimum patient safety, infection prevention and control, and occupational safety standards in all health care facilities across the health system. Ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, in adequate quantity and appropriate fit and of acceptable quality. Ensure an adequate, locally held, buffer stock of PPE. Ensure adequate training on the appropriate use of PPE and safety precautions. Ensure adequate environmental services such as water, sanitation and hygiene, disinfection and adequate ventilation at all health care facilities. Ensure vaccination of all health workers at risk against all vaccine-preventable infections, including Hepatitis B and seasonal influenza, in accordance with the national immunization policy, and in the context of emergency response, priority access for health workers to newly licenced and available vaccines. Provide adequate resources to prevent health workers from injuries, and harmful exposure to chemicals and radiations; provide functioning and ergonomically designed equipment and work stations to minimize musculoskeletal injuries and falls.

Key points from the survey A safety culture is critical for the protection of staff and patients. Psychological Safety for healthcare workers is an essential requirement of all safe health systems People (patient & health worker) safety is inherent in healthcare and Coproduction is the foundation of all initiatives. Measurement of what works well is essential so that there can be learning at all levels. Reporting of clinical incidents is a vital part of learning and needs to be undertaken within a just culture which is blame-free, with clear accountability. The COVID-19 pandemic revealed experiences of good practice and areas where health services need to improve, particularly in the protection of staff and looking after their mental wellbeing. Crisis management is a critical part of health services management. Managing the flow of people through the service is important to control infection.

A transcript of the interview is available below.

In this blog, Patient Safety Learning make the case that staff safety is intrinsically linked to patient safety. It sets out how the six foundations for safer care from the report, A Blueprint for Action, can be used to consider how making improvements to staff safety complements patient safety.[1] It looks in more detail at four key aspects of staff safety and how these areas are intertwined with improving patient safety: Physical safety – considering how the Covid-19 pandemic has highlighted the importance of this in ensuring patient and staff safety is not jeopardised. Safe staffing levels – outlining the importance of this to protect the welfare of staff and avoid creating conditions in which patient safety incidents are more likely to occur. Psychological safety – setting out the importance of having organisational cultures that enable staff to feel secure in speaking up about incidents of unsafe care, ensuring that opportunities for learning and innovation are not shut down by a blame culture. Support to staff after patient safety incidents – highlighting the key role that providing emotional support to health and social care staff who are involved in patient safety incidents can play in fostering an environment of openness and learning. It concludes by setting out the activities Patient Safety Learning will undertake over the course of September to raise awareness of, and promote action for, staff safety. References: 1. Patient Safety Learning, The Patient-Safe Future: A Blueprint for Action, 2019.

The accompanying visual graphic is designed to be posted for staff to see and use daily, and for team leaders to reference and use to create the enabling conditions for key recommendations to be successful. Follow the link below to download the resources.

Key points A robust safety culture is the combination of attitudes and behaviours that best manages the inevitable dangers created when humans work in complex environments. Great leaders know how to wield attitudinal and behavioural norms to best protect against these risks. These include: psychological safety – that is, an environment where no one is hesitant to voice a concern and caregivers know that they will be treated with respect when they do) organisational fairness – where caregivers know that they are accountable for being capable, conscientious and not engaging in unsafe behaviour, but are not held accountable for system failures a learning system in which engaged leaders hear patients and front-line caregivers’ concerns regarding defects that interfere with the delivery of safe care, and promote improvement to increase safety and reduce waste. Leaders are the keepers and guardians of these attitudinal norms and the learning system.