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This resource is intended to help leaders guide conversations with colleagues to: Provide and elicit needed information and problem-solving to ensure staff well-being and the best care possible Use this time during the COVID-19 pandemic to break unnecessary rules and build more robust systems Tap into creative solutions identified by staff for both immediate needs and in an ongoing way Promote joy in work through healthy relationships and environments that support teams and personal growth while diminishing, as much as possible, current and future stress In using this guide, leaders are encouraged to use any opportunity to frequently communicate with team members — using brief in-person huddles, electronic methods, or other approaches — to promote staff well-being.

Key findings The survey results point to conclusions that seem to be equally applicable across different regions. Health workers in all countries need sufficient education and awareness to recognise and report workplace hazards. Workplace cultures must be improved to mandate appropriate reporting of hazards and to improve safety practices and especially to eliminate preventable bullying and harassment that can be intensified during an organisationally destabilising pandemic experience. The global health worker job market is very mobile like COVID-19, so lessons learned in one country or region must be translated to others. Economic classification, region, occupation and sex all play key roles in health worker’s perception of health and safety risk and mitigation measures in the workplace. Despite significant results across different demographic measures, the overall consensus of participants was clear. In spite of calls to action by the international community, risks to healthcare workers remain and mitigation measures are insufficient or in some cases nonexistent. These issues will continue to haunt the healthcare sector and will continue to exacerbate staff shortages globally. In the face of COVID-19 and its impacts on workplaces, it is also another reminder to the global health community to help those countries in need.

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.

The National Action Plan centres on four foundational and interdependent areas, prioritised as essential to create total systems safety, with 17 recommendations to advance patient safety. Culture, Leadership, and Governance 1. Ensure safety is a demonstrated core value. 2. Assess capabilities and commit resources to advance safety. 3. Widely share information about safety to promote transparency. 4. Implement competency-based governance and leadership. Patient and family engagement 5. Establish competencies for all healthcare professionals for the engagement of patients, families, and care partners. 6. Engage patients, families, and care partners in the co-production of care. 7. Include patients, families, and care partners in leadership, governance, and safety and improvement efforts. 8. Ensure equitable engagement for all patients, families, and care partners. 9. Promote a culture of trust and respect for patients, families, and care partners. Workforce safety 10. Implement a systems approach to workforce safety. 11. Assume accountability for physical and psychological safety and a healthy work environment that fosters the joy of the health care workforce. 12. Develop, resource, and execute on priority programmes that equitably foster workforce safety. Learning system 13. Facilitate both intra- and inter-organisational learning. 14. Accelerate the development of the best possible safety learning networks. 15. Initiate and develop systems to facilitate interprofessional education and training on safety. 16. Develop shared goals for safety across the continuum of care. 17. Expedite industry-wide coordination, collaboration, and cooperation on safety.

A transcript of the interview is available below.