Workforce Safety Panel: A Data-Driven Approach to Reducing Workforce Injuries

Added on Mar 20, 2019

By Andrea Fitzgerald, Staff Writer

teamwork (1)Hospitals and health care systems must adopt a proactive approach to workforce injury prevention to become High Reliability Organizations (HROs), said a panel of Press Ganey experts[1] during a recent roundtable discussion on workforce safety.

Incorporating predictive analytics into the organization’s data strategy, in addition to lagging indicators, is an important first step on this transformational journey. Whereas the latter provides key insights into the frequency, severity, and financial impact of workplace injuries, predictive analytics are essential ​for identifying risk and intervention techniques. Combined, they can uncover trends and root causes of workforce injuries that enable organizational leadership to predict where and when injuries are likely to occur and develop strategies to prevent them.

However, even the best injury prevention program will be ineffective if employees are not empowered to work safely. As discussed in last month’s post, shifting from a reactive to a proactive prevention approach to employee harm requires that every member of the workforce, from the CEO to front-line staff, understands their role in achieving Zero Harm.

To help create and sustain such a top-down commitment, we asked the group to identify ways in which measurement and reporting can inform and inspire every worker to reduce harm.

Q: How can health care organizations use data, such as Total Case Incidence Rate (TCIR) and Days Away, Restricted or Transferred (DART), to prevent and reduce the significance of workplace injuries?

Donna Cheek: Health care organizations face a tremendous opportunity to be transparent with their data, including how their TCIR and DART measures compare to both the national rates and other industries. Education will be a vital component of this transparency journey. The workforce must first understand what these data represent before they can begin to decrease the disparities between health care and other high-risk industries like nuclear power and aviation. Doing so will require sharing how workforce injuries have occurred within an organization, and personalizing them to make them more than a number or graph. High-impact tools include training videos featuring employees who have sustained permanent injuries from unsafe behaviors. For example, an ED nurse who sustained a long-term patient handling injury may participate in a training video emphasizing the importance of using patient lift equipment. Once workers see the “faces” of injury, the focus shifts from understanding the data to acting on it to prevent similar injuries in the future.

Don Goble: It is critical that health care organizations compare their data to the national rates and to other industries, as Donna mentioned, as well as to peer organizations. I would also urge organizations to look for trends in their own historical data. If your organization’s TCIR and DART metrics are below the national health care rates, that’s great, but the assessment shouldn’t end there. If your rates have been trending upward for the past few years, or if they are above those of an HRO, then there is still work to be done. Additionally, organizations must understand that these data are not the full story. I think our industry misses improvement opportunities by limiting our focus to serious harm. Some behaviors and unsafe practices contributing to near misses, first aid cases, and other minor events are the same ones contributing to serious safety events. If we started measuring, reporting, and proactively addressing those behaviors, we could prevent more serious events in the workplace.

Rob Douglass: To continue to fill those gaps in the story that worker injury data provide, organizations should review incident rates of individual hospitals and clinics, because performance and accountability vary across a system. Taking these deeper dives into the data will help empower leaders at each facility with a sense of ownership of their team’s workforce safety performance. This will not only personalize reports and root cause analyses of workforce injuries, as Donna mentioned, but will also help transform an organization’s reporting culture from one of data gathering to action planning. The mentality should not be “What’s the number? Next…” It should be “What are the behavior- and system-based corrective actions to protect my workforce moving forward?”

Julie Samuelson: Organizations that continue to drill down to individual service lines and units will be able to tailor improvement opportunities to particular areas of the workplace with higher incident rates and, conversely, to identify high-performing units for others to emulate. Another piece of the story that workforce safety metrics don’t capture is emotional and psychological safety. Like most labor statistics, TCIR and DART measure events where physical harm occurred—and to such a severe degree that employees were unable to work. Not only should we expand the scope of safety culture assessments to include the near misses and first aid cases that Don mentioned, we should also be thinking of ways to include incidents of verbal abuse, intimidation, other threatening behaviors, and workplace stress. For example, how are we assessing and protecting the psychological safety of labor and delivery nurses whose patients experience a fetal loss? Or that of hospice workers? I could go on, since every health care worker experiences emotional and physical distress. It’s inevitable, because health care provides a very different type of service than hospitality and other industries. But that doesn’t mean leaders can’t help alleviate or manage the impact on their workers.

This is Part V in a seven-part series on making the health care workplace a safe and highly reliable environment for patients and caregivers. Part I identified deficiencies in data, education, and investments in workforce safety as top obstacles for health care organizations to overcome on their journey to Zero Harm. Part II provided insights into the possible detractions from reporting or speaking up about unsafe practices resulting in errors and harm. Part III honed in on information that executives need in order to advance workplace safety and the pursuit of a fair and just culture. Part IV took a closer look at the CEO’s role in an organization’s High Reliability journey. Part VI explores the ways leaders can support and empower occupational nursing staff to sustain the organization’s safety culture. Part VII will conclude the series with reflections and advice from the panelists to those in health care considering the commitment to a highly reliable workforce.


[1] Panelists from Press Ganey’s Transformational Advisory Services include Donna Cheek, a safety expert with more than four decades of health care experience in multiple executive and nurse executive roles; Rob Douglass, a safety expert and former commanding officer with 30 years of experience in the nuclear naval and commercial energy industries; Don Goble, a safety expert with more than 35 years of experience in naval and commercial nuclear power; and Julie Samuelson, RN, a patient experience expert with more than 40 years of experience in health care across a range of settings. Christy Dempsey, chief nursing officer and president of Clinical Excellence Solutions, moderated the discussion, and Craig Clapper, Transformational Advisory Services partner, contributed.