Workforce Safety Panel: Empowering and Supporting Occupational Health Nurses

Added on Apr 18, 2019

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While every member of the workforce shares the responsibility of supporting and sustaining a safety culture to protect patients and each other, as observed in last month’s workforce safety blog post, the delivery of health and safety programs and services to employees is the main priority of occupational health nurses. These advanced practices nurses are most effective in their roles when they are empowered by leadership and supported by a collaborative, aligned workforce.

High Reliability Organizations (HROs) achieve this cultural alignment by communicating the expectation that all staff should be prepared to identify and address unsafe behaviors and processes, establishing non-punitive systems for reporting and analyzing serious safety events, and creating interdisciplinary safety programs that nurture communication and trust.

To help hospitals and health care organizations on a High Reliability journey facilitate alignment among their workforces, we asked the panel of Press Ganey experts[1] to provide strategies for bridging the gaps in team coordination, particularly between occupational health nurses and other members of the workforce.

Q: How can occupational health nurses’ efforts be supported by other roles?

Rob Douglass: Health care organizations must empower local managers to own apparent and root cause analysis and action plan development, not as check-the-box exercises at the end of the day but as mission-critical responsibilities. Doing so will not only support occupational health nurses, it will shift the perception of event analysis and action planning from collateral duties to essential objectives for solving issues that lead to preventable harm and serious safety events.

Julie Samuelson: Collaboration between local managers and occupational health nurses—and among all staff—is essential to the delivery of safe, reliable care. In an HRO, everyone is accountable for safety. The commitment starts at the top with leadership and cuts across every level of the organization. Once engaged, staff must be provided the appropriate resources and development opportunities to become effective members in the safety culture. For example, we know it is important that occupational health nurses be visible and proactive in reducing harm, but it’s not enough to just say that. There may be opportunities to redesign the role to better support them as active and successful safety culture leaders on the front line

Don Goble: In my experience, occupational health nurses are key to evaluating and categorizing workforce injuries, providing injury case management, and following up with employees, while operational leaders focus on hazard recognition, risk mitigation and elimination, and culture change to reduce the likelihood of injuries. Should an injury occur, it is imperative for these leaders to partner with occupational health nurses to ensure the injury is treated in a timely manner, documented appropriately, investigated accurately, and that hazards are addressed. When operational leaders are proactive and emulate safety as a core value, workforce safety drastically improves. That is how hospitals and health care systems progress to High Reliability.

Donna Cheek: Making workforce safety a core organizational value is a strategic imperative. If a hospital participates in safety stand-downs for patient falls, then it should support occupational health nurses and all staff to do the same for workforce injuries. If huddles and learning boards are an established practice across departments, then the organization must encourage and support front-line workers to bring forward any workforce injuries or vulnerable situations so that they can be involved in the design and execution of improvement efforts. Many providers across an organization, from occupational health nurses to administrative staff, can be safety officers but it’s up to leadership to establish and communicate it as an expectation.

This is Part VI 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 V explored ways in which measurement and reporting can inform and inspire every member of the workforce to reduce harm. Part VII will conclude the series with reflections and advice from the panelists to those considering the commitment to a highly reliable workforce.

[1] Panelists from Press Ganey’s Strategic Consulting division 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, Strategic Consulting partner, contributed.