Hospital Work Hazardous to Your Health

We hear a lot about patient safety, and rightly so. We've all read the statistics that as many as 100,000 Americans die each year from preventable medical errors.

What doesn't get as much attention is healthcare worker safety, unless it's in the context of front-burner issues like the H1N1 influenza pandemic, or the spate of recent and unrelated assaults at Boston area healthcare facilities.

The fact is that working at a hospital can be hazardous to your health. According to the U.S. Bureau of Labor Statistics' Annual Occupational Illnesses and Injuries report, the rate of injury and illness for hospital workers was 7.6 cases per 100 full-time employees in 2008, compared with a rate of 6.3 cases per 100 FTEs among 19 million or so state and local government workers—including police and fire—and 3.9 cases per 100 FTEs in all industries across the private sector.

Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, says the data show that employee safety is a constant concern for hospitals.

"This is really about people working in a high-risk environment," Foster says. "That isn't surprising when you think about, first of all, we have very fast-paced environment. When one is working swiftly on something, the opportunity for some sort of mishap increases. Beyond that, there are a number of risks that exist in our environment. We make use of big, heavy equipment, often made of metal and other hard substances which could cause injury. We work with lots of sharps, needles, scalpels, all sorts of cutting instruments. We work in an environment where we are constantly cleaning things, and that means wet floors and other slippery environments."

Dealing with patients, of course, opens up a whole range of health risks for hospital workers, including exposure to communicable or infectious diseases, back injuries suffered while moving heavy patients, and violence. Foster says employee safety is sometimes compromised to ensure patient safety. For example, hospitals have evolved away from using restraints on violent or disruptive patients because the straps pose the risk of injury. While that creates a safer environment for the patient, it also creates a hazardous environment for the hospital worker.

"Those who work in a healthcare environment are really heroic because they do put themselves at risk just by coming into work every day," Foster says.

Jim Conway, senior vice president of the Institute for Healthcare Improvement, says too many people within healthcare believe that injuries and illness are part of the job description.

"So much of this is about poor design," he says. "What we have to do is, first of all, declare this current state to be unacceptable. Then we have to look at how we can redesign the workplace, like we did with needles and the patient care units, to reduce the chances of injury and illness from happening."

Conway says hospitals should consider workplace safety in the context of efficiencies. "If you drive out the things that are causing people to hurt themselves, then you are probably driving out poor processes and driving out things that don't add value," he says.

The spike in bariatric procedures provides an excellent example of how procedures can be re-examined to make the transfer of heavy patients safer for healthcare employees.

"With appropriate training and equipment, patients can be transferred very safely from beds to wheelchairs or beds to stretchers, from stretchers to X-ray machines, if you have the right training, equipment, and the right number of staff," Conway says. "But if you miss any of those, there is a much higher chance that the employee is at risk of harm."

Hospitals are high-risk environments. Given the vitally important nature of the job, that risk will never be completely eradicated. That should heighten our respect and appreciation for the work of healthcare professionals. That doesn't mean that we must accept that their workplace cannot be made safer. We owe it to them.