A new Declaration of Principles by 10 healthcare organizations calls for actions to safeguard the emotional, psychological, and physical safety of staff.
A group of healthcare organization CEOs recently adopted a Declaration of Principles to improve the safety of healthcare workers.
Healthcare settings pose several safety concerns for caregivers and other staff members. The dangers include emotional and psychological harm, hazards such as contaminated sharp objects, and workplace violence.
The CEO Coalition's Declaration of Principles focuses on three areas of healthcare worker safety. The CEO Coalition features the top executives at 10 healthcare organizations, including Cleveland Clinic, Henry Ford Health System, SSM Health, and UCLA Hospital System.
1. Safeguarding psychological and emotional safety:
- Investing in processes and technologies that reduce emotional and cognitive burdens on team members and restore human connection to the healthcare experience.
- Creating practices and policies that advance open communication between team members and leaders, so people feel safe to speak up and bring their full selves to work.
- Providing resources to assess and support team members' emotional, social, and spiritual health, and alleviating the stigma and deterrents to seek support.
2. Promoting health justice:
- Declaring equity and anti-racism core components of safety, and requiring explicit organizational and health equity-focused policies and practices to advance diversity, inclusion, and belonging.
3. Ensuring physical safety:
- Implementing a zero-harm program for care team members to eliminate workplace violence, both physical and verbal, whether from colleagues, patients, families, or community members.
- Ensuring that all healthcare organizations can procure and provide evidence-based personal protective equipment, technology, tools, and processes that healthcare team members need to do their jobs safely and care for patients.
Committed to healthcare worker safety
CEO Coalition member A. Marc Harrison, MD, president and CEO of Salt Lake City, Utah-based Intermountain Healthcare, says the Declaration of Principles elevates healthcare worker safety to the same plain as patient safety.
"We have talked about patient safety for a long time. But it seemed like we were not putting the safety of these amazing, heroic people who deliver healthcare on equal footing. One is not better than another; but healthcare workers are all human beings, and they deserve to be safe as well," he says.
The coronavirus pandemic spurred the CEO Coalition to action, Harrison says. "Intermountain has had five staff members die of COVID—not all of them got the virus at work. But I have never seen such a focus on caregiver safety out of necessity based on the challenges posed by the pandemic, particularly in the phase when we did not understand much about the virus. The Declaration of Principles is a natural offshoot of the concern that we felt about the pandemic."
Harrison, who is a pediatric ICU physician, cited a personal experience related to psychological and emotional safety.
"I am still haunted by a day in Syracuse, New York, when I was a young ICU attending physician and I attempted to resuscitate four little African American girls in an emergency department who all had died from smoke inhalation. We were unsuccessful at resuscitating every single one of them. I heard their mother's screams. If that does not affect your psychological wellbeing, I do not know what would. These kinds of experiences happen thousands of times a day across the United States. Historically, healthcare workers have been asked just to buck up. Now, we are smarter," he says.
Equity and racism are linked to healthcare worker safety, Harrison says. "We know there are huge inequities for the people we serve, and we know there are inequities for the people who are doing the serving."
He cited an example of how a racist incident at Intermountain impacted the physical and emotional safety of a nurse. "We had a Black nurse called the N-word by a gang member in one of our emergency departments. First, she felt physically unsafe. Second, she was emotionally traumatized by the experience. So, there are both physical and emotional parts to this puzzle," he says.
Workplace violence is a primary healthcare worker safety concern, Harrison says.
"We have seen workplace violence spike with the substance abuse crisis and the behavioral health tidal wave associated with the pandemic. Those are probably our greatest correlates to physical safety issues—whether people are getting punched, kicked, scratched, or spit upon. We report on this every day in our tiered huddles, and we have made huge progress with lots of tactics. But workplace violence against healthcare workers is a fact of life across the United States in emergency departments and behavioral health units in particular."
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Safeguarding the emotional and psychological health of healthcare workers includes investing in processes and technologies that reduce emotional and cognitive burdens.
The CEO Coalition has linked equity and racism to healthcare worker safety.
Ensuring physical safety of healthcare workers includes addressing workplace violence.