What Do Workforce Issues Have What Do Workforce Issues Have To Do With Patient Safety? To Do With Patient Safety?

Can You Help Control Some Health Care Costs Can You Help Control Some Health Care Costs by Improving Patient Safety?by Improving Patient Safety?

Ed Salsberg, M.P.A.Ed Salsberg, M.P.A.Executive Director Executive Director

Center For Health Workforce Center For Health Workforce StudiesStudies

School of Public HealthSchool of Public Health

Univeristy of Albany,-SUNY Univeristy of Albany,-SUNY

Rensselaer, NYRensselaer, NY

The Health Workforce: The Health Workforce: A Basic PremiseA Basic Premise

Health workers are cornerstone of the health Health workers are cornerstone of the health care delivery systemcare delivery system

Health care system is only as good as its Health care system is only as good as its workforceworkforce

Workforce directly affects quality, cost and Workforce directly affects quality, cost and accessaccess

System wide high turnover, difficulty recruiting, System wide high turnover, difficulty recruiting, worker dissatisfaction are signs of a systemic worker dissatisfaction are signs of a systemic problemproblem

How Health Workforce Issues How Health Workforce Issues Affect Patient SafetyAffect Patient Safety

Health workforce shortagesHealth workforce shortages Basic education and trainingBasic education and training Continuing professional educationContinuing professional education Supervision and feedbackSupervision and feedback Job Satisfaction Job Satisfaction Turnover and retentionTurnover and retention Job designJob design Inadequate information systemsInadequate information systems Lack of diversityLack of diversity

Addressing Workforce Issues Addressing Workforce Issues That Impact Patient CareThat Impact Patient Care

Assure an adequate supply of workersAssure an adequate supply of workers Create a work environment responsive to the Create a work environment responsive to the

workforce: Listen to workersworkforce: Listen to workers Provide feedback to workers on their performance Provide feedback to workers on their performance Assure appropriate education and continuing educationAssure appropriate education and continuing education Design jobs to meet worker needsDesign jobs to meet worker needs Invest in information systems Invest in information systems Support for training of managers and supervisorsSupport for training of managers and supervisors

Workforce Shortages Affect Workforce Shortages Affect Many ProfessionsMany Professions

Nurses, nurse aides, home health aides, lab Nurses, nurse aides, home health aides, lab workers, rad techs, pharmacists, dentists, and workers, rad techs, pharmacists, dentists, and moremore

Hospitals; nursing homes, home health Hospitals; nursing homes, home health agenciesagencies

Urban, rural and suburban areasUrban, rural and suburban areas

How Health Workforce Shortages How Health Workforce Shortages Affect Patient SafetyAffect Patient Safety

Stress and burnoutStress and burnout Rushed care and less attention to individual Rushed care and less attention to individual

patient needspatient needs Use of temporary staff with less knowledge of Use of temporary staff with less knowledge of

facility, other staff and patientsfacility, other staff and patients Turnover and loss of expertise and knowledgeTurnover and loss of expertise and knowledge Substitution of less qualified workersSubstitution of less qualified workers

Factors Contributing to Health Factors Contributing to Health Workforce ShortagesWorkforce Shortages

Short term factorsShort term factors– Competition for workersCompetition for workers– Educational system response lagsEducational system response lags

Long Term factorsLong Term factors– Increase in demand due to aging of nation, growing wealth and new Increase in demand due to aging of nation, growing wealth and new

interventionsinterventions– Aging of workforceAging of workforce– Changing racial/ethnic mixChanging racial/ethnic mix– Career choices for womenCareer choices for women

Workplace factorsWorkplace factors– Physically and emotionally demanding workPhysically and emotionally demanding work– Non-competitive wages and benefitsNon-competitive wages and benefits– Job design, working conditions and paperworkJob design, working conditions and paperwork– Poorly trained managersPoorly trained managers

States Responses to Health States Responses to Health Worker ShortagesWorker Shortages

# of States

Task Force, Committee or Commission 46

Scholarship and/or Loan Forgiveness 45

Health Career Marketing 28

Career Ladder Development 14

Labor Dept. or Workforce Investment Act 10

Job Redesign 5

Workforce Data Collection 31

““In Our Hands-In Our Hands-How Hospital Leaders How Hospital Leaders Can Build a Thriving WorkforceCan Build a Thriving Workforce” April 2002” April 2002

Recommendations from AHA Commission on the Recommendations from AHA Commission on the Workforce for Hospitals and Health Systems Workforce for Hospitals and Health Systems

Foster Meaningful WorkFoster Meaningful Work Improve the Workplace PartnershipImprove the Workplace Partnership Broaden the BaseBroaden the Base Collaborate with OthersCollaborate with Others Build Societal SupportBuild Societal Support

Crisis as OpportunityCrisis as Opportunity

Better quality of careBetter quality of care Adequate supply of health workersAdequate supply of health workers Increased worker satisfactionIncreased worker satisfaction More effective delivery systemMore effective delivery system More cost effective careMore cost effective care Information systems that workInformation systems that work More culturally diverse workforceMore culturally diverse workforce Increased enrollment in health professions schoolsIncreased enrollment in health professions schools