Improving Healthcare Workforce and Patient Safety: A Scoping Meta-Review

Abstract

Background:

Despite recognition of the integral relationship between healthcare worker (HCW) safety and patient safety, few studies have evaluated practices that improve safety for both groups. We undertook a scoping meta-review including only systematic reviews (SRs) to determine the extent to which existing literature identifies practices likely to benefit both HCW safety/well-being and patient safety and remaining research questions.

Methods:

Literature searches were conducted for SRs and meta-analyses from 2011 to 2020 that reported outcome measures related to improving HCW safety/well-being or organizational safety culture as well as patient safety. After multi-stage screening, studies were classified as relationship/association or focused on a specific practice. Among practice-focused, those that found positive outcomes for both HCW/organizations and patients were considered potentially promising practices. Information was extracted on topic area, interventions, care settings, HCW type, outcomes measured and improvements.

Findings:

Of 1,619 abstracts, 114 reviews met all inclusion criteria. Major topic groups were Worker Safety/Well-being (n = 33), Operational Practices (n = 34), Organization Safety Culture (n = 24), and Patient Safety/Quality (n = 23). Of 78 reviews addressing specific practices, 48 described practices likely to benefit both groups. Practices/interventions targeting how work is organized were most promising (subtopics staffing/human resources; structure, policies/procedures; human factors engineering). Practices addressing teamwork and engagement suggest opportunities to enhance safety climate.

Conclusions/Application to Practice:

A wide range of practices and topic areas may directly and/or indirectly improve safety for both HCWs/organizations and patients, suggesting an integrated approach to examining interventions and operational practices. Occupational health/safety and patient safety leaders should consider collaborating to implement promising practices.