Improving the Work Life of our Workforce Jim Rawson, MD, FACR - - PowerPoint PPT Presentation

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Improving the Work Life of our Workforce Jim Rawson, MD, FACR - - PowerPoint PPT Presentation

Apr 10, 2024 385 likes •682 views

Improving the Work Life of our Workforce Jim Rawson, MD, FACR jrawson@augusta.edu @Jim_Rawson_MD P.L., J. Luther and Ada Warren Professor Chair, Radiology and Imaging Medical College of Georgia Hull College of Business Triple to

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Improving the Work Life of our Workforce

Jim Rawson, MD, FACR jrawson@augusta.edu @Jim_Rawson_MD P.L., J. Luther and Ada Warren Professor Chair, Radiology and Imaging Medical College of Georgia Hull College of Business

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Triple to Quadruple AIM

  • Bodenheimer and Sinsky proposed adding 4th aim
  • Improving the work life of health care providers,

including clinicians and staff Ann Fam Med 2014;12:573-576.

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Baldrige Performance Excellence

  • Malcolm Baldrige National Quality Award (MBNQA) is

presented annually by the President of the United States

  • 7 Categories-one is workforce
  • 17 Item requirements-3 are workforce related
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Workforce environment and engagement

  • Safety
  • Abuse
  • Employee Satisfaction/Engagement
  • Stress/Burnout
  • Mindfullness/Resilience
  • Joy at work
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Employee Safety

  • Healthcare had 575,000 injuries (2014)
  • Manufacturing had 440,500 injuries (2014)
  • Construction had 196,300 injuries (2014)
  • U.S. Bureau of Labor Statistics, 2015
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“…more hazardous to work in a hospital than in construction or manufacturing”

https://www.osha.gov/dsg/hospitals/documents/1.1_ Data_highlights_508.pdf

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Safety and Cost

  • Cost of injured employee
  • Personnel budget as percent of operating expenses
  • Absenteeism
  • Working at less than full capacity or capability
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Hospital Worker Safety

  • Spectrum Health, Michigan
  • 2,000 Reported injuries
  • 4,700 Lost Days
  • 10,700 Restricted Days
  • 31% due to patient handling

Danielle Larson-Jaramillo, SHS 2017

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ROI on Safety

  • Direct costs of injuries
  • Indirect costs are 4-20 x Direct Costs
  • https://www.osha.gov/dcsp/smallbusiness/safetypays/in

dex.html

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Workplace Abuse

  • Workplace violence
  • Bullying
  • Discrimination
  • Physical Abuse
  • Sexual Harassment
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Incidence and Cost of Nurse Workplace Violence by hospital patients/vistors

  • N=762 RN surveyed about workplace violence in past year
  • Verbal abuse by patients, 54.2%
  • Physical abuse by patients, 29.9%;
  • Verbal abuse by visitors, 32.9%;
  • Physical abuse by visitors, 3.5%
  • Annual workplace violence charges for the 2.1% of nurses

reporting injuries were $94,156 (Retrospective database review)

Speroni J Emerg Nurs 2014;40:218-28

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Cost of ONE disruptive physician

  • 400 bed hospital
  • $1 million annually
  • Based on staff turn-over, medication errors and

procedural errors

Rawson JV, Thomson N, Sostre G, Deitte L, The Cost of Disruptive and Unprofessional Behaviors in Health Care, Academic Radiology 20 (9) 1074-1076

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Cost of staff turnover?

  • 1.5-2x salary of employee
  • Staff retention vs staff recruitment

Porath C, Pearson C. The cost of bad behavior. New York: Penguin Group, 2009

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  • Just Culture is not a blameless culture
  • Human error-console
  • At-risk behavior-coach
  • Reckless behavior-punish

Just Culture vs Culture of Blame

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Employee Satisfaction and Engagement

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Gallup Employee Engagement 2014

http://www.gallup.com/poll/181289/majority- employees-not-engaged-despite-gains-2014.aspx

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  • 12 core employee engagement items
  • Five show a consistently strong relationship to inpatient

satisfaction

http://www.gallup.com/poll/8650/engagement- unlocks-patient-satisfaction-potential.aspx

Employee engagement = key driver

  • f patient satisfaction
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  • I have the materials and equipment to do my job right.
  • At work, I have the opportunity to do what I do best

every day.

  • The mission or purpose of my organization makes me

feel my job is important.

  • My associates or fellow employees are committed to

doing quality work.

  • This last year, I have had opportunities at work to learn

and grow.

http://www.gallup.com/poll/8650/engagement- unlocks-patient-satisfaction-potential.aspx

Employee engagement

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Burnout

  • Stress: over-engagement
  • Burnout: disengagement
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Physician

  • >50% physicians at least 1 symptom of burnout
  • <30% general population at least 1 symptom of burnout
  • 10% increase in prevalence of burnout in US physicians

between 2011 and 2014 while prevalence in general population was stable

Mayo Clin Proc. 2015;90(12):1600-1613

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Burnout

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Burnout in Medical Students

  • 1354 of 2566 medical students surveyed had burnout
  • 52.8% had burnout
  • JAMA. 2010;304:1173–1180.
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Mindfulness

  • Opposite of mindlessness

“Paying attention; On purpose, in the present moment, and non-judgmentally.” Jon Kabat Zinn

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Resilience

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Joy in Work

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What gets measured…

  • Gets managed
  • Employee injuries
  • Absenteeism
  • Employee satisfaction
  • Employee engagement
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Summary

  • People are our greatest asset
  • Opportunities to improve workplace environment on

many dimensions

  • Linked to lower cost, improved quality, improved

patient satisfaction

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Thank you

jrawson@augusta.edu @Jim_Rawson_MD