Archive for the ‘Resiliency’ Category

Review of “Do Strikes Kill?”

In I-O Psychology, Patient Safety, Resiliency, Safety climate on May 6, 2011 at 9:25 am

Healthcare workers have had the right to strike since 1974. By 2008 there were over one million hospital union workers.  While other industries had declining union memberships, hospital employees’ unionization is growing (Gruber & Kleiner, 2010).

Do Strikes Kill is the provocative title of a working paper by Jonathan Gruber and Sam Kleiner (MIT and Carnegie Mellon).

All hospital employees are imperative to providing safety in a hospital environment, but the authors looked at nurses in particular. They cite Kruger & Metzger (2002) when they describe that nurses function as “the surveillance system of hospitals for detection and intervention when patients deteriorate, and are viewed by many patients as more important to their total recuperation process than their own attending.”  Another CEO was quoted as describing nurses as “the heart and soul of a hospital” (Gruber & Kleiner, 2010).

Given this integral role for nursing, the authors sought to determine the impact on safety and quality in the events of nursing work stoppages. They looked at data over a 20 year period in New York State.  For patients admitted to hospitals during a nursing strike, the authors found MORTALITY increased by 19.4% and readmissions within 30 days increased by 6.5%.

I recommend purchasing this relevant study for $5 at the National Bureau of Economic Research website:

To understand the safety implications for your own institutions, it is important to look at the details of this study and not just the overall results.

At one time, Industrial-Organizational psychologists were employed as union “avoidance consultants.”  They had success through improving the work environment for employees.  While labor lawyers can be a resource for a hospital in interpreting labor laws, an Industrial-Organizational Psychologist can combine theory and practice to improve culture, employee satisfaction, teamwork, front line empowerment, training, leadership approaches and development, quality and many other workplace happiness indicators.  It’s the right thing to do but also Happy Employees aren’t likely to strike.


Learning vs Punishment & Accountability & alittle EBMgt

In hospital, Patient Safety, Resiliency on December 18, 2010 at 9:14 am

I cringe whenever I start hearing the words “employee accountability” for traditionally this refers to a way to blame individuals rather than have a management team or organization take responsibly for the conditions under which an employee has to do their job. Employees must have autonomy to have accountability..strict adherence to scripting or hospital polices is not the definition of accountability. In fact, when a union wants to slow down production in an organization, one tactic is to advise workers to “follow policy to the letter.”
I am constantly searching for blogs who say this in different ways to make the case for this concept as far reaching as possible. These are words from a blog by Jeffrey Pfeffer who an Evidenced Based Management Proponent. He makes… Read the rest of this entry »

Usability and Safety

In ergonomics, Human Factors, Patient Safety, Resiliency, safety on November 24, 2010 at 2:13 pm

* please watch video at the end of this post*
In reading articles and other literature on safety one will find recommendations based on their strength of effectiveness.
Here is a chart from an article by Stevens, Urmson, Campbell and Damignani (2010):

How it works: A simple safety intervention in a hospital is to have everyone wearing visible picture IDs. Problem: the IDs keep flipping over hiding the face and name of the employee. Solutions from least effective to most effective:

  • put a warning on the non-picture side that says “this side faces in” (safety still depends on human action)
  • train the employees to remember to periodically check to ensure their badge is facing out (safety depends on human memory)
  • put the picture on BOTH sides of the badge so the flipping over does not compromise the safety system (safety achieved from designing forced function!)

We tend to rely too much on training and memory: read more Read the rest of this entry »

Enhancing resilience: Medication Error Recovery

In human error, Human Factors, Resiliency on November 13, 2010 at 5:48 pm

Read the rest of this entry »

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