The link between overworked nurses and patient safety has been well established[i],[ii], but there are other safety factors that aren’t talked about as much even though they should be. In industries where overtime is a factor, workplace safety issues are a major concern.
Regardless of industry, jobs with overtime schedules lead to workplace injury hazard rates that are as high as 61% when compared to jobs that don’t operate with overtime schedules[iii]. In fact, simply working as much as 12 hours in a single day leads to a 37% increase in injury rates[iv]. For those of us who work in healthcare these numbers should be cause for concern.
Industry-wide about 50% of full-time nurses work overtime[v], which means their exposure to injury risk is increased. As an industry, healthcare experiences higher injury rates than others. We work in an always-open environment and the work is often physically challenging. In fact, the rate of injury in healthcare is actually two times greater than normal. For an average hospital the cost of nurse injuries can easily climb to $440,000 annually[vi].
However, beyond the tangible cost and impact to the budget there are other costs that should be equally concerning. Nursing assistant injuries have been associated with lower employee satisfaction, increased desire to quit, and a decreased likelihood of recommending the facility for either treatment or as employer[vii]. In an accountable-care business model where financial and clinical metrics are linked to success, employee satisfaction creates a trickle down impact on several factors, including quality care and patient satisfaction.
When overtime is increasingly becoming the rule and not the exception, we need to step back and rethink how we optimize our workforce to ensure employee safety, patient safety and the health of the organization’s bottom line. To learn more, read the white paper, “Adding It Up – Accounting for the Transformational Power of an Optimized Workforce.”
[i]Linda Scott, et al. Effects of Critical Care Nurses’ Work Hours on Vigilance and Patients’ Safety. American Journal of Critical Care. January 2006,
Volume 15, No. 1: 30-37.
[ii]Danielle Olds and Sean Clarke, The Effect of Work Hours on Adverse Events and Errors in Health Care. J Safety Res. 2010 April ; 41(2): 153–162.
[iii] Occup Environ Med. “The Impact of overtime and long work hours on occupational injuries and illnesses: new evidence from the United States. 2005;62:588-597″ Accessed July 10, 2014.
[v]Bae, Sung-Heui. “Nursing Overtime: Why, How Much, and Under What Working Conditions?” Nursing Economics, 30, no 2 (March/April 2012): pg. 64.
[vi]Sage Growth Partners Analysis.
[vii]McCaughey, Deirdre, et al. The relationship of positive work environments and workplace injury: Evidence from the National Nursing Assistant Survey. Health Care Management Review. 39(1):75-88.
Over the nearly 20 years I’ve worked at API Healthcare, I’ve had the lucky opportunity to talk with many, many clients about their challenges and successes with workforce management. It seems that each of our clients has a unique story. They are so savvy, thinking about new ways to manage and navigate as the healthcare industry undergoes monumental changes.
That’s certainly true for the team at Mary Washington Healthcare. They have been proactive, recognizing that they needed to focus on making operational changes to address the changing dynamics in healthcare. They created several ‘Affordable Healthcare Initiatives’ to look at the workforce and identify how to do things differently without sacrificing quality.
On the front line of those changes is Meg Pemberton, Director of Capacity Management at Mary Washington Healthcare. I initially tracked Meg down at the API Healthcare User Group Conference because I was intrigued by her job title. It turns out that the efforts that Meg has been a part of are just as fascinating as her title.
The workforce management initiative at Mary Washington has been focused on providing data transparency so that they can make better staffing decisions, for both their clinical staff and then looking beyond to non-clinical staff as well. They’ve broken down silos so that they can staff better across their entire organization.
Meg sums up their results, explaining, “We now have insight into the complete skill mix of available staff across both hospitals and the freestanding emergency department, something we didn’t have before. As a result we are able to better match qualified staff with patient needs, and we can better prioritize available internal resources instead of utilizing premium external labor.”
You can learn more about Mary Washington Healthcare’s workforce management initiatives by reading their case study.