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Impact of Employee Engagement on Patient Safety

Abstract

  • Background: Health service administrators are exploring ways to improve health service safety and quality.
  • Objective: Review the literature on the impact of employee engagement on patient safety.
  • Methods: Peer-reviewed literature review (Jan 2015 - May 2021) using databases like CINAHL, Medline Complete, Scopus, etc.
  • Results: 15 studies were included; a positive correlation exists between employee engagement and patient safety, with varying strength.
  • Conclusion: Improving employee engagement and patient safety is evident, but research is in early stages; evidence may help manage post-COVID-19 fallout.

Introduction

  • Public expects safe & high-quality health services.
  • Employee engagement: staff are physically, mentally, and emotionally connected to work.
  • Kahn’s model: employee engagement depends on meaningfulness, safety, and availability.
  • Healthcare: staff engagement refers to joy and meaning in work; staff must perceive work as safe with adequate resources.
  • Positive relationship exists between staff engagement and care quality.
  • 'Triple Aim' (improve patient experience, improve population health, reduce costs) has shifted to 'Quadruple Aim' (improve work life of healthcare workers).
  • COVID-19 pandemic affected healthcare staff’s engagement, impacting patient safety.

Aim

  • Review addresses these questions:
    1. What are the indicators of employee engagement and how are they measured?
    2. Which patient safety outcomes are addressed and how are they measured?
    3. What is the impact of employee engagement on these outcomes?

Methods

  • Literature review of medical and business sources regarding employee engagement and patient safety.
  • Databases: CINAHL, Medline Complete, Scopus, Health Business Elite, Business Source Ultimate (English, Jan 2015 - May 2021).
  • Search strategy: keywords for hospital/healthcare setting, employee engagement, and patient safety combined with the AND Boolean operator.
  • Inclusion criteria: empirical research, engagement as a predictor, patient safety measure.
  • Exclusion criteria: engagement as an outcome.
  • Thematic analysis applied to identify themes.

Results

  • Employee engagement is measured using tools like the Utrecht Work Engagement Scale (UWES).
  • UWES assesses vigor, dedication, and absorption.
  • Other tools: Gallup Q12, SCORE survey, Spreitzer empowerment tool.
  • Patient safety indicators include:
    • Objective measures: incidence of large-scale adverse events (LSAEs), 7-day mortality, frequency of medical errors.
    • Staff perceptions: Safety Attitudes Questionnaire (SAQ), Hospital Survey of Patient Safety Culture (HSOPSC), SERVQUAL scale.
  • Positive association between employee engagement and patient safety exists, but the strength varies.
  • Engagement can have a 'protective role', improving patient safety indicators like LSAEs and mortality.

Discussion

Indicators of Employee Engagement
  • Organizational and individual resources influence employee engagement.
    • Resources include job characteristics, culture, staffing levels, personal resilience.
Relationship Between Engagement and Safety
  • The exact nature of the relationship between engagement and safety has not been quantified.
  • Stronger patient safety culture may lead to more engaged employees.
Staff Heterogeneity
  • Staff heterogeneity impacts the generalizability of findings.
  • Differences in work groups (physicians, nurses, admin) affect engagement.
  • Strategies to affect employee engagement may need to be tailored.

Implications and Conclusion

  • More methodologically rigorous research is needed.
  • Use validated, objective tools for measuring engagement and safety.
  • Explore qualitative and quantitative impacts.
  • Investigate the relationship within the Australian healthcare system.
  • High-quality evidence regarding the definitive impact of employee engagement on patient safety remains in its early stages.
  • Further investigation is warranted to identify potential resource investment areas.