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In the article Patient Safety –Worker Safety: Building a Culture of Safety to Improve Healthcare Worker and Patient Well-Being, Annalee Yassi and Tina Hancock note that: “Patient safety and access to high quality patient care are the top priorities for the healthcare system. However, according to the Canadian Adverse Events Study approximately 7.5 percent of Canada’s 2.5 million hospital patients experienced at least one adverse event in 2000 and up to 23,750 patients died as a result…Many of these events were potentially preventable.” (Healthcare Quarterly, October 2005). Yassi and Hancock’s research connects the dots between safety in the workplace, the safety of workers and patients, and workplace conditions:

by Joseline Sikorski

“Workers in high -injury rate facilities had more negative perceptions of their job demands and workload pressures than workers in low injury facilities. They were more likely to report that they did not have time to get their work done, to work safely, to find a partner, or to use a mechanical lift. Workers in high-injury rate facilities also reported more pain, more burnout, poorer personal health and less job satisfaction. Conversely, workers at facilities with low injury rates were more likely to agree that their facility had enough staff to provide good quality care and did indeed provide good to excellent care.” (Healthcare Quarterly, October 2005).

The Lucian Leape Institute at the National Patient Safety Foundation today released a report focusing on the health and safety of the health care workforce

Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care contends that patient safety is inextricably linked to health care workers’ safety and well-being because caregivers who suffer disrespect, humiliation, or physical harm are more likely to make errors or fail to follow safety practices.

“Most health care organizations have done little to support the common contention that ‘people are our most important asset.’”

Toronto Star Thu Jul 2 2015

A nurse is punched in the face by a patient. Another is kicked in the breast. One patient calls a nurse a "Nazi b---h." Another throws urine.

One man fondles his genitals in front of a hospital staffer. Another spits in a nurse's face. These are all incidents of assault that hospital staff reported in 2014 at University Health Network (UHN), according to information obtained by the Star through an Access to Information request. Over the past three years, reports of violence on hospital staff by patients and families of patients have been on the rise - in some cases doubling, according to information provided to the Star. In an email to the Star, a UHN spokesperson said the increases are probably the result of changing violent-incident reporting requirements. There are similar increases in violent incidents reported at other Toronto-area hospitals, statistics show.

Publication date: Fri, 2015-07-24

Canada’s nurses, as represented by the Canadian Federation of Nurses Unions (CFNU), are questioning the recommendation that the Canadian Patient Safety Institute (CPSI) be merged into the proposed Healthcare Innovation Agency of Canada as recommended by the Advisory Panel on Healthcare Innovation in its report, Unleashing Innovation: Excellent Healthcare for Canada. “Since 2003, the CPSI has given patients and families a voice in our healthcare system. It has ensured that the issue of patient safety is a national priority, central to any discussion about the future of our health care system,” said Linda Silas, President of the Canadian Federation of Nurses Unions. “We are concerned that the original mission of the CPSI will be diluted in the proposed Innovation Agency. We must maintain an organization whose fundamental mission is the improvement of patient safety and the quality of patient care.” Last year, CFNU published a report by Dr. Maura MacPhee entitled Valuing Patient Safety: Responsible Workforce Design which vividly documents the effects of the UK’s failure to focus on patient safety in the Mid-Staffordshire NHS Foundation Trust. The report noted that the NHS has taken steps towards making patient safety a priority and improving transparency and public accountability. It recommended that we implement similar measures in Canada. Silas commended the Advisory Panel for its acknowledgement that “federal action and investment” are needed if we are to prevent the decline in Canada’s health care performance relative to our peers.  She added, “Both the CFNU and the Premiers have called on the federal government to cover at least 25% of total health care spending by the provinces and territories.”

Abstract The World Health Report launched the Health Workforce Decade (2006-2015), with high priority given for countries to develop effective workforce strategies including healthy workplaces for health workers. Evidence shows that healthy workplaces improve recruitment and retention, workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes. Over the past few years, healthy workplace issues in Canada have been on the agenda of many governments and employers. The purpose of this paper is to provide a progress update, using different data-collection approaches, on knowledge transfer and uptake of research evidence in policy and practice, including the next steps for the healthy workplace agenda in Canada. The objectives of this paper are (1) to summarize the current healthy workplace initiatives that are currently under way in Canada; (2) to synthesize what has been done in reality to determine how far the healthy workplace agenda has progressed from the perspectives of research, policy and practice; and (3) to outline the next steps for moving forward with the healthy workplace agenda to achieve its ultimate objectives. Some of the key questions discussed in this paper are as follows: Has the existing evidence on the benefits of healthy workplaces resulted in policy change? If so, how and to what extent? Have the existing policy initiatives resulted in healthier workplaces for healthcare workers? Are there indications that healthcare workers, particularly at the front line, are experiencing better working conditions? While there has been significant progress in bringing policy changes as a result of research evidence, our synthesis suggests that more work is needed to ensure that existing policy initiatives bring effective changes to the workplace. In this paper, we outline the next steps for research, policy and practice that are required to help the healthy workplace agenda achieve its ultimate objectives. The early decades of the 21st century belong to health human resources (HHR). The World Health Report (World Health Organization [WHO] 2006) launched the Health Workforce Decade (2006-2015), with high priority given for countries to develop effective workforce strategies that include three core elements: improving recruitment, helping the existing workforce to perform better and slowing the rate at which workers leave the health workforce. In this recent report, retaining high-quality healthcare workers is discussed as a major strategic issue for healthcare systems and employers, and improving workplaces as a key strategy for achieving this goal. The workplace can act as either a push or pull factor for HHR. Heavy workloads, excessive overtime, inflexible scheduling, safety hazards, poor management and few opportunities for leadership and professional development are among the push factors that result in poor recruitment and retention of HHR. Evidence shows that healthy workplaces improve recruitment and retention, workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes. What are healthy workplaces? Based on existing definitions, there is not yet a standardized and comprehensive definition of healthy workplaces. In this paper, we define healthy workplaces as mechanisms, programs, policies, initiatives, actions and practices that are in place to provide the health workforce with physical, mental, psychosocial and organizational conditions that, in return, contribute to improved workers' health and well-being, quality of care and patient safety, organizational performance and societal outcomes (Griffin et al. 2006). Over the past few years, healthy workplace issues in Canada have been on the agenda of many governments and stakeholder organizations. Nationally and internationally, robust evidence has been accumulated on the impact of healthy workplaces on workers' health and well-being, quality of care, patient safety, organizational performance and societal outcomes. This evidence has provided guidance for governments and employers in terms of what should be done to make the workplace healthier for healthcare workers. Across Canada, many initiatives to improve the working conditions for HHR are currently under way, but the continuing concerns suggest that barriers remain. An assessment of the progress to date is necessary in order to inform the next steps for research, policy and practice.

Eight PEI blood collection workers, all women, all part timers, have been on strike for close to eight months now. As Rankandfile reported in January, the women want a guaranteed minimum number of hours each week. That would allow them to qualify for benefits, and bring a bit of predictability into their daily lives. Their employer, Canadian Blood Services (CBS), isn’t budging. CBS is a not-for-profit, charitable organization operating everywhere in Canada except Quebec. Its sole mission is to manage the blood supply for Canadians. Its budget of roughly $1 billion is mostly provincial money.

No matter what happens, the significance of the strike extends well beyond PEI.  The Charlottetown workers are fighting the same issues CBS workers Canada-wide are facing. Not just workers, generous donors anywhere are also encountering obstacles when looking to donate blood. Some argue that CBS is in such a rush to cut costs that it even puts the safety of our blood supply in jeopardy.

CBS likes its workers part time and precarious, not just in PEI but anywhere in Canada. That was the consensus when unions representing CBS workers all across Canada met in Vancouver last fall, Mike Davidson tells Rankandfile.  Davidson is the Canadian Union of Public Employees (CUPE) national representative for three CBS Locals in New Brunswick. “If CBS had it their way, their clinics would  be all staffed by volunteers, and if they couldn’t have that, they’d settle for an entirely casual workforce,” says Davidson. Two of the New Brunswick locals have a few part-timers with guaranteed hours, and it has been an ongoing struggle to keep it that way, Davidson says.  In all of the three New Brunswick locals there are only three full-time unionized employees. “There is no stability. (CBS) doesn’t want stability,” says Davidson. “Meanwhile, they complain about a lack of commitment by the workers.

February 7, 2014

Dismissing a union policy grievance, a British Columbia arbitrator held that a provincial government policy requiring health care workers to get a flu shot or wear a mask while caring for patients during flu season was a reasonable and valid exercise of the employer's management rights.

Arbitrator upholds mandatory flu shot policy for health care workers

Healthcare Quarterly, 16(4) October 2013: 6-9.doi:10.12927/hcq.2014.23643

Psychological health and safety are growing priorities in Canadian workplaces, including Canadian healthcare settings. The workplace has a key role to play in promoting mental health. The Canadian Healthcare Association recently adopted a position statement strongly encouraging members and all health stakeholders to adopt and take action to implement the new voluntary standard, outlined in Psychological Health and Safety in the Workplace. The Canadian Healthcare Association (CHA) recently adopted a position statement (2013) strongly encouraging members and all health stakeholders to adopt and take action to implement the new voluntary standard outlined in Psychological Health and Safety in the Workplace (CSA Group 2013). (On January 1, 2014, CHA is merging with the Association of Canadian Academic Healthcare Organizations [ACAHO] to create a new national health organization). Championed by the Mental Health Commission of Canada (which has applauded "CHA for its leadership on developing this position paper and highlighting the importance of psychological health and safety in the workplace" [CHA 2013, November 26]), the standard was developed collaboratively by the Bureau de normalisation du Québec and CSA Group.

Toronto Star Sat Sep 27 2014

Three Toronto colonoscopy clinics have had hepatitis C outbreaks since 2011, the Star has learned. Toronto Public Health, which revealed the outbreaks when pressed by the Star, says 11 patients were infected and that tainted sedative injections were the "possible" cause in all cases. The authorities responsible for investigating the spread of infection and inspecting the clinics - TPH and the College of Physicians and Surgeons of Ontario, respectively - kept the outbreaks secret. NDP health critic France Gélinas said public awareness of the first outbreak might have prevented the next two. "It has gone beyond appalling that the same mistakes are being repeated and are not being reported," she said.

Gélinas is calling on the province to remove the CPSO as the regulator of such clinics - known as "out-of-hospital premises" - charging that the outbreaks show the organization is failing in its duties to uphold quality of care and to be transparent, and is placing patients at risk. The MPP for Nickel Belt also wants the province to suspend the downloading of hospital services into the community and place a moratorium on the creation of any new clinics until a new oversight body is created to ensure public safety. "The minister of health has to realize that this push into the community is not safe. It won't be safe until we have in place much more robust oversight," she said. Health Minister Eric Hoskins said he is seeking advice on ways to strengthen outbreak protocols and inspection programs to ensure patient safety in clinics outside of hospitals.

North Bay Nugget Sat Apr 2 2016

The president and CEO of the North Bay Regional Health Centre disputes the results of a poll about employee safety released Friday. In a prepared statement, Paul Heinrich said he is "disappointed in the relentless nature of the Canadian Union of Public Employees/Ontario Council of Health Union's efforts to position our organization and our staff negatively." Heinrich said the campaign "is not based on fact and is harmful to our staff and their care of our patients."

The CUPE/OCHU poll indicated that 67 per cent of hospital staff who took part in the Union Calling poll this week do not believe the hospital is doing enough to protect employees from violence in the workplace, and that 72 per cent have experienced physical violence in the past year. Heinrich said the health centre conducts an "organizationwide staff survey" annually, with 75.5 per cent of staff reporting "my organization takes effective action to prevent violence in the workplace," while "73.7 per cent of staff report my workplace is safe."

William Charney, a Seattle-based consultant and author of “Epidemic of Medical Errors and Hospital Acquired Infections: Systemic and Social Causes,” along with the Ontario Council of Hospital Unions, is holding a one-day conference on June 4th in Toronto

The conference will address some of the biggest contributors to the systemic and social causes of the epidemic of medical errors and HAIs in the US and Canada.

Along with William Charney, a 30-year expert as a health and safety officer in healthcare, speakers include: Joe and Terry Graedon, Kathleen Bartholomew, and Michael Hurley, the president of the Ontario Council of Hospital Unions/CUPE (OCHU)

Release of The Safety at Home: A Pan- Canadian Home Care Study 26/06/2013

One out of every six seniors receives home care services in Canada. As the aging population continues to grow there is a greater need to ensure the delivery of Home Care in Canada is safe.  The release today of The Safety at Home: A Pan- Canadian Home Care Study is the first of its kind that examines adverse events in the home and includes recommendations on how to make care safer. The Canadian Patient Safety Institute (CPSI) partnered with other sponsoring organizations for the study including, the Canadian Institutes of Health Research (CIHR), Institutes of Health Services and Policy Research (IHSPR), The Change Foundation, and the Canadian Foundation for Healthcare Improvement (CFHI). The study examined the reasons for harmful incidents, determined the impact on families and clients and made suggestions on how to make home care safer.

The number of deaths from adverse events in hospitals in the Netherlands has halved during a national five year programme to improve safety, show figures from the country’s latest survey of harm related to care.

The study found that the number of deaths related to failures in organisational or professional standards fell by just over half from 1960 in 2008 to 970 in 2011-12

The proportion of potentially preventable adverse events also fell over the same period, from 2.9% of all admissions in 2008 to 1.6% in 2011-12. Meanwhile, rates of adverse events in general caused by unforeseeable or unexpected complications remained static at about one in 14 patients.

April 8, 2014

Federal Health Minister Rona Ambrose said the initiative makes Canada "a world leader in the posting of drug-safety reviews and post-market access to this information."

TORONTO — Health Canada has begun posting summaries of drug safety reviews on its website with the goal of better informing the public about potential harm associated with certain medications.First on the list is the controversial acne remedy Diane-35.

The Hamilton Spectator Fri May 29 2015

Blowing the whistle on McMaster Children's' Hospital's failure to properly prepare staff to handle the deadly Ebola virus last year has earned a provincial honour for Hamilton labour activist Kathy MacKinnon. She received the Ontario Health and Safety Award from the Canadian Union of Public Employees this week for exposing the facility's lack of worker training and protective equipment.

"Kathy has been on their case quite often over the last 25 years," said Dave Murphy, president of CUPE Local 7800, representing 3,800 Hamilton Health Sciences workers. "She was instrumental in the Ebola case after the hospital said they were ready for it and we found out they weren't." A spokesperson for Hamilton Health Sciences did not respond by deadline.

Tue, 2014-05-27

Today the Canadian Federation of Nurses Unions published a new report which calls for nurses, patients and their families to safeguard our health care system and to reject irresponsible workforce redesign. Valuing Patient Safety: Responsible Workforce Design provides stark evidence of the effects of ill-considered experiments in the delivery of patient care. Workforce redesign refers to nursing care delivery, and changes to staff mix and staffing levels are the two most common, outward signs. Valuing Patient Safety argues that patients must be at the forefront of any redesign decisions. This means patient priority care needs must be properly assessed using real time tools, based on factors such as acuity, stability and complexity. Once patient needs are determined, nurses and their managers should base staffing assignments on the best fit between patient needs and nurse competencies.

Toronto Star Thu Mar 12 2015

Prescription pharmaceuticals have saved and improved many lives, but they can also be deadly. How can we make sure Canadians get the prescription drugs they need without causing unnecessary harm? The federal government plays a vital role in pharmaceutical drug regulation. We have many reasons to be proud of the systems for drug safety already in place in Canada. Yet there's room for significant improvement. Over the course of nearly three years, the Senate standing committee on social affairs, science and technology has studied prescription pharmaceuticals in Canada, and our findings are summarized in the newly tabled report, Prescription Pharmaceuticals in Canada. We heard hundreds of hours of testimony from a wide range of experts in the field on the strengths of our regulatory systems, but there was also a strong chorus of criticism from those who believe we can do much better.

For example, we heard frequent testimony regarding Health Canada's passive role in drug regulation, its lack of transparency in relaying safety information to the public, its inability to conduct adequate inspections at all phases of a drug's life cycle, and we witnessed, in some cases, the department's failure to provide our Senate committee with reliable testimony. But there's room for optimism. Over the course of our study, we made a number of recommendations for updated legislation and regulations, many of which are reflected in the newly adopted Vanessa's Law (Bill C-17). Key to this new legislation are transparency provisions, including the introduction of a requirement for the public disclosure of clinical trial and drug safety information, improved mechanisms to collect post-market safety information, the power to recall unsafe products when necessary and new penalties for regulatory violations - all concerns raised during the course of our study.

Toronto Star Mon Feb 9 2015

Canada's biggest pharmacies are selling allergy pills made with ingredients from a drug facility in India that hid unfavourable test results showing excessive levels of impurities in their products, a Star investigation has found. Recently, the Star purchased packs of over-the-counter desloratadine tablets from Toronto-based Shoppers Drug Mart, Rexall, Walmart and Costco stores.

One month before, on Dec. 23, Health Canada had announced these antihistamines - made by Pharmascience - were under quarantine after serious problems were unearthed during an inspection of the company's drug facility in India. Inspectors found unsanitary conditions at the facility, including high growth of bacteria and mould. Even though government inspectors discovered significant misconduct dating back to 2012, the December quarantine technically affects only new products made in the past month and a half - not ones already sitting on store shelves.

22/02/2016

The Pursuit of Perfection through Quality and Innovation: A View into Denmark's Public Health, Health House and Patient Safety Initiaitves.

The Danish System In October 2015, we traveled to Copenhagen, Denmark in search of quality and innovation in healthcare. We were eager to learn from experts in patient safety and public health working in a high-performing system.