Exploring front-line hospital workers' contributions to patient and worker safety

Concerns about stubbornly persistent high rates both of error-related patient injuries and of occupational injuries among healthcare workers have generated intense exploration of etiologies, interventions, and the role of underlying safety culture. Much of this work has centered on the role of physicians and nurses in health care, and suggests common issues related to safety culture. However, the role of front-line health care workers, such as nursing assistants, ward clerks, environmental service workers, food workers and transportation workers, among others, has not been explored sufficiently. This article provides the background for a workshop held in Washington, D.C., to identify gaps and opportunities for integrating front-line hospital workers into safety efforts. It provides a brief review of available information, the results of a series of focus groups of front-line workers from a single urban hospital addressing the question, and a series of framing questions for the workshop itself.