Improving Healthcare Workforce and Patient Safety: A Scoping Meta-Review

Despite recognition of the integral relationship between healthcare worker (HCW) safety and patient safety, few studies have evaluated practices that improve safety for both groups. We undertook a scoping meta-review including only systematic reviews (SRs) to determine the extent to which existing literature identifies practices likely to benefit both HCW safety/well-being and patient safety and remaining research questions.

Literature searches were conducted for SRs and meta-analyses from 2011 to 2020 that reported outcome measures related to improving HCW safety/well-being or organizational safety culture as well as patient safety. After multi-stage screening, studies were classified as relationship/association or focused on a specific practice. Among practice-focused, those that found positive outcomes for both HCW/organizations and patients were considered potentially promising practices. Information was extracted on topic area, interventions, care settings, HCW type, outcomes measured and improvements.

Of 1,619 abstracts, 114 reviews met all inclusion criteria. Major topic groups were Worker Safety/Well-being (n = 33), Operational Practices (n = 34), Organization Safety Culture (n = 24), and Patient Safety/Quality (n = 23). Of 78 reviews addressing specific practices, 48 described practices likely to benefit both groups. Practices/interventions targeting how work is organized were most promising (subtopics staffing/human resources; structure, policies/procedures; human factors engineering). Practices addressing teamwork and engagement suggest opportunities to enhance safety climate.

A wide range of practices and topic areas may directly and/or indirectly improve safety for both HCWs/organizations and patients, suggesting an integrated approach to examining interventions and operational practices. Occupational health/safety and patient safety leaders should consider collaborating to implement promising practices.