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Impact of healthcare restructuring in Massachusetts on the health andsafety of healthcare workers

C. Eduardo Siqueira, MD, ScD, Department of Community Health and Sustainability, UMass Lowell, 1 University Avenue, Kitson 200, Lowell, MA 01854, 978-934-3147, carlos_siqueira@uml.edu, Ainat Koren, PhD RN, Nursing Department, University of Massachusetts Lowell, 3 Solomont Way, Suite 2, Lowell, MA 01854, Craig Slatin, ScD, MPH, Department of Community Health and Sustainability, University of Massachusetts Lowell, 3 Solomont Way, Weed Hall, Lowell, MA 01854, Kathleen Sperrazza, MS RN, PHASE in Health Care Research Team, University of Massachusetts Lowell, 19 Maugus Hill Rd., Wellesley, MA 02481, Michael J. O'Sullivan, DrPH, Program in Health Management and Policy, University of Massachusetts, School of Health and Environment, 3 Solomont Way, Lowell, MA 01854, and The PHASE in Healthcare Research Team, Center for Public Health Research and Health Promotion, University of Massachusetts Lowell, 3 Solomont Way, Lowell, MA 01854.

Neoliberal restructuring of Massachusetts healthcare has forced staffing reductions and using inadequately trained workers to deliver patient care. Market-based changes in healthcare delivery in the last two decades resulted in intensification of work, reduction of direct patient staffing, and increasing turnover.The changes to healthcare have come at a time when population health changes have increased health and safety risks to healthare workers. An aging and increasingly obese population, combined with shorter stays for acute care, higher acuity case loads in hospitals and nursing homes, have resulted in musculoskeletal injury rates equal to or greater than those found in manufacturing. Population health is dynamic, changing in response to environmental conditions and the systems humans establish to prevent morbidity and mortality. Consequently, worker health and safety programs in the healthcare industry must be dynamic and vigilantly responsive to work conditions that change with population health status. Blaming the patient condition for hazards and risks to healthcare workers is wrong. These hazards and risks exist due to failures of health and safety programs to address changing patient health patterns. The variability of population health demands far greater health and safety resources than those needed in more fixed industrial settings such as manufacturing. Healthcare system restructuring has not only failed to provide such resources but also exacerbated the need for these resources. We present findings that support this perspective from qualitative case studies of community hospitals and nursing homes conducted as part of the five-year study Promoting Health and Safe Employment (PHASE) in Healthcare.

Learning Objectives:

Keywords: Health Care Workers, Occupational Health Programs

Related Web page: www.uml.edu/phase

Presenting author's disclosure statement:

Any relevant financial relationships? No

Social Context of Occupational Health Disparities for Healthcare Workers: Findings of the PHASE in Healthcare Research Project

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA