Healthcare triad of safety—patient, provider and environment

In the healthcare setting, the “Triad of Safety” is a continuum that is inextricably linked between patient, provider and environment. An unsafe workplace or unsafe work practices can lead to injuries and illnesses in health care workers as well as their patients. Current US Bureau of Labor Statistics reports (2008) show an 82% higher incidence rate for work-related injuries and illnesses for workers in general medical/surgical hospitals when compared to all industries combined. In 1997, OSHA began to identify workplaces (under federal OSHA jurisdiction) with occupational injury and illness rates that were more than twice the national average of injuries or illnesses resulting in lost workdays. This study reviewed all of the medical/surgical hospitals (SIC Code 8062/NAICS Code 622110) that received cautionary letters from OSHA, covering the years 1998-2007 inclusive. A total of 677 letters were received by 351 unique institutions in 29 different states. 79 of these institutions received 3 or more letters, and 16 received 6 or more. Institutions receiving at least 3 consecutive letters from 2005-2007, were selected for further analysis. There were 24 institutions meeting this criterion, and 17 had active accreditation by the Joint Commission, one was accredited by the American Osteopathic Association and 6 were unaccredited. Quality measures of healthcare organizations typically include patient safety metrics, but few include any rating of how safe the workplace is from an employee standpoint. A concerted effort must be made to better incorporate healthcare worker safety metrics into current and future quality measures.