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Can You Minimize Health Care Costs by Improving Patient Safety?

Session 3: What Do Workforce Issues Have to Do with Patient Safety?

Presentation by Ed Salsberg


Via the World Wide Web and telephone, the second session of a Web-assisted audio teleconference series occurred on September 30, 2002. The User Liaison Program (ULP) of the Agency for Healthcare Research and Quality (AHRQ) developed and sponsored the program.

This is the text version of the slide presentation.


Slide 1

What Do Workforce Issues Have To Do With Patient Safety?

Can You Help Control Some Health Care Costs by Improving Patient Safety?

Ed Salsberg, M.P.A.
Executive Director
Center For Health Workforce Studies
School of Public Health
University of Albany, SUNY
Rensselaer, NY

Slide 2

The Health Workforce: A Basic Premise

  • Health workers are cornerstone of the health care delivery system.
  • Health care system is only as good as its workforce.
  • Workforce directly affects quality, cost and access.
  • System wide high turnover, difficulty recruiting, worker dissatisfaction are signs of a systemic problem.

Slide 3

How Health Workforce Issues Affect Patient Safety

  • Health workforce shortages.
  • Basic education and training.
  • Continuing professional education.
  • Supervision and feedback.
  • Job satisfaction.
  • Turnover and retention.
  • Job design.
  • Inadequate information systems.
  • Lack of diversity.

Slide 4

Addressing Workforce Issues That Impact Patient Care

  • Assure an adequate supply of workers.
  • Create a work environment responsive to the workforce: Listen to workers.
  • Provide feedback to workers on their performance.
  • Assure appropriate education and continuing education.
  • Design jobs to meet worker needs.
  • Invest in information systems.
  • Support for training of managers and supervisors.

Slide 5

Workforce Shortages Affect Many Professions

  • Nurses, nurse aides, home health aides, lab workers, rad techs, pharmacists, dentists, and more.
  • Hospitals; nursing homes, home health agencies.
  • Urban, rural and suburban areas.

Slide 6

How Health Workforce Shortages Affect Patient Safety

  • Stress and burnout.
  • Rushed care and less attention to individual patient needs.
  • Use of temporary staff with less knowledge of facility, other staff and patients.
  • Turnover and loss of expertise and knowledge.
  • Substitution of less qualified workers.

Slide 7

Factors Contributing to Health Workforce Shortages

  • Short term factors.
    • Competition for workers.
    • Educational system response lags.
  • Long Term factors.
    • Increase in demand due to aging of nation, growing wealth and new interventions.
    • Aging of workforce.
    • Changing racial/ethnic mix.
    • Career choices for women.
  • Workplace factors.
    • Physically and emotionally demanding work.
    • Non-competitive wages and benefits.
    • Job design, working conditions and paperwork.
    • Poorly trained managers.

Slide 8

States Responses to Health Worker Shortages

Response Number of States
Task Force, Committee or Commission 46
Scholarship ad/or loan forgiveness 45
Health Career Marketing 28
Career ladder development 14
Labor Department or Workforce Investment Act 10
Job Redesign 5
Workforce data collection 31

Slide 9

"In Our Hands—How Hospital Leaders Can Build a Thriving Workforce," April 2002

Recommendations from AHA Commission on the Workforce for Hospitals and Health Systems

  • Foster Meaningful Work.
  • Improve the Workplace Partnership.
  • Broaden the Base.
  • Collaborate with Others.
  • Build Societal Support.

Slide 10

Crisis as Opportunity

  • Better quality of care.
  • Adequate supply of health workers.
  • Increased worker satisfaction.
  • More effective delivery system.
  • More cost effective care.
  • Information systems that work.
  • More culturally diverse workforce.
  • Increased enrollment in health professions schools.

Current as of March 2003


Internet Citation:

Text Version of Presentation by Ed Salsberg. Can You Minimize Health Care Costs by Improving Patient Safety? Session 3: What Do Workforce Issues Have to Do with Patient Safety?. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/costsafetele/sess3/salsbergtxt.htm


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