Major Articles
Organizational and environmental factors that affect worker health and safety and patient outcomes

https://doi.org/10.1067/mic.2002.119820Get rights and content

Abstract

This article reviews organizational factors that influence the satisfaction, health, safety, and well-being of health care workers and ultimately, the satisfaction, safety, and quality of care for patients. The impact of the work environment on working conditions and the effects on health care workers and patients are also addressed. Studies focusing on worker health and safety concerns affected by the organization and the physical work environment provide evidence of direct positive and/or adverse effects on performance and suggest indirect effects on the quality of patient care. The strongest links between worker and patient outcomes are demonstrated in literature on nosocomial transmission of infections. Transmission of infections from worker to patient and from patient to patient via health care worker has been well documented in clinical studies. Literature on outbreaks of infectious diseases in health care settings has linked the physical environment with adverse patient and worker outcomes. An increasing number of studies are looking at the relationship between improvement in organizational factors and measurable and positive change in patient outcomes. Characteristics of selected magnet hospitals are reviewed as one model for improving patient and worker outcomes. (Am J Infect Control 2002;30:93-106.)

Section snippets

Background

A wealth of literature exists on how health care workers experience job- and work-environment-related stressors that adversely affect their safety and health. Studies have identified many stressors, including role ambiguity, role conflict, heavy workload, pressure, and physical discomforts.2Work stress has been shown to result in job dissatisfaction, burnout (physical, emotional, and mental exhaustion), staff turnover, occupational illness and injuries, reduced mental health, depression, and

Outcomes: Effects of organizational and environmental factors on workers and patients

The link between organization of health services or institutions and patient outcomes is rarely tested empirically. Studies on the organizational structure of health care and studies on patient outcomes have been performed independently. The most commonly studied outcome variables are hospital costs; occupancy rates; service mix; and staff outcomes such as job satisfaction, turnover, and vacancy rates. The appropriateness of various outcomes, such as mortality and complication rates, as

Conclusion

The multi agency Quality Interagency Coordination Tack Force (QuIC) coordinates activities and plans for quality measurement and improvement across all US federal agencies involved in health care. In October 2000. QuIC convened a conference to examine how health care workplace quality influences the quality and safety of patient care. There was general consensus at this meeting on the need for a serious, evidence-based approach to identify opportunities to improve the quality of the health care

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