BackgroundPromoting patient and occupational safety are two key challenges for hospitals. When aiming to improve these two outcomes synergistically, psychosocial working conditions, leadership by hospital management and supervisors, and perceptions of patient and occupational safety climate have to be considered. Recent studies have shown that these key topics are interrelated and form a critical foundation for promoting patient and occupational safety in hospitals. So far, these topics have mainly been studied independently from each other. The present study investigated hospital staffs’ perceptions of four different topics: (1) psychosocial working conditions, (2) leadership, (3) patient safety climate, and (4) occupational safety climate. We present results from a survey in two German university hospitals aiming to detect differences between nurses and physicians.MethodsWe performed a cross-sectional study using a standardized paper-based questionnaire. The survey was conducted with nurses and physicians to assess the four topics. The instruments mainly consisted of scales of the German version of the COPSOQ (Copenhagen Psychosocial Questionnaire), one scale of the Copenhagen Burnout Inventory (CBI), scales to assess leadership and transformational leadership, scales to assess patient safety climate using the Hospital Survey on Patient Safety Culture (HSPSC), and analogous items to assess occupational safety climate.ResultsA total of 995 completed questionnaires out of 2512 distributed questionnaires were returned anonymously. The overall response rate was 39.6%. The sample consisted of 381 physicians and 567 nurses. We found various differences with regard to the four topics. In most of the COPSOQ and the HSPSC-scales, physicians rated psychosocial working conditions and patient safety climate more positively than nurses. With regard to occupational safety, nurses indicated higher occupational risks than physicians.ConclusionsThe WorkSafeMed study combined the assessment of the four topics psychosocial working conditions, leadership, patient safety climate, and occupational safety climate in hospitals. Looking at the four topics provides an overview of where improvements in hospitals may be needed for nurses and physicians. Based on these results, improvements in working conditions, patient safety climate, and occupational safety climate are required for health care professionals in German university hospitals – especially for nurses.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3862-7) contains supplementary material, which is available to authorized users.

BackgroundWorkload and demands on hospital staff have been growing over recent years. To ensure patient and occupational safety, hospitals increasingly survey staff about perceived working conditions and safety culture. At the same time, routine data are used to manage resources and performance. This study aims to understand the relation between survey-derived measures of how staff perceive their work-related stress and strain and patient safety on the one hand, and routine data measures of workload and quality of care (patient safety) on the other.MethodsWe administered a written questionnaire to all physicians and nurses in the inpatient units at a German university hospital. The questionnaire was an amalgam of the Copenhagen Psychosocial Questionnaire (COPSOQ), the Copenhagen Burnout Inventory (CBI) scale to assess patient-related burnout of and portions of the Hospital Survey on Patient Safety Culture (HSPSC). Indicators from administrative data used to assess workload and patient-related work-strain were: amount of overtime worked, work intensity recording of nurses, cost weight, occupancy rate and DRG-related length of stay. Quality of care was assessed using readmission rates and disease-related length of stay. Univariate associations were tested with Pearson correlations.ResultsResponse rate were 37% (224) for physicians and 39% (351) for nurses. Physicians’ overtime correlated strongly with perceived quantitative demands (.706, 95% CI: 0.634 to 0.766), emotional demands (.765; 95% CI: 0.705 to 0.814), and perceived role conflicts (.655, 95% CI: 0.573 to 0.724). Nurses’ work-intensity measures were associated with decreasing physician job satisfaction and with less favorable perceptions of the appropriateness of staffing (-.527, 95% CI:-0.856 to 0.107). Both professional groups showed medium to strong associations between the morbidity measure (cost weight) and role conflicts; between occupancy rates and role clarity (-.482, 95% CI: -0.782 to -0.02) and predictability of work (-.62, 95% CI: -0.848 to -0.199); and between length of stay and internal team functioning (-.555, 95% CI: -0.818 to -0.101). Higher readmission rates were associated with lower perceived patient safety (-.476, 95% CI: -0.779 to 0.006), inadequate staffing (-.702, 95% CI: -0.884 to -0.334), and worse team functioning (-.520, 95% CI: -0.801 to -0.052). Shorter disease-related length of stay was associated with better teamwork within units (-.555, 95% CI: -0.818 to -0.101) and a lower risk of physician burnout (-.588, 95% CI: -0.846 to -0.108).ConclusionPerceptions of hospital personnel regarding sub-optimal workplace safety and teamwork issues correlated with worse patient outcome measures. Furthermore, objective measures of overtime work as well as objective measures of workload correlated clearly with subjective work-related stress and strain. This suggests that objective workload measures (such as overtime worked) could be used to indirectly monitor job-related psychosocial strain on employees and, thus, improve not only staff wellb...

No abstract

ObjectiveCommon mental disorders like mood and anxiety disorders and somatoform disorders have high costs, yet under-treatment is still frequent. Many people with common mental disorders are employed, so the workplace is potentially a suitable context in which to provide early treatment. Our study investigates whether a change of setting (workplace versus standard care) improves access to treatment for common mental disorders.MethodsConditional latent profile analysis was applied to identify user profiles for work ability (WAI), clinical symptoms like depression (patient health questionnaire depression, PHQ-9), health-related quality of life (QoL, SF-12), and work-related stress (Maslach Burnout Inventory, irritation scale). Patients were recruited consecutively, via psychotherapeutic consultation in the workplace (n = 174) or psychotherapeutic consultation in outpatient care (n = 193).ResultsWe identified four user profiles in our model: ‘severe’ (n = 99), ‘moderate I—low QoL’ (n = 88), ‘moderate II—low work ability’ (n = 83), and ‘at risk’ (n = 97). The ‘at risk’ profile encompassed individuals with reduced work ability (36.0, 34.73 to 37.37), only mild clinical symptoms (PHQ-9 5.7, 4.92 to 6.53), no signs of work-related stress and good quality of life. A higher proportion of the ‘at risk’ group than of the ‘severe’ group sought help via the psychotherapeutic consultation in the workplace (OR 0.287, P < 0.01); this effect remained after controlling for gender.ConclusionsOffering secondary mental health care in the workplace is feasible and accepted by users. Offering treatment in the workplace as an alternative to standard outpatient settings is a viable strategy for improving access to treatment for common mental disorders.

Purpose An increasing prevalence of work-related stress and employees’ mental health impairments in the health care sector calls for preventive actions. A significant factor in the workplace that is thought to influence employees’ mental health is leadership behavior. Hence, effective leadership interventions to foster employees’ (leaders’ and staff members’) mental health might be an important measure to address this pressing issue. Methods We conducted a systematic review according to the PRISMA statement (Liberati et al. 2009) and systematically searched the following databases: PubMed (PMC), Web of Science, PsycINFO (EBSCOhost), EconLit (EBSCOhost), and Business Source Premier (EBSCOhost). In addition, we performed a hand search of the reference lists of relevant articles. We included studies investigating leadership interventions in the health care sector that aimed to maintain/foster employees’ mental health. Results The systematic search produced 11,221 initial search hits in relevant databases. After the screening process and additional literature search, seven studies were deemed eligible according to the inclusion criteria. All studies showed at least a moderate global validity and four of the included studies showed statistically significant improvements of mental health as a result of the leadership interventions. Conclusions Based on the findings, leadership interventions with reflective and interactive parts in group settings at several seminar days seem to be the most promising strategy to address mental health in health care employees. As the available evidence is limited, efforts to design and scientifically evaluate such interventions should be extended.