Introducing Routine Measurement of Healthcare Worker's Well-being as a Leading Indicator for Proactive Safety Management Systems Based on Resilience Engineering

Although the need to improve patient safety is widely recognized, there is general agreement that ambitious targets for improvement have not been met. Resilience Engineering focuses on complex adaptive systems and provides a holistic view of interacting elements that adjust, adapt and reinforce one another in response to emerging forces. This provides a framework to understand both why organizations succeed or fail and, therefore, how to improve their reliability. One component that is often identified as a key factor in safety and reliability by complex adaptive systems and RE are the individuals within the system and their relationship to organizational performance. The goal of this paper is to identify and transfer knowledge regarding healthcare worker's well-being from health sciences to the development of proactive safety management systems, with a specific emphasis on the RE framework as offering the most potential for this. To achieve this, the paper will: First provide a review of relevant determinants associated with a healthcare worker's well-being that suggest both risk and contribution to the success of system performance. Next, the benefits of utilizing indicators for proactively monitoring system performance in healthcare will be reviewed. This will have a particular focus on the benefits and challenges to the routine monitoring of the healthcare worker's well-being as a specific indicator for system performance and patient safety. Finally, further research necessary to address a number of critical key factors to investigate the utility, validity, and usability of the design and implementation of healthcare worker well-being indicators into healthcare safety management systems are identified.