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Dr. Heather K. Spence Laschinger, RN, PhD, FAAN, FCAHS, Distinguished University Professor, Arthur Labatt Family Chair in Health Human Resource Optimization and Ontario Ministry of Health and Long-Term Care Healthy Workplace Champion, Arthur Labatt Family School of Nursing, University of Western Ontario

At the recent QWQHC Summit, two of the presenters were identified as “Healthy Work Environment”
Champions appointed in the province of Ontario. How is Healthy Work Environment defined and what is the research that supports it? What prompted the province to appoint Champions for Healthy Work Environment?

A Healthy Work Environment (HWE) is a work setting that takes a strategic and comprehensive approach to
providing the physical, cultural, social, and job design conditions that maximize the health and well-being of
health care providers. HWES are becoming increasingly more important in improving the quality of care provided by Ontario’s health care workforce. HWEs can help retain older workers who may be considering retirement, as well as help recruit and retain younger workers who tend to place a higher value on work-life balance and positive work environments. The 2004 Canadian Adverse Events Study suggested that the greatest gains in patient safety will come from modifying health care professionals’ work environments, creating better defences against adverse events and mitigating their effects when they do occur. Furthermore, healthy work environments yield improved health outcomes for employees and reductions in employer costs related to turnover, lost-time injuries, and absenteeism.

Creating HWEs will be fundamental to the future of healthcare in our province. Recent statistics tell us that 88% of health care workers report insomnia, headaches, depression, weight changes, and panic attacks related to work stress and 35% of Ontario nurses report at least one musculoskeletal condition. A staggering 28% of Ontario nurses report that they were physically assaulted at work over the past 12 months by a patient, and even more troubling is that 46% of Canadian physicians report that they are in advanced stages of burnout. The average number of days of work lost due to illness or disability is at least 1.5 times greater for workers in health care than the average for all workers. To make this idea more concrete, if the average absenteeism rate for health care could be reduced to that of all Canadian workers, it could mean the equivalent of more than 13,700 “extra” full-time employees on the job, including 5,500 Registered Nurses. Particularly disturbing is that health professionals currently have the lowest level of trust in and commitment to their employer, lowest ratings of workplace communication, the least amount of influence on workplace decisions and the least supportive and least healthy workplaces.

A recent study done by the Brock University Workplace Health Research Laboratory in conjunction with
Metrics@Work found that HWEs resulted in a significant decrease in sick days and a significant increase on
employee health and productivity. An ongoing intervention study taking place in Nova Scotia and Ontario has
implemented a program aimed at enhancing civility, respect and engagement in the workplace (CREW). This
project is combining action and research to address the themes of organization and policy, management of the
healthcare workplace, workforce planning, adaptation to change, leadership, and quality and safety in current
health care workplaces. The study will also provide an in-depth assessment of the social context of work and its
relationship to fundamental issues challenging health care workplaces. Results thus far have indicated that the
CREW program has significantly decreased co-worker incivility, exhaustion, intentions to quit and absences per
month, while significantly increasing trust in management and access to support.

The Ministry of Health and Long-Term Care (MOHLTC) along with the Ministry of Training, Colleges and Universities have partnered with the province’s health care consumers and providers to address strategies for creating HWEs. They have appointed two HWE Champions and an HWE Expert Advisory Group and have funded the development of a variety of tools and resources to support HWEs in hospitals, long-term care homes, and home care. The role of the champions is to promote the benefits of HWEs among fellow leaders in the health system and encourage them to implement HWE initiatives in their workplaces, and with the aid of the Advisory group, to provide advice to MOHLTC on how to effectively implement HWEs and build a culture of workplace health safety across the province. The inadequate priority of providing physical, mental and workplace health for our health care providers is one paradox that will no longer continue to go unresolved.