HR Pulse - Winter 2007 - (Page 29) Medical Professional Issues The association between fatigued employees and medical errors has been well documented. Nurses routinely embrace 12-hour shifts over fewer days to maximize their free time. By doing so, they incur assaults on their circadian rhythms and never establish a healthy pattern of sleeping, eating, exercising, and working. Professional burnout has been linked to poor health and has significant implications for recruiting, retention and turnover—critical issues at a time fraught with nursing and allied health professional shortages. It is far better and less costly to prevent professional burnout than to have to suffer the consequences of turnover and the risk management issues of medical/patient safety error. Medical Errors Between 44,000 and 98,000 Americans die from medial errors annually. Medical errors kill more people per year than breast cancer, AIDS or motor vehicle accidents. Cost to Hospitals Agency for Healthcare Research Quality (AHRQ): Medical errors cost typical large hospitals $5 million/year. The Caregiver Persona The final ingredient that renders very smart medical professionals into blobs of poor health habits is a caregiver personality. These employees altruistically focus on the health of others, not their own. Yes, they know what to do, but they are frustrated by their inability to translate their knowledge into behavior. This embarrassing failure leads to an over-reliance on rationalization and denial mechanisms. But when a hospital employee’s unhealthy lifestyle continues unaddressed and manifests in disease, watch out. Medical professionals are experts at accessing and utilizing medical care. They can easily finesse a healthcare system—accessing experimental drugs and engaging the best surgeons, for example—that befuddles laypeople. They know the system well because they are the system. When medical professionals do become ill or injured, they are very costly users of healthcare. In fact, they are the most costly of any industry segment, according to a study published in the Journal of Occupational & Environmental Medicine (March 2006). Changing Behavior Through Lifestyle Coaching So, what’s a healthcare HR professional to do? Many hospitals are addressing the problem by helping the helpers through a coaching program that “de-medicalizes” their lifestyles. In other words, it meets medical employees where they are. Here are 13 steps to implementing an effective lifestyle coaching program within a hospital: 1. A lifestyle coaching program should be staffed by coaches who have worked in hospitals and understand the special challenges and stresses. 2. Hospital HR professionals should avoid the temptation to provide the lifestyle intervention services via their own staff. Hospital employees are very concerned about confidentiality and go to great lengths to protect their privacy and HIPAA rights. Trying to do it internally will undermine utilization of the program. 3. A good lifestyle coaching program treats hospital employees as colleagues, not patients. 4. Almost all lifestyle coaching programs address issues like smoking, weight management, nutrition and exercise and some also may address substance abuse. Look for a program that understands hospital populations and tackles their specific challenges, such as fatigue, sleep issues associated with shift work, stress and professional burnout. These issues are critical to hospitals not only because they contribute to lifestyle problems but also because of the implications for medical errors, patient safety and the overall quality of medical care. How is it that welleducated medical professionals, who are so knowledgeable about health and who see the devastating consequences of poor health habits on a daily basis, embody such unhealthy lifestyles? Medication Errors Medication-related errors for hospitalized patients cost roughly $2 billion annually. Source: “To Err is Human: Building a Safer Health System.” Institute of Medicine, 2000. 29 HR Pulse Winter 2007 Organizational Issues Added to this already demanding atmosphere is work stress engineered into the organizational culture of a hospital that might be described kindly as “hyper-matrixed.” Less kindly, a hospital is a very loosely organized set of feudal fiefdoms (called services or departments), rallying around professional affiliations that act out degree-driven power trips. The in-fighting is so severe that 91 percent of nurses reported experiencing verbal abuse (mistreatment that left them feeling attacked, devalued or humiliated), according to a study cited in Orthopedic Nursing (July/August 2003). Physicians were the most frequent abusers. Add a medical school or university affiliation to the hospital, and you have an overly complex organization that is dysfunctional by design. Then there is the way medicine is taught. Hospital rounds are generally a competitive, non-nurturing learning trauma, where newcomers must pay their dues in shame and embarrassment. These rites of passage—including unreasonably long resident work hours and rotating shifts for nurses—institutionalize and perpetuate organizational dysfunction. It’s no wonder that nurses “eat their young.” >>
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