The characteristics of the work environment in a health care setting can impact the outcomes for patients. It is important for organizations to support an atmosphere conducive to healthful practice.
There is extensive evidence that a healthful practice environment impacts patient care outcomes, including, but not limited to, reducing medication errors, reducing incidence of hospital-acquired infections and improved patient satisfaction.
What exactly is a healthful practice environment? The American Nurses Association defines a healthful practice environment as:
• One that is safe, empowering and satisfying.
• It is not merely the absence of real and perceived threats to health, but a place of “physical, mental and social well-being” supporting optimal health and safety.
• A culture of safety is paramount, in which all leaders, managers, health care workers and ancillary staff have a responsibility as part of the patient-centered team to perform with a sense of professionalism, accountability, transparency, involvement, efficiency and effectiveness.
• All must be mindful of the health and safety for both the patient and the health care worker in any setting providing health care, providing a sense of safety, respect and empowerment to and for all persons.
The World Health Organization also recognizes the significant value of improving the work environment. WHO has developed the “Healthy Workplace Model: Avenues of Influence, Process and Core Principles.”
The model contains the elements of the physical work environment, personal health resources, psychosocial work environment and enterprise community involvement. The premise behind it is recognizing the negative effects of an unhealthy practice environment and the impact on the workers and, ultimately, the impact on the outcomes of performance for the organization.
The American Association of Critical Care Nurses has developed six essential standards of evidenced-based, relationship-centered principles for healthy practice environments. The standards are:
• Skilled communication: Nurses must be as proficient in communication skills as they are in clinical skills.
• True collaboration: Nurses must be relentless in pursuing and fostering true collaboration.
• Effective decision-making: Nurses must be valued and committed partners in making policy, directing and evaluating clinical care and leading organizational operations.
• Appropriate staffing: Staffing must ensure the effective match between patient needs and nurse competencies.
• Meaningful recognition: Nurses must be recognized and must recognize others for the value each brings to the work of the organization.
• Authentic leadership: Nurse leaders must fully embrace the imperative of a healthful practice environment, authentically live it and engage others in its achievement.
A shared governance decision-making structure allows nurses to partner with other health care professionals to influence the work environment and improve practice standards. They are tasked with the responsibility to develop actions and goals toward creating a sustained healthful practice environment using the principles listed.
A healthful practice environment is critical to the safety of patients and the success and growth of all heath care professionals.
Carol Bensen is a registered nurse and senior director of critical care at Providence St. Patrick Hospital.