Health Canada’s Healthy
Workplace Initiative Promoting Wellness in
Canada’s Health Human
Resources
January 5, 2007
Robin Buckland RN MScN
Senior Policy Analyst
Health Canada
Overview
 Why healthy workplaces?
 What makes a workplace healthy?
 What is the federal government doing about it?
 The Healthy Workplace Initiative
 What’s next
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Why ‘Healthy Workplaces’?
1. Absenteeism and on-the-job injuries are high
among health care workers:
 Average number of days of work lost due to illness
or disability has been at least 1.5 times greater than
the average for all workers (CIHI, 2005)
 CMA’s 2003 study of Canadian physicians found
that 46% are in advanced stages of burnout.
2. Unhealthy workplaces cost our health system:
 productivity costs, wage replacements, disability
pay-outs and workplace absenteeism costs around
$30 billion a year (Corbett, 2003)
 On an annual basis, nursing hours lost to
absenteeism cost the Canadian health system $17.7
million – the equivalent of 9,754 full-time positions
(CNA 2006).
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Why ‘Healthy Workplaces’?
3. Quality work environments, worker satisfaction and
productivity are directly correlated with patient
outcomes:
Hospital nurses working more than 12.5 hours at a
time are three times more likely to make mistakes.
Errors and medical incidents increase significantly
when nurses work more than 40-hour weeks or when
they work overtime (CHSRF, 2001).
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What is a Healthy Workplace?
…a working definition:
“practice settings that maximize
the health and well-being of
health care workers, quality
patient outcomes, and
organizational performance”
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What Makes a Workplace Healthy?
Major elements:
 Physical environment – safe, healthy, secure;
equipment, technology.
 Professional environment - human resources/staffing
practices, leadership, practice issues (e.g., autonomy,
scopes of practice, workload).
 Psychosocial/cultural environment – recognition,
respect, communication, values, support.
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What Is the Federal Government
Doing About It?
 Health Canada’s Healthy Workplace Initiative
 Health Accord 2003
 First Ministers Meeting 2004
 Pan-Canadian Health Human Resources Strategy
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The Healthy Workplace Initiative
Objectives…
•
•
• Establish policies/settings
that enhance the workplace,
thereby improving provision
of quality health care
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Improve the health and
well-being of health care
workers
Decrease absenteeism,
turnover and overtime of
health care workers to
improve health system
productivity
The Healthy Workplace Initiative
Desired Impact:
• Improve working environment for all health care
workers
• Improve workers’ health and well-being
• Improve quality of care
• Improve patient safety
• Improve health providers’ job satisfaction
• Improved recruitment and retention
• Improve efficiency of health care organizations
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The Healthy Workplace Initiative
Four core areas…
1. Knowledge generation
 guidelines, surveys, complementary projects (VON, RNAO, CFNU)
2. Leading practice application
 targeted funding of approximately $3.5 million to support 11
innovative projects in health care organizations nominated by P/T
ministries of health
3. Change management
 Provinces/Territories, employers, providers, etc.
 Quality of Worklife – Quality of Healthcare Collaborative
4. Knowledge translation and transfer
 5 knowledge utilization projects
 Knowledge Exchange activities
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The Healthy Workplace Initiative
Four core areas…
1. Knowledge generation
 Guidelines, surveys, complementary projects (VON, RNAO, CFNU)
 Five knowledge utilization projects
2. Leading practice application
 Targeted funding of approximately $3.5 million to support 11
innovative projects in health care organizations nominated by P/T
ministries of health
3. Change management
 Provinces/Territories, employers, providers, etc.
 Quality of Worklife – Quality of Healthcare Collaborative
4. Knowledge translation and transfer
 Knowledge Exchange Days
 HWI Dissemination Framework
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Knowledge Generation
National Survey of the
Work and Health of Nurses




First nationally representative survey of nurses in Canada
Partnership between CIHI, Health Canada and Statistics Canada
Data collection: October 2005 – January 2006
Response rate: 80% (18,676 nurses)
 Survey objectives:
 Provide information on the health and working conditions of the 3 regulated nursing
professions (RNs, LPNs, and PRNs)
 Comparisons among provinces and territories
 Compare nurses with the total employed population
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Knowledge Generation
National Survey of the
Work and Health of Nurses
 Results:
 Nurses worked more paid overtime:
 Women: 30% of nurses vs. 13% of all employed
 Men: 37% of nurses vs. 28% of all employed
 Nurses more likely to have more that one job:
 Women: 19% vs. 9%
 Men: 23% vs. 9%
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Knowledge Generation
National Survey of the
Work and Health of Nurses
 Results:
 Perceived changes in quality of care in past year:
 27%: deteriorated
 16%: improved
 57%: no change
 Main reason given for deterioration:
 Fewer staff (67%)
 Too many patients (38%)
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Knowledge Generation
National Survey of the
Work and Health of Nurses
 Results:
 Nurses’ reports of adverse events in past year
 Patient received wrong medication or dose – 18%
 Patient nosocomial infection – 35%
 Complains from patients or families – 38%
 Patient injured in a fall – 31%
 Nurse injured while working – 9%
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Knowledge Generation
National Survey of the
Work and Health of Nurses
 Results:
 29% reported physical assault by a patient in past year
 67% reported often too much work for one person – role overload
 31% female nurses reported high job strain where the psychological demands
of the job exceed worker’s discretion in deciding how to do it
 45% female nurses reported low co-worker support
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Knowledge Generation
National Survey of the
Work and Health of Nurses
 Results:
 Job dissatisfaction was more common in nurses than in total employed:
 Women: 12% vs. 9%
 Men: 12% vs. 8%
 9% of nurses had experienced depression in the last year
 7% reported fair or poor general health
 6% reported fair or poor mental health
 14.5 sick-days/year on average
 14% took more than 20 sick-days in past year
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Leading Practice Application
A Snapshot Across the Country
Labrador Grenfell
East Central
Health
BC MOH
Sask
Health
PEI DOH
MRHA
WRHA
McGill
VON
AVH
CFNU
West Park,
et al.
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QWQCC
Halton
Healthcare
Leading Practice Application
HWI Targeted Funding Projects
Results and significant learnings in 2007/08
• Newfoundland - Labrador Grenfell Regional Integrated Health
Authority on behalf of all provincial RIHAs: Creating a Culture of
Safety
• PEI Health and Social Services: Provincial Musculoskeletal Injury
Prevention Strategy for Health Care Workers: An Expansion and
Enhancement Project
• New Brunswick - Miramichi Regional Health Authority: MRHA
Workplace Wellness Initiative
• Ontario - Halton Health Care: Kailo Workplace Wellness Program
• Alberta - East Central Health: Quality of Worklife Project
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Leading Practice Application
HWI Targeted Funding Projects
• Ontario – West Park Health Centre: A Healthy Workplace
Initiative Best Practice Initiative
• Québec – Centre Universitaire de santé McGill: Programme
interhospitalier de recherche action sur le climat de travail
• Saskatchewan Health: Electronic Survey Tool (EST)
• Manitoba – Winnipeg Regional Health Authority: WRHA Healthy
Workplace Program
• British Columbia Ministry of Health Services: A Collaborative
Approach to Supporting Health in the Workplace
• Nova Scotia - Annapolis Valley Health: Organizational Health:
Quality and Healthy Workplace Integration
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Change Management
Quality of Worklife – Quality of
Healthcare Collaborative
 To help stakeholders find the most effective ways to
build a foundation of excellence in work environments
and human resources practices
 Why?
 Gap – mechanisms to share info and coordinate actions
nationally
 Opportunity for interprofessional collaboration to address
QWL issues of relevance to all health professionals
 Common strategy to raise the standards for QWL across the
system
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Change Management
Quality of Worklife – Quality of
Healthcare Collaborative
Mandate:
1. Develop a national framework and action strategy for
healthcare stakeholders to build a foundation of excellence
in quality healthcare work environments and HHR practices
2. Facilitate recognition of strategic link between high quality ,
healthy work environments and high quality patient care and
patient safety
3. Create a national clearinghouse for QWL practices
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Knowledge Translation/Transfer
 Five knowledge utilization projects
completed in April 2006
 To inform our understanding of the utilization of
recommendations resulting from national and
other reports aimed at improving the workplaces
of health professionals
 (e.g., Commitment and Care, CNAC report,
CPRN reports, Listening for Directions, Kirby
report, Romanow report, provincial reports, etc.)
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Knowledge Translation/Transfer
1. “The Supply, Distribution and Working Context of Health
Professionals: Why Do Things (Almost) Never Change”
McMaster U. (Lavis)
2. “Building Quality Health Care Workplaces: Nurses as
Knowledge Sharers in Atlantic Canada” Acadia U.(Leiter)
3. “Canada’s Experience Translating Workplace Knowledge in
a Cancer Setting” Sunnybrook & Women’s College Health
Sciences Centre (Fitch)
4. “Knowledge Utilization: Creating Quality Northern Rural
Health Workplaces” Laurentian U. (Rukholm)
5. “Promoting High Quality Health Care Workplaces: Learning
from Saskatchewan” U. of Saskatchewan (Smadu)
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What’s next?
 Learning from 11 ‘targeted funding’ projects
 Learning from complementary projects
 Move to focus between worker health and wellbeing and patient safety & quality care
 Evaluation of the HWI – more lessons learned!
 Moving forward together – Quality of Worklife,
Quality of Healthcare Collaborative
 Knowledge Exchange and Uptake
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Some final thoughts…
“If we want to create a workplace that values
idealism, human connection, and real, in depth
learning, we will have to create it ourselves.”
- Peter Block
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Robin Buckland RN MScN
Senior Policy Analyst,
Health Canada
Visit us online!
www.healthcanada.gc.ca/hwi
www.santecanada.gc.ca/ipsmt
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