engleski

Presenteeists in hospitals make patients safer?

Problem: The term presenteeism refers to the situation when employees show up at their workplaces, but fail to adequately attend to their professional duties for various reasons, offering therefore either less efficient or a lower-quality performance . Employees prone to presenteeism might feel sick or be less motivated for their work either because of their low working morale or their low opinion on the job. When it comes to healthcare settings, this issue gains in importance, since presenteeism of healthcare professionals may equally jeopardise a vast number of patients ; namely, healthcare professionals’ job performance has a huge impact on patients’ health and the quality of healthcare delivered, giving rise to already high healthcare costs and compromising the quality of healthcare and the quality of performance of healthcare professionals. Assessment of problem and analysis of its causes: Our aim was to determine whether presenteeism is associated to patient safety culture. Study design: This cross-sectional study embraced two different hospitals, that is to say, one Clinical Hospital Centre CHC and one County General Hospital CGH and was carried out from January to April 2014. In total, 595 subjects were recruited (response rate 54.28%), out of which 150 physicians and 445 nurses/paramedics, 399 of them being affiliated with the CHC and 196 with the CGH. The study made use of the following questionnaires: WHO Health and Work Performance Questionnaire (WHO HPQ) designed to measure presenteeism and Hospital Survey on Patient Safety Culture (HSOPSC). Among other questions, participants were asked in to rate their overall job performance and to compare the usual performance of most workers in a job similar to theirs. Relative presenteeism was then calculated as the rate of those two questions. HSOPSC measures patient safety culture in 42 questions, resulting in 12 dimensions. Measurement of improvement: Collected data were used in linear regression models, adjusted for hospital and unit. No other predictors (like demographic) were used since mulitcollinearity was found. Effects of changes: Four dimension of patient safety culture (Overall perceptions of safety, Communication openness, Teamwork across hospital units and Handoffs and transitions) were associated to relative presenteeism. Higher relative presenteeism (i.e. lower job performance) is associated to higher levels of patient safety culture. In other words, when doctors and nurses are working with lower job performance, patient safety culture is higher. These result are quite opposite from what we expected to find. The possible explanation might be that healthcare workers are often dealing with numerous patients, numerous tasks and high responsibilities. They are also dealing with unexpected events and sometimes even „carrying“ their own personal problems to work. It might be possible that overburdened and tired healthcare workers decrease patient safety. Another explanation might be that the answers regarding relative presenteeism are biased since questionnaire is constructed in a way that participants were asked to rate their overall job performance and compare it with the usual performance of most workers in a job similar to theirs. Lessons learnt: What lessons have you learnt from this work? What would you do differently next time? Workplace interventions should be aimed at recognising and reducing presenteeism. Future research should be aimed at developing a reliable and comprehensive tool which would measure all aspects of presenteeism (low job performance, sickness presenteeism and being at work when all of the tasks are completed). Message for others: Relative presenteeism was found to be associated to higher levels of 4 dimensions of patient safety culture (Overall perceptions of safety, Communication openness, Teamwork across hospital units and Handoffs and transitions). This finding might be explained by the fact that overburdened healthcare workers make patients less safe.

presenteeism; patient safety culture; healthcare workers

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