The World Health Organization (WHO) is calling on governments and health care leaders to address persistent threats to the health and safety of health workers and patients.
Released yesterday in line with World Patient Safety Day, the WHO Charter calls on governments worldwide to take action to protect health workers and patients. The Charter calls for five actions which are to protect healthcare workers from violence; to improve their mental health; to protect them from physical and biological hazards; to advance national programmes for health worker safety, and to connect health worker safety policies to existing patient safety policies.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said: “The COVID-19 pandemic has reminded all of us of the vital role health workers play to relieve suffering and save lives. No country, hospital or clinic can keep its patients safe unless it keeps its health workers safe. WHO’s Health Worker Safety Charter is a step towards ensuring that health workers have the safe working conditions, the training, the pay and the respect they deserve.”
Health workers fighting COVID-19
COVID-19 is exposing health workers and their families to unprecedented levels of risk.
Thousands of health workers infected with COVID-19 have lost their lives worldwide and they represent a disproportionate amount of COVID-19 infections across the globe. However, the WHO points out that data availability and quality are limited, and it is not possible to establish whether health workers were infected in the work place or in community settings. Health workers have also been under psychological pressure due to the pandemic, working for long-hours and living in constant fear of disease.
Before COVID-19 hit, medical professionals were already at higher risk of suicide in all parts of the world. A recent review of health care professionals found that one in four reported depression and anxiety, and one in three suffered insomnia during COVID-19.
The WHO also recently highlighted an alarming rise in reports of verbal harassment, discrimination and physical violence among health workers in the wake of COVID-19.
Improving safety for workers
The WHO is reminding governments that they have a legal and moral responsibility to ensure the health, safety, and wellbeing of health workers.
The health worker charter calls on all Member States and relevant stakeholders to take the following five steps to ensure worker and patient safety.
Establish synergies between health worker safety and patient safety policies and strategies
- Develop linkages between occupational health and safety, patient safety, quality improvement, and infection prevention and control programmes
- Include health and safety skills in personal and patient safety into education and training programmes for health workers at all levels
- Incorporate requirements for health worker and patient safety in health care licensing and accreditation standards
- Integrate staff safety and patient safety incident reporting and learning systems
- Develop integrated metrics of patient safety, health worker safety and quality of care indicators, and integrate with health information system
Develop and implement national programmes for occupational health and safety of health workers
- Develop and implement national programmes for occupational health for health workers in line with national occupational health and safety policies
- Review and upgrade, where necessary, national regulations and laws for occupational health and safety to ensure that all health workers have regulatory protection of their health and safety at work
- Appoint responsible officers with authority for occupational health and safety for health workers at both the national and facility levels
- Develop standards, guidelines, and codes of practice on occupational health and safety
- Strengthen intersectoral collaboration on health worker and patient safety, with appropriate worker and management representation, including gender, diversity, and all occupational groups
Protect health workers from violence in the workplace
- Adopt and implement in accordance with national law, relevant policies, and mechanisms to prevent and eliminate violence in the health sector
- Promote a culture of zero tolerance to violence against health workers
- Review labour laws and other legislation and, where appropriate, the introduction of specific legislation, to prevent violence against health workers
- Ensure that policies and regulations are implemented effectively to prevent violence and protect health workers
- Establish relevant implementation mechanisms, such ombudspersons and helplines to enable free and confidential reporting and support for any health worker facing violence
Improve mental health and psychological wellbeing
- Establish policies to ensure appropriate and fair duration of deployments, working hours, rest break and minimising the administrative burden on health workers
- Define and maintain appropriate safe staffing levels within health care facilities
- Provide insurance coverage for work-related risk, especially those working in high-risk areas
- Establish a ‘blame-free’ and just working culture through open communication and including legal and administrative protection from punitive action on reporting adverse safety events
- Provide access to mental well-being and social support services for health workers, including advice on work-life balance and risk assessment and mitigation
Protect health workers from physical and biological hazards
- Ensure the implementation of minimum patient safety, infection prevention and control, and occupational safety standards in all health care facilities across the health system
- Ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, inadequate quantity and appropriate fit and of acceptable quality. Ensure an adequate, locally held, buffer stock of PPE. Ensure adequate training on the appropriate use of PPE and safety precautions
- Ensure adequate environmental services such as water, sanitation and hygiene, disinfection, and adequate ventilation at all health care facilities
- Ensure vaccination of all health workers at risk against all vaccine-preventable infections, including Hepatitis B and seasonal influenza, in accordance with the national immunisation policy, and in the context of emergency response, priority access for health workers to newly licenced and available vaccines
- Provide adequate resources to prevent health workers from injuries, and harmful exposure to chemicals and radiations; provide functioning and ergonomically designed equipment and work stations to minimise musculoskeletal injuries and falls
The WHO has also outlined specific World Patient Safety Day 2020 Goals for health care leaders to invest in, measure, and improve health worker safety over the next year. These include preventing sharps injuries; reducing work-related stress and burnout; improving the use of personal protective equipment; promoting zero tolerance to violence against health workers, and reporting and analysing serious safety-related incidents.