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Workplace Engagement and Workers’ Compensation Claims as Predictors for Patient Safety Culture

Thorp, Jonathon MD, MBA*; Baqai, Waheed MPH; Witters, Dan MS; Harter, Jim PhD; Agrawal, Sangeeta MS; Kanitkar, Kirti PhD; Pappas, James MD, MBA*†

doi: 10.1097/PTS.0b013e3182699942
Original Articles

Objective Demonstrate the relationship between employee engagement and workplace safety for predicting patient safety culture.

Introduction Patient safety is an issue for the U.S. health-care system, and health care has some of the highest rates of nonfatal workplace injuries. Understanding the types of injuries sustained by health-care employees, the type of safety environment employees of health-care organizations work in, and how employee engagement affects patient safety is vital to improving the safety of both employees and patients.

Methods The Gallup Q12 survey and an approved, abbreviated, and validated subset of questions from the Hospital Survey on Patient Safety Culture were administered to staff at a large tertiary academic medical center in 2007 and 2009. After controlling for demographic variables, researchers conducted a longitudinal, hierarchical linear regression analysis to study the unique contributions of employee engagement, changes in employee engagement, and employee safety in predicting patient safety culture.

Results Teams with higher baseline engagement, more positive change in engagement, fewer workers’ compensation claims, and fewer part-time associates in previous years had stronger patient safety cultures in 2009. Baseline engagement and change in engagement were the strongest independent predictors of patient safety culture in 2009. Engagement and compensation claims were additive and complimentary predictors, independent of other variables in the analysis, including the demographic composition of the workgroups in the study.

Conclusions A synergistic effect exists between employee engagement and decreased levels of workers’ compensation claims for improving patient safety culture. Organizations can improve engagement and implement safety policies, procedures, and devices for employees with an ultimate effect of improving patient safety culture.

From the *Loma Linda University School of Medicine, †Department of Patient Safety and Reliability, Loma Linda University Medical Center, Loma Linda, California, and ‡Gallup, Omaha, Nebraska.

Correspondence: James Pappas, MD, MBA, Loma Linda University Medical Center, Patient Safety and Reliability, 11234 Anderson St., MC 1157 Loma Linda, CA 92354 (e-mail:

Disclosure: The authors declare no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.