Patient safety and human factors: Action on stress and fatigue

Stress and fatigue impact on patient safety (HSE 2009; HSE 2010). The Health and Safety Executive (HSE) suggests that they be tackled like any other work hazard and recommends a system based approach to these issues.

Tools and interventions

The HSE guide on tackling work-related stress describes its Management Standards approach. These define the characteristics or culture of an organisation where the risks from work related stress are being effectively managed and controlled.

The six standards cover the following aspects.

• Demands - includes workload, work patterns and the work environment.
• Control - how much say a person has in the way they do their work.
• Support - includes the encouragement, sponsorship and resources provided by the organisation, line management and colleagues.
• Role - whether people understand their role in the organisation and whether the organisation ensures they do not have conflicting roles.
• Change - how organisational change (large or small) is managed and communicated.
• Relationships - promoting positive working to avoid conflict and dealing with unacceptable behaviour.

The guide sets out the stages involved in implementing the Management Standards. The HSE also provides case studies from healthcare organisations including trusts and care homes who have conducted stress management projects - see HSE Business solution case studies.

The HSE advises that any changes to working hours be risk assessed and identifies the key considerations in its guidance. Risk assessment may include the use of tools such as HSE’s ‘fatigue risk index’ (HSE 2006).

References

These resources were last accessed on 25 March 2013. Some of them are in PDF format - see how to access PDF files.

HSE (2010) Specific topics. Specific topic 2:Managing fatigue risks (PDF 66.KB), London: HSE. (extract from inspectors human factors toolkit).

HSE (2009) How to tackle work-related stress. A guide for employers on making the Management Standards work, London: HSE.

HSE ( 2006) Research Report 446. The development of a fatigue/risk index for shift workers, London: HSE.

HSE: Business solutions case studies, HSE website.

HSE (n.d.) Human factors: fatigue, HSE website.

Material for tools and interventions

Listening into Action website
Listening into Action™ (LiA) is a comprehensive, outcome-oriented approach to engage all the right people behind quality outcomes.

Healthcare People Management Association (2010) Excellence in HRM awards: compendium of winning entries (PDF 1.3MB)
Made available on the Listening into Action website.

Unison London Ambulance Branch: Linc Peer Support.

Go to: Human factors - stress and fatigue.

See also information about other human factors and interventions.