Date: 11 June 2018
Category: Staff wellbeing
It makes sense that staff who are stressed or unhappy cannot look after patients well. But now we have evidence to prove it.
A study of routine data showed that NHS organisations with higher levels of staff satisfaction had better patient outcomes. This included reported levels of patient satisfaction – and even some relationship between staff wellbeing and rates of patient deaths. We can measure links between how staff feel and the performance of an organisation.
As well as this high-level analysis using largescale datasets (such as national staff survey data), we also have some research from the bottom-up. A three year mixed methods study in four organisations looking at high and low performing teams showed a relationship between staff wellbeing and patient satisfaction with their care. Staff reporting low satisfaction with their jobs often failed to connect with their patients. We know how challenging it is for the service now, with rising demands and ever tighter resources. Most frontline health and care jobs are very tough. But this research showed how high levels of job control and good supervision, as well as personal attributes like competence, skills and work dedication, can counter the negative effects of job stress on wellbeing. In a nursing context, the study also showed the importance of ward managers in fostering a positive climate for good patient care.
So, what else can organisations do to support their staff and get them engaged in the work that they do? One study looked at evidence – not just from health – on what works in improving staff engagement. Important elements included having enough resources to do the job properly, positive and supportive leadership and help for individuals to develop resilience.
Other research has evaluated particular initiatives – like the Schwartz round, a structured monthly meeting for all staff to discuss challenging or distressing patient encounters. The national evaluation published this year showed improvements in psychological wellbeing for staff who took part in these rounds. There is now a guide for organisations on how best to introduce and run Schwartz rounds, based on this research.
Another study is looking particularly at doctors’ mental health and approaches to prevent and reduce levels of stress, anxiety and other problems. This review which is not yet completed should help organisations to see which strategies are effective and to tailor existing approaches to improve the mental wellbeing of medical and other staff.
The NHS employs over 1 million staff and over 70% of provider costs are invested in the people who deliver care. At a time of increased pressure on resources, some of these measures to nurture and support staff may seem like luxuries. One of the greatest problems facing organisations are staff shortages and rates of retention and turnover. Keeping good staff and trying to make their work as manageable and enjoyable as possible should be a priority for organisations. Just as parents on plane safety drills are told to fix their own oxygen masks before sorting out their children, staff welfare is paramount. As these studies show, it’s not just good for staff – but good for patients too.
It makes sense that staff who are stressed or unhappy cannot look after patients well. But now we have evidence to prove it. Tara Lamont kicks off our #StaffWellbeing blog series.
Deputy Director of the NIHR Dissemination Centre