Dr James Riley, pioneer in histamine and mast cell studies.

Dr James Riley, an honours graduate of Edinburgh University, had to give up a surgical career because of an affliction of his hands, and instead became a radiotherapist in Dundee. He had always been fascinated by past heroes of medical research, and set out to carve his own niche in the study of mast cells. In the early 1950s, no one knew what their function was other than the mast cell granules being the storehouses of heparin. Riley and pharmacologist Dr Geoffrey West went on to galvanise this area of study by showing in a notable series of experiments that the mast cell granules are also the main repository of histamine, a key participant in allergic and anaphylactic reactions. Riley's story is a prime example of the ability to make cutting-edge discoveries even in the face of modest facilities.

How employee engagement matters for hospital performance.

Managers increasingly understand that employee engagement is a prerequisite for high performance. This article examines how job, work environment, management and organizational factors influence levels of engagement among healthcare employees. Original data come from the Ontario Hospital Association-NRC Picker Employee Experience Survey, involving over 10,000 employees in 16 Ontario hospitals. The article provides a clear definition and measure of engagement relevant to healthcare. In addition to identifying the main drivers of engagement, findings shows that a high level of employee engagement is related to retention, patient-centred care, patient safety culture and employees' positive assessments of the quality of care or services provided by their team. Implications of these findings for healthcare leaders are briefly considered.

Using common work environment metrics to improve performance in healthcare organizations.

This article proposes a comprehensive framework for assessing, reporting and improving the quality of work environments in healthcare organizations across Canada. Healthy work environments (HWEs) contribute to positive outcomes for healthcare employees and physicians. The same HWE ingredients also can reduce operating costs, improve human resources utilization and ultimately lead to higher-quality patient care. We show how health system employers, governments, quality agencies and other stakeholders can implement effective HWE metrics. The common reporting framework and metrics we propose enable managers and policy makers to use HWE ingredients as levers to improve organizational performance. Progress requires the active involvement of stakeholders in developing common metrics, the integration of these metrics into existing measurement and reporting systems, the building in of managerial accountability for work environment quality and support for ongoing improvements at the front lines of care and service delivery.

Let's Talk Tactics.

This has turned out to be a very productive discussion, which we encourage readers to continue in their own networks. There is broad agreement that, as one commentator put it, "the time has come" for Canada to develop a unified system for measuring and reporting the quality of healthcare work environments. And all commentators look into the future, asking practical questions and offering constructive suggestions for how best to develop and implement such a system. So, in our view, this is a mark of progress.

The role of healthcare work environments in shaping a safety culture.

Patient safety is a basic goal of all Canadian healthcare organizations. Yet we still have much to learn about the determinants of safety. For instance, little is known about the how workplace environment factors that have an influence on employee behaviour also have implications for patient safety.

Raising the bar for people practices: helping all health organizations become "preferred employers".

Human resources are the single largest budget line in any healthcare organization. But employees are not costs; rather, they must be viewed by managers, boards, and governments as the core assets of the system.

Correlates of employees' perceptions of a healthy work environment.

PURPOSE: This study analyzed correlates of workers' perceptions of the extent to which their work environment is healthy and how these perceptions influence job satisfaction, employee commitment, workplace morale, absenteeism, and intent to quit. DESIGN: One-time cross-sectional telephone survey. SETTING: Canadian employees in 2000. SUBJECTS: A randomly chosen, nationally representative sample of 2500 employed respondents, using a household sampling frame. The response rate was 39.2%. Self-employed individuals were excluded, leaving a subsample of 2112 respondents. MEASURES: The dependent variable was the response to the item, "The work environment is healthy" (5-point strongly agree-strongly disagree Likert scale). Independent variables used in bivariate and ordinary least-squares regression analyses included sociodemographic characteristics, employment status, organizational characteristics, and scales that measured job demands, intrinsic rewards, extrinsic rewards, communication/social support, employee influence, and job resources. Perceptions of a healthy work environment were related to job satisfaction, commitment, morale (measured on a 5-point scale), number of self-reported absenteeism days in the past 12 months, and whether or not the respondent had looked for a job with another employer in the past 12 months. RESULTS: The strongest correlate of a healthy work environment was a scale of good communication and social support (beta = .27). The next strongest was a job demands scale (beta = -.15.) Employees in self-rated healthier work environments had significantly (p < 0.01) higher job satisfaction, commitment and morale, and lower absenteeism and intent to quit. CONCLUSIONS: The study supports a comprehensive model of workplace health that targets working conditions, work relationships, and workplace organization for health promotion interventions.

How many injured workers do not file claims for workers' compensation benefits?

BACKGROUND: Anecdotal evidence suggests that there are injured workers who do not file for workers' compensation (WC). Several recent studies support this, and we aim to quantify the extent of under-reporting. METHODS: A Canadian survey asked about work injuries in the previous year, and several questions established eligibility for WC and whether a claim had been filed. The proportion of eligible injuries with a claim was estimated. Logistic regression identified predictors of claim submission. RESULTS: Of 2,500 respondents, 143 had incurred an eligible injury, of whom 57 (40%, 95% CI 32-48%) had not filed a WC claim. Severity of injury was the strongest predictor of not claiming. CONCLUSIONS: Survey respondents reported a substantial degree of under-claiming of WC benefits, contrasting with public attention on fraudulent over-claiming. Policy makers should ensure that all relevant parties are aware of their obligations to report work injuries. This will create a more accurate picture of work safety.

High-quality healthcare workplaces: a vision and action plan.

Looking into a future marked by intense competition for talent, growing numbers of employers are striving to create "workplaces of choice." Yet, despite the consensus that health human resources are a vital piece of the healthcare reform puzzle, few health service organizations have developed comprehensive strategies to address work environment issues. The cumulative impact of years of cost-cutting, downsizing and restructuring have left Canada's healthcare workforce demoralized, overworked and coping with working conditions that diminish both the quality of working life and organizational performance.