Currently, in many areas, South Australia’s healthcare workforce is feeling strained and organisations are under pressure.

We know that our people are critical to the effectiveness and sustainability of our healthcare system and, ultimately, our patient outcomes. As such, the CEIH has used the evidence base and understanding of the SA context to identify critical areas for action and develop resources to assist the sector in strengthening workplace wellbeing.

Read our discussion paper for more on how we can create a health system that protects and promotes the wellbeing of our healthcare workforce.

For healthcare organisations, our Building Workplace Wellbeing guide provides step-by-step advice on establishing the foundational structures and processes necessary to optimise workforce wellbeing and team effectiveness.

What does ‘workplace wellbeing’ mean?

Workplace wellbeing refers to the physical, psychological, social and organisational conditions that influence worker health, wellbeing and safety. A workplace with a good wellbeing culture considers the physical circumstances of the workplace, individuals’ resources and perceptions of psychological safety at work, and the structures and systems that underpin the way people work.

Excellence is found in organisations that are serious about not just protecting workers from physical and psychological harm, but also creating a health-promoting environment that enables and encourages workers to thrive.

Ideally, everyone needs to work together towards an agreed vision of workplace wellbeing, where workers and managers have control over factors that influence their health, drive, positivity and job satisfaction.

Why is it important to South Australia’s healthcare sector?

Globally, healthcare workers have markedly high rates of absenteeism, burnout and mental distress compared to other sectors. The South Australian health workforce is no exception, with data showing our workers experience heightened levels of stress and struggle to establish a healthy work-life balance.

Our healthcare system has been under strain for many years, even prior to the COVID-19 pandemic, with an ageing population and people with increasingly complex care needs. Research has shown the pandemic has exacerbated the impact of work on the mental health and wellbeing of healthcare workers with links to absenteeism, presenteeism, workforce attrition, increased healthcare costs, medical errors and poorer healthcare delivery.

Evidence shows that creating a culture of workplace wellbeing in the healthcare sector can lead to:

Improved patient outcomes:
- Patient health outcomes
- Patient safety outcomes
- Patient experiences

Improved workforce outcomes:
- Worker physical and psychological health outcomes
- Worker physical and psychological safety
- Worker job satisfaction and work experience

Improved sector outcomes:
- Better attraction and retention in the sector

What is the problem?

The CEIH has engaged with sector leaders, analysed existing data and reviewed literature to identify the following key issues for the South Australian context:

Many healthcare workers are experiencing low levels of wellbeing which is impacting patient care, safety and workforce sustainability
There is currently a perceived lack of system leadership and accountability for driving system change to improve worker wellbeing
There is no consistent workplace wellbeing data collection and therefore no means to identify priority areas for action or to measure progress
Many healthcare organisations have inadequate capacity and capability to identify and address root causes of poor worker wellbeing and occupational stress
Middle level managers in particular are critical in shaping a culture of workplace wellbeing but do not currently have the capacity or capability to dedicate to it
Much of the healthcare workforce does not feel safe to speak up or empowered to contribute to system improvement

Read more about what we heard about the current state of workplace wellbeing in South Australia in our stakeholder consultation summary report.

It is also important to note that initiatives to improve worker wellbeing have largely been focused on supporting or improving individual coping skills and resilience rather than addressing the underlying work-related causes of poor health and wellbeing. Research shows that interventions targeting individuals are far less likely to have a sustainable impact on workplace wellbeing than systemic solutions.

What should we be working towards?

The diagram below compares the current state model – as determined through sector consultation, data analysis and literature review – and an ideal future state model based on evidence and best practice.

Full sized diagram of current vs future state

Current vs future state diagram — text only (PDF 104KB)

What can we do?

To really address workplace wellbeing across the South Australian healthcare sector, we need to start by acknowledging the need for commitment and empowerment across four levels, as illustrated in the below diagram.

Full sized diagram of system levels of accountability

System levels diagram — text only (PDF 98KB)

We have distilled our research and engagement into seven key messages which we recommend as a starting point for collective action toward strengthening workplace wellbeing across the South Australian health sector.

#1: Our health system needs to urgently prioritise the wellbeing of our healthcare workforce

#2: Workplace wellbeing is about the protection and promotion of workers’ physical and psychological health

#3: Worker health and wellbeing directly affects patient care and service quality

# 4: A system-level commitment is critical to achieving the necessary culture change, including taking shared responsibility, maintaining accountability and driving coordinated action at all levels

#5: A multi-level, multi-strategy approach is required to address the underlying factors influencing worker wellbeing and to put protective factors in place

# 6: This work must be integrated across existing organisational systems and practices including Work Health and Safety (WHS), Human Resources, Organisational Development, Safety and Quality and Health Promotion

# 7: Healthcare organisations must adopt internal structures and processes that enable rapid identification of issues with clear escalation, response and accountability pathways and metrics

System level actions

The healthcare system in South Australia is complex and interconnected and, therefore, a coordinated and collaborative system-level response is required to drive effective and sustainable change.

The CEIH has developed this model to demonstrate the system-level change required.

Full sized diagram of pillars of change

Pillars of change diagram — text only (PDF 101KB)

Organisational level actions

How can healthcare organisations create workplace cultures that protect and promote workforce wellbeing?

The CEIH has developed a step-by-step organisational guide to help. Based on best practice, this guide describes how to build sustainable and effective structures and processes that enable the rapid identification of issues, forge pathways to accountable resolutions and ensure people are appropriately empowered and resourced to properly look after themselves and each other.

A number of other evidence-based and comprehensive resources exist in South Australia to support organisations develop integrated and tailored wellbeing strategies. The State Government funded Healthy Workplaces Strategy 2021 – 2025 was established to build the capability of organisations across all sectors to create workplaces that protect and promote the health and wellbeing of their workers. The State Government also maintains a Healthy Workplaces website full of resources.

To support the role of Executive leaders and Governing Board members within our South Australia public health system, the CEIH collaborated with psychological health and safety experts, FlourishDX to deliver training to build understanding and confidence in psychological health and safety obligations under the Work Health and Safety Act (2012).

If you are a leader/board member within the SA Health system, you can access a recording of the webinar on SA Health intranet. (Please note, only employees within SA Health will be able to access the link)

Measurement and accountability

Adopting a data-driven approach provides value well beyond generating a snapshot of an organisation’s current state. It can:

proactively assess work system factors known to impact health, wellbeing and safety.
assist in identification of priority issues and development of appropriate solutions.
track and measure the impact of any implemented interventions.
identify priority and “at risk” workgroups.
assist with compliance with WHS regulations and codes of practice.
identify opportunities to improve practice efficiencies and effectiveness.
engage leaders and stimulate discussions about the importance of workplace wellbeing.
enhance transparency and accountability.

There are a range of metrics that can be used to measure both workplace and worker wellbeing.

Organisational wellbeing indicators are the systems, processes, programs, policies and environmental factors in a workplace that can positively or negatively impact wellbeing and culture. They can be measured through an organisational assessment or audit process.

Team wellbeing indicators generally relate to team-specific factors that impact team wellbeing and performance, such as local work systems and processes, interpersonal relationships and leadership behaviours. This can be measured through psychosocial risk assessment tools, staff perception surveys, focus groups and leadership performance assessment.

Individual wellbeing indicators relate to the health and wellbeing status of individual workers. These are usually collected by means of self-assessment relating to one or more domains of health and wellbeing.

For more information on how to collect and use data, please see our Measuring Workplace Wellbeing Fact Sheet.

Links and Tools