Commission on Excellence and Innovation in Health

Strengthening Workplace Wellbeing

Ensuring we’re looking after our people to deliver the best possible services to our patients.

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. 

current vs future state diagram

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.

System level graphic

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.

Wellbeing five pillars

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.