Strengthening Workplace Wellbeing

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.

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

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.

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)

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 

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)

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)

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.

CEIH Resources

Strength­en­ing Health­care Work­place Well­be­ing dis­cus­sion paper (2 MB, PDF)

Build­ing Work­place Well­be­ing organ­i­sa­tion­al guide (6 MB, PDF)

Mea­sur­ing Work­place Well­be­ing fact sheet (1 MB, PDF)

CEIH 2022 stake­hold­er con­sul­ta­tion sum­ma­ry report (2 MB, PDF)

Addi­tion­al Resources: sys­tem level

Dee­ble Insti­tute (Deakin Uni­ver­si­ty): Towards a thriv­ing health­care workforce

Every Doc­tor, Every Set­ting: A Nation­al Framework

Addi­tion­al Resources: organisational/​individual level

South Aus­tralian Gov­ern­ment: Healthy Workplaces

Well­be­ing SA Healthy Work­places Strat­e­gy 2021 – 2025

Safe Care Vic­to­ria: Health­care work­er wellbeing

Nation­al Men­tal Health Com­mis­sion: Nation­al Work­place Initiative

Fed­er­al Gov­ern­ment, Com­care: Psy­choso­cial hazards

Black Dog Insti­tute: Resources for health professionals

Doc­tors’ Health SA