Exploring the Impact of High Reliability Organization Implementation on Patient Handling Injury Rates: A Cross-Sectional Study

Details

• Journal Article:
  Journal of Occupational Medicine and Toxicology
• Personal Author:
  Morales, Michael Joshua G. ; Hilton, Pauline ; Hong, Oi Saeng ; Bialous, Stella ; Martin, Marie ; Foley, Mary ; Lee, Soo-Jeong
• Description:
  Background: Patient handling injuries (PHIs) are among the leading causes of workplace injuries among healthcare workers. High-reliability organization (HRO) programs aim to prevent detrimental errors and improve organizational safety. This study examined the relationship between HRO implementation and direct care staffs' PHI rates. Methods: This cross-sectional study used data from 124 Veterans Health Administration (VHA) facilities. HRO implementation was measured by program duration and HRO climate. Negative binomial regression models were used to examine the relationship between HRO implementation and PHI rates, progressively adjusting for staff-to-patient ratio, facility type, size, and complexity. Results: A longer HRO program duration was associated with higher HRO climate (p = .01), but HRO implementation (duration and climate) was not associated with PHI rates. Higher staff-to-patient ratio was associated with lower PHI rates (p < .05). Ambulatory care service facilities had lower PHI rates than acute care facilities (β = -0.824, p = .03). The most clinically complex facilities (level 1a) had higher PHI rates than the level 3 least complex facilities (β = 0.806, p = .04). Conclusion: While this study did not observe a significant relationship between HRO implementation and PHI rate among direct care staff, the study findings highlight the importance of adequate staffing for injury prevention and the need to consider facility type and complexity in PHI prevention efforts. Future research is needed to explore the impact of HRO on worker safety, using more sophisticated measures to assess HRO programs and climate.
• Subjects:
  Health Personnel Musculoskeletal System Occupational Health Occupational Injuries Safety
• Keywords:
  Author Keywords: High Reliability Organization; Organizational Culture; Patient Handling Injury; Health Care Staff; Safe Patient Handling And Mobility; Musculoskeletal Disorders Patient Handling; Health Care Workers; Cross Sectional Studies; Occupational Safety; Injuries; Injury Prevention; Worker Safety; Musculoskeletal Disorders; MSD; Work Organization;
• Source:
  J Occup Med Toxicol 2025 Nov; 20:40
• ISSN:
  1745-6673
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; District of Columbia ; Philadelphia Region [OSHA] ; San Francisco Region [OSHA]
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  10 pdf pages
• Volume:
  20
• Issue:
  40
• NIOSHTIC Number:
  nn:20071236
• Contact Point Address:
  Michael Joshua G. Morales, University of California, San Francisco, San Francisco, CA, USA
• Email:
  Michaeljoshua.morales@ucsf.edu
• Federal Fiscal Year:
  2026
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:29bdcdffe407cfddf5332d04760f8f340cbb1dd08ca1722eb7c0d3290cfcebd109b1534efa5206ceb54462eb7f859b80e23dd1f8167922597917ed466490965a
• Download URL:
  https://stacks.cdc.gov/view/cdc/258714/cdc_258714_DS1.pdf
• File Type:
  [PDF - 1.19 MB ]