How does worker fatigue affect a healthcare organization’ s level of regulatory compliance?  

It turns out, employees who are not getting enough rest have a higher chance of making mistakes or performing their work at a sub-standard level. And in healthcare, this can mean increased non-compliance with facility policies and adverse effects on patient care.  

Worker fatigue during a pandemic 

Healthcare workers have always been at risk of fatigue, particularly with the traditionally long shifts for residents and the high stakes of patient care. The pandemic adds the unknowns of treatment, grief over lost patients, fear of catching the virus and missing family and routine. Unfortunately, this dual fatigue- at work and at home – increases the risk for errors around patient care and other highly regulated elements of healthcare.  

Worker fatigue and increased mistakes 

Workers who are fatigued may not have the same ability to focus on their tasks.  For example, when sending a fax from the hospital to a primary care office on behalf of a patient, a nurse might type in the wrong fax number, thus sending protected health information (PHI) to the wrong person. Or worse, an employee may click on a link embedded in an email that is associated with malware and cause a breach. These are just two examples of how worker fatigue could cause compliance concerns.  

Worker fatigue and decreased quality of work  

Similarly, when people are fatigued or burned out, the quality of their work and judgment can decrease.  For example:

• A usually conscientious employee may cut corners and not ensure a signature is obtained on a patient consent for surgery. 
• A contract manager may upload a new contract but forget to obtain a required business associate agreement (BAA) form.  
• A compliance audit may show that a Human Resources employee delayed scheduling flu vaccines and tuberculosis test for a group of new employees. 
• A nurse may leave confidential patient information showing on a computer screen at the nurses’ station when called away to answer a nurse call light.  

How Compliance can help 

Helping staff stay well rested doesn’t fall just to the Compliance team, of course. But Compliance is a stakeholder and can partner with Human Resources to make sure the organization prioritizes reducing worker fatigue and supporting employees’ wellbeing. 

• Compliance professionals can identify regulatory risks and help prioritize issues and develop materials for staff meetings to reinforce the need for adequate rest. Check out these CDC guides for material:
  • COVID-10 and Workplace Fatigue: Lessons Learned and Mitigation Strategies  
  • Managing Fatigue During Times of Crisis: Guidance for Nurses, Managers, and Other Healthcare Workers 
• Human Resources can create and offer support such as include peer support programs, supporting mental health paid time off, and referrals to the organization’s employee assistance (EAP) program. (An EAP is a work-based intervention program – like counseling – designed to assist employees in resolving personal problems that may adversely affect their performance.) 
• Hospital administration can work with department heads to make sure shifts are scheduled in a way that allows for adequate rest. 

The issue of worker fatigue is rooted in every aspect of a healthcare organization’s operation. People are passionate about their work and want to care for their team and their patients. Managers are doing their best to schedule people appropriately, but COVID has made existing staff shortages worse. A reminder from the Compliance team may help everyone in the organization take better care of themselves to ultimately deliver better care. 

Keep on top of regulations affecting your organization and make sure those regulations are translated into policies and procedures that affect patient care. YouCompli customers have access to notifications about changes to regulations, resources to inform policy and procedure updates, and tools to track compliance. Contact us today to learn more. 

Denise Atwood, RN, JD, CPHRM 
District Medical Group (DMG), Inc., Chief Risk Officer and Denise Atwood, PLLC 
Disclaimer: The opinions expressed in this article or blog are the author’s and do not represent the opinions of DMG.