Effectiveness of the Healthy Workplace Participatory Program With Peer-led Teams in Public Sector Healthcare Facilities

Safety \& Health through Integrated, Facilitated Teams (SHIFT) is a five-year study with etiologic, intervention, and translational research components. Six public sector healthcare institutions are enrolled, in three pairs matched by agency and type of services. The sites are four Massachusetts state healthcare facilities, which have recently been mandated by law to achieve "Occupational Health and Safety Administration (OSHA) equivalent compliance," and two Veterans Administration facilities each of which has multiple nationally mandated programs addressing employee health and safety. Using a "stepped wedge" design, one of each pair will be randomly selected as the immediate intervention site, while the other facility will be the concurrent control or "lagged intervention" site, having access only to technical reports and information until mid-project, when it will also receive the full intervention.

The intervention is the CPH-NEW Healthy Workplace Participatory Program (HWPP), a process for increasing the effectiveness of occupational health and safety committees or peer-led employee teams, through root cause analysis, prioritizing health and safety needs for effective problem-solving, identifying feasible interventions, and presenting these to leadership. Each facility has a pre-existing labor-management health and safety committee (HSC), which is the unit of intervention, so the HWPP will be adapted to joint management-labor teams. The committee is a partner in designing the program to fit the constraints and needs of the specific workplace and workforce. The research team provides training, coaching in the HWPP process, technical information, and practical assistance to committee members, facilitators, champions and leadership.

Etiologic research will entail analysis of baseline data for cross-sectional associations of work organization with worker health indicators. Intervention research will entail effectiveness and cost-outcome analysis of the HWPP. Outcomes will be both generic indicators of employee well-being and specific outcomes appropriate to the topics that the HSC's select for intervention. Translational research (process evaluation) will evaluate the efficacy of the dissemination and training strategy, as well as obstacles to and facilitators of uptake and implementation.

• Proportion of content followed according to the HWPP protocol [Time frame: Through study completion, an average of three years]
• Change in scope of health/safety/well-being [Time frame: Through study completion, an average of three years]
• Shared labor-management awareness of job-related health issues [Time frame: Through study completion, an average of two years]
• Work Ability of Employees [Time frame: Prior to random selection of immediate and delayed intervention site, and 3 years later]
• Quality of Care of Patients/Residents: All-Employee Survey [Time frame: Prior to random selection of immediate and delayed intervention site, and 3 years later]
• Organizational Support for Health, Safety, and Wellbeing [Time frame: Prior to random selection of immediate and delayed intervention site, and 3 years later]
• Employee Burnout: Exhaustion and Disengagement [Time frame: Prior to random selection of immediate and delayed intervention site, and 3 years later]
• Frequency of Threats, Assault, and Harassment of Employees [Time frame: Prior to random selection of immediate and delayed intervention site, and 3 years later]
• Change in Worker Injuries [Time frame: Through study completion, an average of five years]
• Musculoskeletal Pain [Time frame: Prior to random selection of immediate and delayed intervention site, and 3 years later]