Breaking down hospital silos: A ticket to protecting patients and caregivers

Patient-handling activities are a common cause of workplace injuries for patients and care providers in hospital settings. When an incident involving patient handling results in the patient, provider or both being injured, two safety systems typically swing into action. One tracks, assesses and responds to the patient’s injury. The other tracks, assesses and responds to the employee’s injury. These systems rarely talk to each other. According to Associate Professor David Hurtado, Sc.D. at the Oregon Institute of Occupational Health Sciences and OHSU, getting these systems to communicate and work together is the ticket to reducing injuries for patients and providers.

In a new paper published in the International Journal for Quality in Health Care, the research team argues it’s time to bring these parallel tracks together to address overlapping risks that endanger everyone. In the paper, the researchers present a framework of four straightforward recommendations that hospitals can follow to uncover and address issues in patient-handling activities that result in injuries to patients and providers. The recommendations are:

1. Establish routine interdepartmental meetings 

2. Collaborate on incident reviews 

3. Share risk assessments 

4. Integrate policy development

   
   

According to the researchers, these recommendations or “indicators” as they’re referred to in the paper, provide a structure for improving safety efforts through decompartmentalization and increased focus on systems that address the safety and well-being of everyone involved in providing and receiving care.

The need for this integration becomes clear when you consider the typical hospital environment. Cluttered hallways don't just trip patients—they force nurses to maneuver awkwardly around obstacles, increasing the risk of injury. Poorly placed equipment creates hazards for both populations. Inadequate staffing strains workers while leaving patients more vulnerable to fall. Yet, many hospital safety programs address these issues separately, often with competing priorities and different leadership structures.

The consequences of this fragmentation are substantial. Healthcare workers experience some of the highest rates of musculoskeletal disorders among all professions, while patient falls remain one of the most common adverse events in hospitals.

The research team's proposed indicators offer hospitals a way to measure progress toward genuine integration. Interdepartmental meetings bring together leaders from employee health, patient safety, quality improvement, and frontline staff to align priorities and coordinate interventions.

Collaborative incident reviews take this step further. When a patient falls, both patient safety and employee health leaders participate in the same investigation. This approach reveals systemic contributors that single-focus reviews can miss.

Shared risk assessments allow teams to identify dual-risk environments. A congested hallway or an inaccessible mobility aid can threaten both patient stability and caregiver safety, yet traditional assessments may evaluate only one dimension. Integrated tools ensure both perspectives inform mitigation plans. 

Perhaps most importantly, co-developed policies create unified protocols for injury prevention, mobility support, and incident reporting. When departments jointly write these rules, they eliminate conflicting procedures and build consistency. This could prove especially valuable in rural hospitals, where staff often fulfill multiple roles and can't afford redundant systems.

According to the research team, the framework draws on existing models—including the Agency for Healthcare Research and Quality's Total Systems Safety and the Institute for Healthcare Improvement's Safer Together Action Plan—that advocate for integrated governance and shared accountability.

As healthcare faces an uncertain financial and regulatory landscape, the case for integration strengthens. The question isn't whether integration makes sense. It's whether healthcare systems can overcome decades of parallel development to finally treat workforce and patient safety as the mutually reinforcing priorities they've always been.