Perceptions of Workplace Fatigue and Fatigue Risk Management Among Health Leaders in Aotearoa New Zealand

Introduction: It is well recognized that workplace fatigue is associated with decreased patient safety, increased healthcare costs and adverse health and safety consequences for health workers. Recent nationwide surveys of the public health workforce in Aotearoa New Zealand have highlighted that fatigue-related outcomes are commonly experienced by workers at all levels of the organization, including those in leadership roles. Leaders in the health sector have an important role in implementing policies and organisational approaches to address fatigue among health workers. However, little is known about their perceptions and understanding of fatigue risk management (FRM), including in Aotearoa New Zealand. Among health leaders in Aotearoa New Zealand, we aimed to explore perceptions of fatigue and its impacts, understanding of FRM, and perceived barriers and facilitators for being involved in developing new FRM approaches.

Methods: All leaders working in national, clinical, and occupational health and safety (OHS) leadership roles in Aotearoa New Zealand’s national public health organization were invited to participate in an anonymous online survey.

Results: The survey was completed by 632 leaders in our target groups (national: n = 89, clinical: n = 523, OHS: n = 20). Overall, the majority of leaders reported that workplace fatigue has consequences for patient and worker health and safety outcomes, and that it negatively impacts staff retention. Approximately half of the sample (46.5%) felt that there is equal responsibility between leadership and individual workers in managing workplace fatigue, but a small proportion (13.1%) reported that individual workers were mostly or completely responsible. Most leaders thought that their organization did not have effective policies (65.7%), processes (85.3%) or strategies (78.0%) for managing workplace fatigue. While most leaders (86.7%) acknowledged they would benefit from resources or tools to increase their knowledge of FRM, many (61.8%) did not feel they had the time to engage with them. Similarly, some leaders (23.9%) reported that compared with other issues that needed to be addressed, managing fatigue was not at all, slightly or moderately important.

Conclusion: Workplace fatigue is acknowledged as having significant consequences in the health sector in Aotearoa New Zealand, but is perceived to be one of many risks that health organisations must manage. FRM systems include fatigue monitoring and allow for improved management of fatigue risks. One barrier to addressing the health- and safety-related consequences of fatigue in a workforce, including New Zealand’s health workforce, is the lack of implementation of FRM systems. Targeted strategies for health leaders may support them to increase their knowledge of FRM and increase participation in developing new system-based approaches to FRM. Support: This project was funded by the Health Research Council of New Zealand.