This systematic review, authored by Safa Elkefi, Roa Sabra, Julia Marie Hajjar, Dina Idriss-Wheeler, and Enas Aref, delves into the crucial role of participatory ergonomics (PE) in enhancing the safety of healthcare workers within clinical settings. Published in Theoretical Issues in Ergonomics Science, this article addresses a significant gap in existing healthcare safety literature, which has traditionally centered on patient safety rather than the well-being of the healthcare professionals themselves. Given the inherently dynamic, fast-paced, and demanding nature of modern healthcare environments, where staff face continuous pressure, complex tasks, and high physical and psychological burdens, investigating strategies to support worker safety is paramount.
The authors highlight that despite considerable attention to safety in healthcare, efforts have largely been patient-centric. This study aims to redress this imbalance by exploring how participatory ergonomics approaches can effectively promote the safety of healthcare workers and identifying the challenges encountered during their implementation. PE, rooted in the Human Factors and Ergonomics (HFE) discipline, involves workers in redesigning their work activities to ensure they have the knowledge and power to influence processes and outcomes, which is considered essential for improving and maintaining safe workplace behaviors and fostering adaptive safety cultures.
To achieve its objectives, the review employed a rigorous methodology, following PRISMA guidelines and utilizing the PICO framework for a comprehensive search across multiple databases in April 2023. A total of 36 peer-reviewed studies were included after a meticulous screening process, ensuring focus on human factors interventions based on PE aimed at improving workplace safety for healthcare professionals.
The findings underscore that PE is an efficient approach to supporting healthcare workers’ safety. The review identified that PE interventions successfully address a range of critical safety issues, including:
- Musculoskeletal injuries (MSDs) (N=14 studies). These are a predominant focus, with PE interventions like patient-handling devices and pre-work stretch programs demonstrating positive outcomes such as reduced MSDs and increased job satisfaction.
- Occupational injuries (N=8 studies). PE interventions, such as the PErforM Risk Assessment tool and the EPIC program, were effective in reducing the risk, severity, and rate of injuries related to manual handling, emphasizing the importance of active frontline worker involvement and supportive management.
- Performance in complex systems (N=7 studies). PE helps in organizing healthcare systems, designing care pathways, and addressing challenges related to freedom of choice, mobility, and decision-making for staff, ultimately enhancing safety and performance.
- Medication errors and management (N=3 studies). PE facilitated improved medication safety through targeted training, interprofessional collaboration, involvement of clinical pharmacists, and increased willingness to report errors.
- Physical load (N=2 studies). Though less explored, PE provided insights into physical demands, particularly for paramedics, informing training and job analysis to reduce strain.
- Occupational stress (N=2 studies). PE tools and tailored interventions were shown to address psychosocial safety concerns, promoting a well-educated and stable workforce and enhancing occupational safety interventions.
Despite these successes, the review also highlights implementation challenges, such as resistance to change, lack of suitable funds and resources, staff shortages, turnover, safety culture, insufficient staff time, and communication issues. The authors emphasize that proactive and intentional support from management and the organization, alongside appropriate financial and personnel resources, is crucial for successful PE implementation.
Ultimately, this systematic review offers evidence-based policies, guidelines, and recommendations for integrating participatory ergonomics into healthcare safety programs, aiming to mitigate occupational hazards, improve worker well-being, and ensure the efficient and safe functioning of the healthcare system for all stakeholders.
Reference: Elkefi, S., Sabra, R., Hajjar, J. M., Idriss-Wheeler, D., & Aref, E. (2025). The role of participatory ergonomics in supporting the safety of healthcare workers; a systematic review. Theoretical Issues in Ergonomics Science, 26(3), 257-303. https://doi.org/10.1080/1463922X.2024.2373439.
