Changes in population health and morbidity, the health care workforce, and health care delivery have led to significant changes in the health care workplace. The Institute of Medicine was asked by the Agency for Healthcare Research and Quality of the US Department of Health and Human Services to study the working conditions of nurses and their relationship to patient safety. This project identified:

• key aspects of the work environment for nurses that likely have an impact on patient safety; and
• potential improvements in health care working conditions that would likely increase patient safety.

The study committee was made up of individuals with experience in areas such as: nursing, patient safety, health care quality, engineering, operations research, multidisciplinary team practice, human factors, industrial psychology, and communications.

The committee reviewed existing evidence, commission papers and receive expert testimony. Evidence from both the health care industry and other industries was reviewed. This evidence was assessed in the context of current policy debates on regulation of nursing work hours and workload and will cover topics such as: extended work hours and fatigue, including mandatory overtime; nurse staffing; workplace processes such as patient care documentation, decision support systems, and communication with other members of the health care team. The start date for this project was September 30, 2001.