Issue: Expecting staff and management to work with minimal breaks.

1. What are we trying to accomplish? (A.S)

● Our main goal is to assure that all the employees receive the proper amount of
breaks for hours worked, as well as an adequate amount of time allotted for
those breaks.

2. How will we know that change is an improvement (measures)? (CK)

● A contract will be written by employers designating mandatory breaks to

employees based on a number of hours worked.
● Employees will sign a contract stating that they will take mandatory breaks.
● Employees will take a survey every 6 months to assess employee satisfaction
concerning breaks.

3. What change can we make that will result in an improvement?

● Define the processes currently in place; use process mapping or flow
charting (AS, CK, AM, CF)

● The state of Pennsylvania does not require employers to give their employees
rest or meal breaks if they are over the age of 18.

● Identify opportunities for improvement that exist (AM)

● Proposing a bill to Congress that requires hospital workers to receive

mandatory breaks for rest and meals.
● Form a team of educators to inform hospitals on the importance of breaks for
the health and productivity of their employees.
● Create an environment where hospital employees can communicate their
concerns regarding the overworking of staff and the neglect of employee well
being.
● Increase staff size so that there is a lower chance that employees will be
overwhelmed by emergency patients (small staff might not have time for breaks
in these situations).

● Decide what you will change in the process; determine your intervention
based on your analysis. (CF)

● If there is negative results:

● Increase staff size so employees can take breaks appropriately
 ● Propose a bill to Congress to have laws about mandatory meals/breaks for
hospital staff
● Have an educator to inform the hospital staff explaining why it is important to
take breaks for the health status of employees
● To have a mandatory meeting every month of the hospital staff to discuss
positive or negative issues employees are having
● Other organization for employees working in the hospital have these laws in the
state of Washington
○ https://www.medscape.com/viewarticle/874517
○ Employees are not required to work more than 5 consecutive hours
without a meal period
○ Employees working 3 or more hours longer than normal work day should
be allowed to have a 30 min meal period prior to or during overtime
○ Employees shall be allowed a rest period of not less than 10 minutes, on
the employer's time, for each 4 hours of working time. No employee
shall be required to work more than 3 hours without a rest period
○ Employees shall be allowed a meal period of at least 30 minutes which
commences no less than 2 hours nor more than 5 hours from the
beginning of the shift.
● If there are positive results:
○ No changes needed

Plan (A.S) ● Improve employee satisfaction by assuring that all the

employees receive the proper amount of breaks for hours
worked, as well as an adequate amount of time alloted for those
breaks.
● Employees will be surveyed regarding their satisfaction with
breaks and break times in the work setting. This survey would
include the following questions:

1. When you work for at least 4 ½ hours , do you get a 15 - minute

 break?

● Always
● Very Often
● Sometimes
● Rarely
● Never

2. When you work for 6 or more hours, do you get one 15-minute
break as well as one 30 minute break?

● Always
● Very Often
● Sometimes
● Rarely
● Never

3. When you are given a break (s) do you take them?

● Always/
● Very Often
● Sometimes
● Rarely
● Never

Reason(s) why you do not take breaks __________ .

4. How important is it for you to take work breaks as a hospital employee?

● Very Important
● Important
● Moderately Important
● Slightly Important
● Not Important

5. Do you think breaks should be mandatory in hospitals?

● Yes
● No
 ● The hospital members that will be involved in this PDSA include
all staff working full-time hours (40-hour work week minimum).
This could range from administrators to doctors and nurses.
● After completing the short survey, the results will be entered in
Microsoft Excel to create a spreadsheet in order to analyze and
create a conclusion.
● If positive results are observed from the survey then no changes
will be implemented. However, if there are areas of
improvement, changes will then be implemented based on the
survey results. There will be a period of 8 weeks to implement a
change. After 6 months employees will be surveyed again to
determine if the change generated positive outcomes or not.

Do (C.K) ● A total of 300 participants from 10 different hospitals in

Pennsylvania were surveyed.
● Participants will sign informed consent form and fill out survey
via email.
● 85% of employees who answered survey questions 1 and 2 said
that they rarely or never get breaks.
● 75% of employees said that they rarely or never take breaks.
The number one reason for why the hospital employees do not
take breaks is an abundance of work or work overload.
● 95% of hospital employees said it was very important for them to
take breaks.
● 96% of survey participants also said that breaks should be made
mandatory.
● Conclusion: all of the data collected indicate the need for a
change to be implemented within these hospitals in
Pennsylvania.

Study (AM) ● Previous prediction was made regarding the outcomes of the
survey.
● Due to recent data that points to a nursing shortage in
Pennsylvania it was predicted that the hospitals would be
understaffed and therefore there would be more work for the
employees to do. More work for the employees leaves little time
if any to take breaks.
● https://www.wnwlaw.com/pa-nurses-shortage-major-problem/
● From this survey, it can be concluded that hospital employees
need mandatory breaks by law or by hospital requirements in
order to take the necessary breaks that they need.
● Information collected from this survey should be given to the
administrator in charge of employee information as it relates to
employee satisfaction.
● There were no unintended consequences or surprises with this
 study based on current research that had been conducted.

Act (CF)
● For the next cycle, there will be changes implemented within
these hospitals in Pennsylvania for employees to receive an
adequate number of breaks for hours worked along with an
adequate amount of time allotted for those breaks.
● Also, the hospitals used in these surveys will expand their
organization to additional staff in order to provide employee
breaks when needed.
● It would be important to have an educator inform hospital staff
why it is important to take breaks for certain amounts of time.
● It would also be necessary to have mandatory meetings with the
hospital staff to discuss any positive/negative effects of not
taking breaks. Ex. Not allowing employees to take breaks could
result in low work productivity and efficiency.
● Every 4 hours an employee works, should get no less than at
least one 10 minute break.
● Employees have to take a 30-minute meal break before they
work more than five hours
● Since there are going to be changes implemented, there will be
a period of 8 weeks to implement these changes.
● After 6 months, hospital employees will do another survey to
determine if these changes generated a positive or negative
outcome.