Workplace health and safety hazards in a medical practice can be costly to lives and the bottom line, but can be largely preventable if you take the right precautions. Protecting your employees is also the right thing to do and nothing better communicates to your staff that you don’t care about them than to neglect safety.
“Employers establish a business plan for almost everything they do, except safety,” says Howard Mavity, co-chair of Fisher & Phillips LLP’s Workplace Safety and Catastrophe Management Practice Group in its Atlanta, GA office. “Safety will not magically occur because you maintain impeccable patient care and train your employees in their professional or other duties.”
According to Mavity, more fatal workplace errors are committed by experienced professionals than by new hires. Your staff members must have basic policies which fit the workplace; not just forms from a book or website. They must also be trained and document the on-the-job portions.
“Just watching a DVD does not guarantee site or job-specific skills,” says Mavity. “And importantly, a messy workplace and lack of focus on safety always indicates deeper behavior patterns which lead to a wide range of legal, workplace and patient care errors.”
Hazards in the workplace
Even acute care and teaching facilities attract less OSHA scrutiny than manufacturers or construction contractors, notes Mavity. “Smaller providers are seldom inspected and generally consider their work to be safe. Moreover, patient safety is far more on the mind of many healthcare professionals than their own wellbeing.”
Additionally, other than bloodborne pathogens issues (BBP), radiology and certain chemical hazards, many healthcare employees simply do not think of their workplaces as hazardous. As a patient, Mavity says he is fine with the selfless healthcare professional focusing first on patient care, but that admirable behavior will not protect them from injury.
“One should not commit the common error of isolating safety, patient care, and even profitability into separate silos,” he says. “The mindset and habits of robust safety processes translate seamlessly into and buttress all facets of the medical business.”
Mavity stresses the fact that healthcare workplace safety is more than needle sticks and handling chemicals posing reproductive hazards.
“I have seen hospital fatalities involving industrial laundries and sterilization equipment,” he says. “Yes—there are universal concerns for every healthcare workplace, including BBP, needle sticks, hazard communication, infection control, and Personal Protective Equipment (PPE) and the accompanying, required, signed and dated Job Safety Analysis detailing the hazards requiring gloves, masks and other PPE.”
Every workplace is also exposed to the often cited safety electrical standards involving damaged extension cords, no GFI plug near sinks and water, damaged switch plates, overworked or misused surge protectors, and missing labels in electric panels.
“Likewise, retail and other supposedly safe workplaces have experienced hundreds of thousands each in OSHA penalties because exit doors, extinguishers, and electric panels were inadvertently blocked,” says Mavity. “This also occurs in cramped office suites or storage areas.”
In fact, if your facility has fire extinguishers, you must provide annual training or develop what is known as a “fight or flight plan.”
“What about maintenance and engineering?” asks Mavity. “Some of your maintenance doctors are handling sophisticated mechanical and electrical repairs requiring detailed written lock out/tag out procedures, documented training, and annual review. Even more worrying is when a non maintenance doc decides to work on a copier or other equipment presenting electrical hazards.”
Stick to what one knows, stresses Mavity. “Just because your office has a unique mission, you are still a business with many of the same seemingly mundane safety duties. Some of these concerns may seem nit picky, but there are times when that partially blocked or unmarked exit door might cost lives, and that is the seriousness with which OSHA cites the violation.”
Making safety a top priority
Strong workplace safety policies and procedures in place could lead to fewer accidents, less time off work, lower workers comp insurance premiums and more engaged employees. But if safety is to be a main priority at your office, Penny Miller, an HR consultant with Venture HRO, LLC, in Wichita Falls, Texas, says you need to walk the talk and have the policies, training, equipment and enforcement in place.
“There are still medical practices out there without safety needles or that do not enforce the use of PPE, except perhaps gloves—and I think that is because patients expect them,” she says. “Employers need to really look at the hazards in their practices as not every medical office has the same hazards to the same extent, so one size does not fit all.”
Of course, she says, every office has the potential for bloodborne pathogens, but the threat is a lot different for an allergist than a surgeon, for example. Likewise, the risk of hazardous chemical exposure is much higher in oncology than gynecology.
“Once you look at the potential hazards, look at how best to reduce the hazards and what training needs to be done,” says Miller. “Then train on the procedures. Most of all you need to set the example and enforce standards. You can have the best practices in place, but if your employees don’t follow them, they do you no good.”
Dr. Odelia Braun, medical director for Emergency University in Redwood City, Calif., which provides online and blended CPR, AED, and first aid training, believes many medical offices also fail to properly prepare office personnel for significant medical emergencies.
“They improperly believe they can rely on just calling 911,” she says.
However, to save the life of a patient or a fellow employee who suffers a sudden cardiac arrest, the victim must receive high quality CPR and a shock from an AED within four minutes. The likelihood of survival decreases 10% with each minute that passes staring at the moment that the victim collapses.
“No matter if you believe EMS is just up the road, the average EMS response time is significantly greater than four minutes, most often 8-12,” says Dr. Braun.
Simply providing your office staff with CPR and AED training, as well as practicing how the office would respond in case of a medical emergency can save lives.
“No medical office should rely on EMS to manage their cardiac emergencies,” she says.
Making a list and checking it weekly
Like lawyers, Mavity says healthcare professionals do not feel as if they have time to learn the nuances of the applicable OSHA standards and various codes and consensus standards. He offers a basic checklist below which would require someone from your office to weekly or monthly walk the floor and check for those items.
First, the policies. Do you have and do you update:
- A written Hazard Communication program and MSDS’s for chemicals?
- Written Job Safety Analysis (JSA) under OSHA standard 1910.132(d)(2) for all jobs with hazards requiring PPE, which is basically anything other than white coast which one provides as protection from chemicals, infections, eye hazards, odors and respiratory hazards, etc.
- Evacuation/Response Plan, including fire extinguisher considerations and any additional provisions triggered by certain chemicals or gases;
- Radiation exposure, TB
As to training, Mavity recommends:
- Needle stick and blood borne pathogens, universal precautions, sharps, and latex allergy
- Hazard Communication training for all types of hazardous chemicals in the workplace and by December 1, 2013, documented training under the new OSHA Global Harmonization Standard, including how to read those new Material Safety Data Sheets (MSDS).
- PPE use, eye wash response (and stations) cleaning and disinfecting, including less “medical” activities such as laundry and kitchen or restroom clean up – especially for larger facilities.
- Workplace Violence, including for personnel visiting patients and for access to the facility;
- Regular self-inspection items should include:
- Common electrical items;
- Exits, extinguishers (also monthly and yearly inspections) and electrical areas;
- New chemicals without an MSDS or requiring additional hazard training;
- Slips, trips and falls;
- Work stations, including vision and ergonomic challenges.
Finally, Mavity says bloodborne pathogens warrants its own category and he suggests checking the OSHA’s BBP/Needle stick site at: https://www.osha.gov/SLTC/bloodbornepathogens/index.html.
“Especially when you open or acquire new facilities, BBP compliance falls through the cracks,” he says. “Ensure training and that the details of sending an employee for testing and follow-up are adhered to all of them.”