All Entries Tagged With: "hazard vulnerability analysis"
From the muddy banks of compliance
Let’s break from form a little bit and start with a question:
How often are you (and by you, I mean your organization) screening contracted staff, including physicians, physician assistants, nurse practitioners, etc.?
A recent TJC survey resulted in a finding under the HR standards because the process was being administered on a biannual cycle. The finding vaguely referenced OSHA guidelines in identifying this deficiency, but the specific regulatory reference point was not provided (though apparently a call to Chicago validated that this was the case). Now, anyone who’s worked with me in real time knows that I have an exhaustive (and, at times, exhausting) curiosity about such matters. The deficiency “concepts” are usually sourced back to a “they;” as in, “they told me I had to do this” “they told me I had to that.” I am always, always, always curious as to who this “they” might be and whether “they” were good enough to provide the applicable chapter and verse. The answer, more often than not, is “no.” Perhaps someday we’ll discuss the whimsical nature of the” Authority Having Jurisdiction” (AHJ) concept, but we’ll save that for another day.
At any rate, I did a little bit of digging around to try and locate a regulatory source on this and in this instance, the source exists; however, the standard is not quite as mandatory as one might first presume (If you’re thinking that this is going to somehow wrap around another risk assessment conversation, you are not far from wrong). So, a wee bit of history:
Back in 1994, the CDC issued their Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Facilities, (http://www.cdc.gov/mmwr/pdf/rr/rr5417.pdf) which, among other things, advises a risk-based approach to screening (Appendix C speaks to the screening requirements for all healthcare workers, regardless of who they work for. The guidance would be to include contract folks. The risk level is determined via a risk assessment (Appendix B of the Guidelines is a good start for that). So, for a medium exposure risk environment, CDC recommends annual screening, but for a low exposure risk environment, they recommend screening at time of hire, with no further screening required (unless your exposure risk increases, which should be part of the annual infection control risk assessment).
But, in 1996, OSHA issued a directive that indicates annual screening as the minimum requirement , even for low-risk exposure risks, and even while referencing the CDC guidance: (http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=1586) with medium risk folks having semi-annual screening and high-risk folks being screened on a quarterly basis. So, friends, how are you managing folks in your environment, particularly the aforementioned contracted staff? Do you own them or is it the responsibility of their contracted employer? Does this stuff give you a headache when you think about it too much? It sure gives me one…occupational hazard, I guess. At any rate, it’s certainly worth checking to see whether a risk assessment for TB exposure has been conducted. The OSHA guidance document clearly indicates that if you haven’t, it’s the responsibility of the surveyor to conduct one for you, and I don’t know that I’d be really keen on having that happen.
Implementing workplace violence policies
Howdy, safety profs!
I’ve received a number of inquiries lately looking for workplace violence policies. I figured if a few might have questions, then that’s enough indication to me that there may be some other folks as well looking for these elusive policies.
With all that said, to be honest, I don’t know that I would advise pursuing policy development. It’s more than likely that any policies you would need to support the management of risks associated with workplace violence are already in existence. The key to compliance is to follow the risk assessment recommendations in the SEA and, for all intents and purposes, conduct a gap analysis based on the elements identified in the SEA.
Some risk assessment targets that you should aim at
Overall, risk assessments are really useful in two general instances:
- When you have a risk that you cannot eliminate and you need help identifying the means of reducing that risk to the extent possible
- When you have a risk for which there is no regulatory guidance or requirement and the “way” is not clear
With those thoughts in mind, there are plenty of situations that can benefit from a risk assessment, such as [more]
Despite bigger influences, Joint Commission wants emergency prep to stem from staff’s abilities
The surveyor cadre is not particularly knowledgeable about the practical application (and implications, for that matter) of federal level emergency management activities.
There is a broad-based Joint Commission requirement for organizations to comply with applicable local, state, and federal laws and regulations, but even the National Incident Management System and Hospital Incident Command System only truly become “requirements” when [more]
Nurse firings during emergency response should trigger an HVA assessment on your end
Any of you been following the headlines regarding Washington (DC) Hospital Center firing a handful of staff for calling in to work during blizzards in February?
In a nutshell, the hospital has terminated 21 nurses and other essential personnel, saying they allegedly disregarded their duties and ignored attempts by the facility to offer [more]
Embrace the ebb and flow of emergency management planning
When it comes to Joint Commission emergency management strategies and your hazard vulnerability analysis, there is room for imperfections within the confines of preparedness.
This is a constantly fluid process for which assessment and re-assessment are the order of the day, and, to be honest, the process should reflect:
- Improvements made in your planning activities
- Improvement opportunities
- Any shifting variables that would impact the organization’s response capabilities
By the way, when communicating to organizational leadership as a function of the annual evaluation of your HVA, I like to prepare a summary of the HVA results in narrative form to focus attention on the key programmatic elements, vulnerabilities, etc.
