Author Archive for: Steven Porter

This week: OSHA emphasizes fall prevention

May 8th, 2017 Email This Post Print This Post

A failure to provide workers with adequate fall protection is the violation cited most frequently by OSHA inspectors. Each year, hundreds of construction workers are killed in falls, which is why OSHA and its partners set aside this week, May 8-12, as a “National Fall Prevention Safety Stand-Down” to encourage employers to pause during the workday and revisit safety topics.

Given the high number of fall-related fatalities among construction workers, that industry serves as the natural focus of this week’s events, but the stand-down carries worthwhile reminders for those overseeing safety in healthcare settings as well.

Late last year, OSHA cited Jersey City Medical Center RWJ Barnabas Health with one willful and four serious safety violations, proposing a penalty of nearly $175,000 after a maintenance worker was electrocuted while working on a 6-foot A-frame ladder. The worker, who fractured multiple bones and sustained a subdural hematoma, died from the injuries more than two weeks after the fall. Kris Hoffman, director of OSHA’s Parsippany Area Office, called the death “tragic” and “preventable.”

Employers who hope to prevent fall-related injuries and deaths are encouraged this week to have conversations with their workers about hazards and protection. To that end, OSHA assembled a website, www.osha.gov/StopFallsStandDown/. The free resources available on the site include fall-prevention training guides in English and Spanish and a downloadable version of Falling Off Ladders Can Kill: Use Them Safely, a document that details proper ladder usage.

Will you pause this week for a fall prevention stand-down? If not, you should consider working these resources into your future training sessions. The emphasis may be only a week long, but the hazards exist year-round.

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When does workplace violence violate OSHA’s General Duty Clause?

May 5th, 2017 Email This Post Print This Post

It remains unclear whether the feds will follow California’s lead in implementing an occupational health and safety standard on workplace violence prevention in healthcare settings, despite a largely positive response from those who commented on OSHA’s recent request for input on the idea.

The federal standard could specify which steps employers must take to protect healthcare workers and impose fines for noncompliance. Even without the nationwide standard, however, it’s already possible for OSHA to penalize healthcare employers anywhere in the country for failing to prevent violence against doctors, nurses, and other healthcare professionals.

That possibility comes, of course, from the OSH Act’s General Duty Clause, which requires that an employer keep its workplaces “free from recognized hazards that are causing or likely to cause death or serious physical harm to [its] employees.” But what exactly does it take to support an allegation that an employer whose workers have been victimized by violence should be held accountable, to some degree?

Clarence Webster III, JD, with the firm Bradley Arant Boult Cummings LLP, addressed that question this week in a blog post, citing a directive that took effect in January. The directive guides OSHA officials on when and how to issue citations in response to workplace violence, Webster explained.

“In determining whether to initiate an inspection, the Directive sets forth a list of known risk factors, none of which would individually trigger an inspection,” Webster wrote.

These risk factors include employment in healthcare, working alone or in small numbers, late-night or early-morning shifts, working in high-crime areas, and others. If your workplace has some of these factors, there are four questions OSHA must answer in the wake of a violent incident to determine if you violated the General Duty clause:

  1. Did the employer fail to keep its workplace free of a foreseeable workplace violence hazard?
  2. Was the hazard explicitly recognized or recognized in a high-risk industry?
  3. Was the hazard causing or likely to cause death or serious physical harm?
  4. Was there a feasible and useful means by which to correct the hazard?

Answering “yes” to all four questions above–which align loosely with the four-pronged test articulated last year in a Government Accountability Office report on workplace violence prevention—would tend to support an alleged violation of the General Duty Clause. (An affirmative response to fewer than four of the above questions could still warrant a “hazard alert letter” with recommendations to improve safety.)

For any employers looking for practical steps to minimize risks, there is an 11-page list in Appendix A of the directive. It outlines engineering and administrative controls, and it provides a table with recommended applications in various healthcare settings.

Webster said one of the keys to preventing workplace violence is making sure that your employees understand that they should report potentially violent behavior, not tolerate it.

“However, when you get to the suggested engineering and administrative controls,” Webster added, “be sure to balance them against other laws governing your workplace, including state, local, and federal privacy laws and safety and building codes and standards.”

For more on the prospect of a federal OSHA standard on workplace violence prevention in healthcare, see the June edition of HCPro’s Briefings on Hospital Safety newsletter.

Workers’ Memorial Day: A somber reminder of progress made, work left to do

April 28th, 2017 Email This Post Print This Post

Carrie Rouzer was caring for a patient last July at Parrish Medical Center in Titusville, Fla., when a stranger barged in and gunned down both Rouzer, 36, and her 88-year-old patient before being subdued by security guards.

The shocking case, which drew attention to workplace violence as a real threat to healthcare workers, was certainly on the minds of groups who gathered Friday in Jacksonville and Miami in observance of Workers’ Memorial Day. The two sites were among hundreds nationwide holding local ceremonies commemorating the lives of those killed on the job, whether by violence or accidents.

The annual event is held on April 28, the day OSHA was established in 1971, as a reminder of the progress made in workplace safety in recent decades and the work yet to be done. Rouzer’s story, sadly, is among many others collected over the years.

Among the thousands of occupational fatalities recorded across all industries, between 100 and 150 occur in the healthcare and social assistance sectors each year, according to the Bureau of Labor Statistics. In 2015, there were 109. (Finalized numbers for 2016 will be released this December.)

When you consider how many hours workers put in, those 109 fatalities translate to a fatal injury rate of 0.6 per 100,000 full-time equivalent workers. That’s much less than the overall rate across all industries, which was 3.4 in 2015, according to BLS data. Workers in transportation and warehousing, by contrast, suffered a fatal injury rate of 13.8—which is 23 times higher than the rate in healthcare.

Within the healthcare sector, the numbers are broken down into three categories. Ambulatory healthcare services, which saw 47 fatalities in 2015, had a rate of 0.7. Nursing and residential care facilities, which saw 24 fatalities, had a rate of 1.1. And hospitals, which saw 21 fatalities, had a rate of 0.4. All of these numbers are down slightly from rates reported for 2006.

Although the fatal injury rate in healthcare remains low compared to other industries and has declined slightly in recent years, OSHA continues to look for ways to improve safety. Those improvements should be balanced against other considerations. But let’s take Workers’ Memorial Day as an opportunity to reflect on Rouzer’s story and others like it. Are we doing all we can reasonably do to protect workers? Is there more?

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A summary report on the number and rate of workplace fatalities by industry and sector published by the U.S. Bureau of Labor Statistics groups healthcare with educational services. Full report: https://www.bls.gov/iif/oshwc/cfoi/cfch0014.pdf

 

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