Lessons learned in healthcare safety

By: August 18th, 2014 Email This Post Print This Post

September is traditionally the month when the nation’s students go back to school. So for the upcoming September issue of Medical Environment Update, we thought it would be a good time to think about lifelong learning in the safety profession, which is constantly changing.

We asked some safety experts: if you could teach the newer folks in the safety field a thing or two about the job, what would it be?

“That idea didn’t work last time we tried.” – Veteran safety experts have seen a lot of things come and go in the world of healthcare safety. Some things are with us still and some aren’t. They will tell you about the days when sucking blood up into a pipette with your mouth was an acceptable way to transfer blood, and about the days when wearing gloves was a personal decision. Then again, Hepatitis and HIV weren’t as big a concern back then, either.

“Safety comes first, sometimes.” – Human nature being what it is, we usually look for the easiest, cheapest, and quickest way to complete tasks. In the workplace, that can lead to injuries, especially if strict protocols and safety procedures aren’t adhered to, or if safety equipment isn’t used. Consider the fact that the majority of injuries suffered by healthcare workers from slips, trips and falls are caused by improperly lifting heavy loads, wearing the wrong footwear, or just simply being careless while rushing through a task.

“Accept what you don’t know.” – Medical training programs only teach so much, and there’s a big difference between what you learn in the books and on-the-job experience. Many veterans in the healthcare safety field will tell you that much of what you learn will be in the trenches, making mistakes and watching others go about their jobs. Don’t be afraid to be a lifelong student.

“But study up, and take notes.” – Your time as a student will be short lived, however, as you will at some point need to step up and be the one in the know, the one who teaches, and the one responsible for the answers others don’t know. You should develop a habit for taking detailed notes, keeping good files and records, and knowing where to find the answers—especially if an OSHA inspector comes looking for them.

“We’re all in this together.” – You may be the safety expert, but you are only one person. Many veteran safety experts will tell you that they can only do their jobs properly if every person under them (and above them, for that matter) is committed to working within a culture of safety. For that reason, it is extremely important early on in your safety career to establish a good rapport with your staff, model good behaviors, and find people within your facility that you can trust to be your eyes (and your mouth) when you can’t be there.

“There are so many lessons, but I think a really important message is that it is everyone’s responsibility,” says Anne Newman, RN, Nurse Manager, Employee Health Services, Meriter – UnityPoint Health, Madison, Wisconsin.

“Your job is yucky.” – We all take for granted that when we visit the doctor, we will be cared for in an environment that is free from germs and generally clean. Unfortunately, that’s not always the case. Improper disinfection in hospitals and medical clinics is one of the reason that one in four patients get an infection they didn’t come in with.

“I am shocked at the things I see in doctors’ offices,” says Kathy Rooker, owner of Columbus Healthcare & Safety Consultants in Canal Winchester, Ohio, and who also specializes in performing mock healthcare inspections.

Check out these and other lessons in the September issue of MEU, coming out soon.

Guest Column: Should docs carry guns?

By: August 11th, 2014 Email This Post Print This Post

Thomas A. Smith, CHPA, CPP, is President of Healthcare Security Consultants, Inc. in Chapel Hill, North Carolina, and was formerly Director of Hospital Police and Transportation at University of North Carolina Hospitals, Chapel Hill.

In July, a patient shot and killed his case worker and wounded a physician at Mercy Wellness Center in Darby, Pennsylvania. The wounded physician then pulled a gun and shot the gun-wielding patient who was then subdued by other staff members in the clinic.  That same week video was released from an incident that had occurred earlier this year in an emergency department in North Logan, Utah. In this incident, a patient entered the ED waiting room, pulled two guns and demanded to see his doctor saying that “someone is going to die today.” This patient was shot four times by law enforcement staff that happened to be on site for something unrelated.

After having been responsible for security operations in healthcare facilities since 1981, I could not help but analyze the police and security response, physical security measures (or lack of) emergency responders, public relations staff, and then the gun control and gun proponents during the news cycle or two after the incident.

The answer to the title question is of course, no. But, what should hospitals do to reduce the potential for these incidents and to effectively respond when they do occur?

Conduct a comprehensive evaluation of your security program – Reducing the likelihood of a serious incident involves a layered approach involving many aspects of security including policies, procedures and training as well as physical security, design and other factors. A competent hospital security professional should lead this effort using a multidisciplinary team. Competent means someone with hospital experience and credentials (CHPA and/or CPP). The local PD may have some resources, but you want someone that understands healthcare.

Workplace Violence Policy Assessment – Evaluate your policy and make sure it has senior leadership support. There are several excellent resources to assist in this process including OSHA’s “Guidelines for Preventing Workplace Violence for Health Care and Social Services Workers,” and the ASIS Workplace Violence Prevention and Intervention Standard.

Threat Management Team – A threat assessment team will be part of any decent workplace violence program. Establish this team (usually composed of representatives from Legal, Security, Human Resources, Psychiatry, local law enforcement and others depending on the resources readily available in your HCF). Train the team and use them for threats. This group gets better with experiences as with most teams.

Implement Flag Systems in the Electronic Medical Record – Develop policies and procedures for identifying threatening patients and family members, and patients with violent criminal records. Patients and family members that have previously threatened and or assaulted staff in the past should be identified and flagged so staff members that encounter them in the future have the benefit of the previous experiences. This then allows them to take appropriate measures to protect themselves and others. The best predictor of future behavior is past behavior.

Design Security into New Construction and Renovation Projects – In the next decade there will be billions of dollars spent on new construction and renovation projects. This is a major opportunity to build security into each project. The IAHSS has developed security design guidelines for healthcare facilities. HCFs and healthcare systems should consider these guidelines and develop systems security requirements that each design project implements as a required part of any new project.

Training – Train staff in security sensitive areas on crisis intervention and security policies and procedures. Evaluate your current crisis training and consider if it meets your needs given this new era of violence toward healthcare and human service workers.

This is a call to action. It is easy to become complacent and think these things don’t happen here. Every healthcare organization should consider the risks and take action to make sure you have reasonable, appropriate, risk based security programs in place.

What’s up with OSHA’s proposed I2P2 rule?

By: August 1st, 2014 Email This Post Print This Post

In case you haven’t heard, OSHA has been rather quietly avoiding implementing a rule that the agency’s top brass has said would help prevent worker injuries and illnesses on the job.

OSHA’s proposed Injury and Illness Prevention Program, known as (I2P2) for short, has been in the planning stages since way back in 2010, when Dr. David Michaels, the Assistant Secretary of Labor, made worker safety his top priority to get a written rule on the books by 2011. The rule would, among other things, require employers to implement a to develop and implement an injury and illness prevention program, including a systematic process to proactively and continuously address workplace safety and health hazards.

In addition, OSHA is reportedly pushing for regulatory action to address the risk to workers exposed to infectious diseases in healthcare and other related high-risk environments. This would look at all routes of infection not currently covered by the bloodborne pathogen standard.

It’s now 2014, and the latest information is that OSHA is looking to publish a rule by September. It’s August, and we haven’t heard much. My guess is that it will get delayed again.

I think there’s a reason for that. It’s getting towards election time, and a rule of this caliber would place lots of pressures on healthcare employers, who would be required to comply with yet another, very vague OSHA standard. It would place large financial and time burdens on them, and reportedly people are worried that it would just add another “General Duty Clause” for inspectors to have free reign over what they perceive as infractions of the rule.

I’d like to know your opinions on this. Is it a good thing? Should this standard be adopted? Is OSHA playing games here?

As always, feel free to drop me a line with your opinions at jpalmer@hcpro.com.

Lessons to teach the younger safety crowd

By: August 1st, 2014 Email This Post Print This Post

Hi folks -

I’m in the middle of writing a compilation story for the September issue of Medical Environment Update, and I’d like your help, especially from those who have been doing lab and clinic safety for a while!

Since September is back to school season, I’d like to know what lessons you would teach the younger folks in safety if you had the chance. What lessons have you learned over the years? What kind of training and education do you think is needed to make the healthcare industry safer?

Please drop me a line at jpalmer@hcpro.com with your ideas, along with a sentence or two giving some elaboration or examples and I’ll work your comments into our story.

Thanks so much!

John Palmer

 

Webcast: Learn the basics of the CMS Life Safety Code update!

By: July 31st, 2014 Email This Post Print This Post

The Centers for Medicare & Medicaid Services (CMS) has published a proposed rule to adopt the updated 2012 edition of the Life Safety Code® (LSC), and facilities must be ready to comply.

Join HCPro on Thursday, September 18, 2014 from 1–2:30 p.m. Eastern Time for a 90-minute webcast that will help you prepare your facility to shift from the current 2000 edition of the LSC and understand the changes present in the 2012 edition. Join expert speakers Brad Keyes, CHSP, and James Murphy, RA, NCARB, as they discuss the changes governing fire alarm systems, sprinkler systems, and all aspects of the Code.

 This program will:

-         Explain how the 2012 LSC will affect how healthcare facilities are maintained and operated

-        Discuss changes that require additional testing and inspection activities as well as reduce other testing and inspection requirements

-        Describe how to prepare for these changes when CMS formally adopts the 2012 edition of the LSC

If you can’t listen live, no problem. For the low price, you’ll be able to download the on-demand version at no additional charge when you buy the live version. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times!

Learn more and register by clicking here to visit the HCPro Marketplace.

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