Archive for: General Safety and Health

Missouri hospital in ‘immediate jeopardy’ fires 12 workers, installs interim leadership team

By: September 13th, 2017 Email This Post Print This Post

Corrective steps being taken to protect patients and workers alike, hospital says

A hospital in Missouri at risk of losing its Medicare funding within the month installed an interim leadership team this week as it seeks to appease federal inspectors.

Mercy Hospital Springfield was placed in “immediate jeopardy” by CMS after an inspection last month found significant violations of the regulations pertaining to nursing services and patient rights. The hospital announced last week that it had fired 12 employees whose behavior in “highly tense situations” was deemed inadequate. That news was followed Tuesday by an announcement that the interim leaders would step in to right the ship.

“They bring a fresh perspective and will help bolster local resources,” said Jon Swope, interim president of Mercy Springfield Communities, in a statement announcing six temporary leaders.

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Treatment center slapped with $207k proposed fine as OSHA announcements grow rarer

By: August 16th, 2017 Email This Post Print This Post

Facility accused of failing to address workplace violence risks it had promised to remedy

A psychiatric treatment center in Massachusetts faces more than $207,000 in proposed penalties after OSHA accused the facility of failing to adequately protect employees from workplace violence, despite having promised specifically to do so.

Notice of the proposed action against Lowell Treatment Center, which is operated by UHS of Westwood Pembroke Inc., comes as OSHA has grown significantly quieter about its enforcement activity under President Donald Trump’s administration than it had been under former President Barack Obama. There have been fewer enforcement-related OSHA press releases issued in the seven months since Trump took office than there were in just the final month of 2016.

It remains unclear how OSHA decides which enforcement actions warrant a press release. An agency spokesperson was not immediately able Wednesday to answer questions about this threshold. But we know that this case entails allegations that the facility failed to keep specific promises it made last year in a formal settlement agreement stemming from an unfavorable 2015 evaluation by federal inspectors.

“Our inspectors found that employees throughout the Lowell Treatment Center continued to be exposed to incidents of workplace violence that could have been greatly reduced had the employer fully implemented the settlement agreement,” OSHA’s Boston-based regional administrator Galen Blanton said last week in a written statement.

The management company, which operates 350 facilities throughout the United States and United Kingdom, notified OSHA that it intends to contest the findings, according to the press release.

Micah Smith, an OSHA attorney with Conn Maciel Carey in Washington, D.C., said during a webinar Tuesday that the Obama administration had engaged in “regulation by shaming.” And any Republican in the White House would be expected to back off of Obama-era levels of enforcement, he said.

“We’re expecting to see this change, and that press-heavy enforcement model to be rolled back,” Smith said. “We haven’t seen any official actions, but in the early days of the administration, most agencies across the government have been encouraged or required to reduce their press activity.”

Smith said there were two or three OSHA enforcement press releases in June and July this year, compared to 25-40 for each of the same months last year. Even so, it’s important to note that OSHA’s priorities are just as unsettled as its staffing.

“As with all things, without the permanent OSHA team in place, we’re still reading the tea leaves a little bit,” Smith said.

The press release in this case comes two months after OSHA endured criticism for backing off an allegation that Bergen Regional Medical Center (BRMC) in Paramus, New Jersey, had an inadequate workplace violence prevention plan. Jordan Barab, a former OSHA official under Obama, drafted a lengthy blog post critical of the move, and he clashed on Twitter with Eric Conn, another attorney with Conn Maciel Carey, who was hired to represent BRMC’s defense against the citation.

Barab, who has also been critical of the marked decrease in the issuance of OSHA enforcement press releases, hasn’t blogged since OSHA issued its press release last week.

Update (8/23/17): Barab blogged yesterday about this case. “Although I am frequently critical of OSHA under the Trump administration,” he wrote, “never let it be said that I have failed to praise the agency when they do something good.”

Bizarre circumstances led to hospital’s hazmat response, ER lockdown

By: August 2nd, 2017 Email This Post Print This Post

Report: Suspicious package that prompted mini-emergency was letter from government agency

If you subscribe to HCPro’s monthly Briefings on Hospital Safety newsletter, you will recall the story of a hazardous material scare and emergency lockdown at Frederick Memorial Hospital in Maryland. Two men opened a piece of mail at home in May, discovered a suspicious substance inside, and began experiencing skin and respiratory irritation, so they went to the local ED—and brought the unknown substance with them. That, of course, sent hospital staff scurrying to contain the threat.

Because the men live across the street from the U.S. Army’s Fort Detrick, a hub for biodefense research, there was added concern that the substance might be a biological agent. That turned out not to be the case. Investigators quickly identified the substance as a relatively common household chemical. But the circumstances leading up to that hazmat scare and lockdown, as reported in the local newspaper, are still baffling.

The substance that caused the hubbub was ultimately determined to be an ingredient found in rat poisoning, The Frederick News-Post’s Jeremy Arias reported last week. That substance was delivered in an envelope from the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland, to the home address of Jay Zimmerman, who said he had held a position with NIST for 33 years. The envelope also reportedly contained a letter from NIST informing Zimmerman that he would be removed from his position.

Zimmerman, who retired from NIST in June, told the News-Post that he believes his former employer used the substance to target him as an act of retaliation because Zimmerman had filed a complaint against NIST earlier this year alleging discrimination and harassment on account of his sexual orientation and disability. A spokesperson for NIST declined to comment on the allegations, citing the Privacy Act.

Investigators reviewed surveillance footage at NIST that shows the suspicious package being sealed, Frederick police Sgt. Andrew Alcorn told the News-Post.

“There is nothing on the video that appears to be suspicious or that indicates any of that substance was put into the package at that point,” Alcorn said.

Although the case was officially suspended without any charges being filed, the resulting response gave Frederick Memorial an opportunity to test its own emergency preparedness.

“When events like this take place,” said Phil Giuliano, the hospital’s director of public safety and security, “I think it’s a reminder for hospital staff, hospital leaders, and community members as a whole how important it is to have strong relationships, to maintain strong relationships with those other partners you have in your county, in your jurisdiction, in your area of operations.”

For more on this story and how Frederick Memorial kept its workers and patients safe, be sure to read the News-Post’s full report and the August edition of Briefings on Hospital Safety.

Spruced-up online OSHA form aims to help whistleblowers

By: July 28th, 2017 Email This Post Print This Post

A revised online form backed by OSHA aims to make it easier for whistleblowers to complain about their employers, the U.S. Department of Labor (DOL) announced Friday.

Workers still have a right to lodge formal complaints in a number of other ways: snail mail, fax, hand-delivery, verbally on the phone or in person. But the updated web-based filing option offers an interactive option available all day every day, designed help workers navigate the potentially daunting seascape of laws and regulations that keep worker rights afloat.

The whistleblower provisions of some 22 statutes are enforced by OSHA, affecting everything from workplace health and safety to consumer protection and nuclear power. (Details on that are available at www.whistleblowers.gov.)

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Jobs report: American healthcare sector keeps growing amid uncertainty

By: July 7th, 2017 Email This Post Print This Post

While the number of people working in construction, manufacturing, and several other major industries held steady last month, the American healthcare sector continued to grow, adding 37,000 jobs in June, the U.S. Bureau of Labor Statistics (BLS) announced today.

That figure outperformed the average number of healthcare jobs gained monthly all of last year and so far this year, the BLS announcement noted. (The economy added 32,000 healthcare jobs per month, on average, in 2016 and 24,000 jobs per month in the first half of 2017.)

The number of people working in hospitals grew by 12,000 in June, but employment in ambulatory healthcare services grew even faster, with 26,000 jobs added. This reflects a decades-long shift in how and where physicians and their staffs care for patients. More services are being offered in outpatient settings, and some community hospitals, especially in rural areas, have fallen on hard times.

The shifting landscape impacts everything from the way clinics ensure basic environmental cleaning to how health systems strategize with regard to employment and market share. And, of course, it impacts the way OSHA and other regulatory bodies go about protecting workers and the public.

Across all industries, the U.S. economy added 222,000 jobs in June, beating both expectations and recent monthly averages. This bird’s-eye view of the economy, however, misses much of the nuance on the ground level, where many hiring managers are on unsure footing. Healthcare employers, especially, are watching Washington, where the Republican-controlled Congress and White House are struggling to finalize a budget and healthcare plan, as The New York Times reported.

“This is an unprecedented level of political uncertainty,” William E. Spriggs, chief economist for the AFL-CIO union, told the Times. “That is creating a drag on the economy.”

Hiring at medical labs and nursing homes, for instance, has been on the decline, Spriggs said, attributing the slowdown to the number of unknowns in the future of the U.S. healthcare system.

For the latest news and advice in healthcare safety and compliance, be sure to follow HCPro’s line of products to keep you informed and thriving.

‘Don’t Hold The Door’: Boston hospital uses multimedia approach to reinforce safety training

By: June 23rd, 2017 Email This Post Print This Post

Brigham and Women’s Hospital (BWH) in Boston is well-acquainted with the dangers an unauthorized person can pose when granted access to restricted areas. The facility suffered unflattering headlines earlier this year when the public learned that 42-year-old Cheryl Wang had bluffed her way into five ORs and other patient care areas late last year by posing as a doctor-in-training, despite having been dismissed from her surgical residency program.

Wang’s case—which brought an unsettling reminder of the 2015 security lapse that enabled a disgruntled man to corner and kill a BWH doctor in an exam room—drew attention to an extremely common security vulnerability known as “tailgating” or “piggybacking.” When walking through a doorway, it’s common courtesy to hold the door for whoever is behind you. That’s a problem, however, if the person behind you doesn’t have permission to go where you’re going.

To reinforce the lesson that every hospital employee has a responsibility to help keep unauthorized people out of restricted areas, BWH produced instructional videos that depict disturbingly mundane security lapses. The two dramatizations, titled “Be Aware” and “Don’t Hold The Door,” will be shown to all 18,000 of BWH’s employees.

“We intended for the videos to be provocative, to invoke a strong reaction, so that they would be memorable,” said Erin McDonough, BWH’s chief communication officer, in a statement.

One video depicts two workers chatting as they return to their stations from a coffee break, unaware that an unknown woman has followed them onto a restricted elevator. From there, the woman gains access to a maternity ward to abduct a newborn. The other shows a worker in scrubs politely holding the door for an unknown man.

Be Aware from BWH Public Affairs on Vimeo.

“Closing a door to someone feels uncomfortable and impolite, and it contradicts what many of us have been taught from a young age,” McDonough said. “We need our staff to know the potentially dangerous consequences of enabling people who do not have permission to access restricted areas—whether consciously or unconsciously—and give them tools that empower them to take action.”

The two videos are the centerpiece of BWH’s safety campaign, but they are buttressed by a multi-pronged approach that includes the following:

  • Signage. The points where unauthorized access is most likely to occur, including some 1,200 card scanners throughout BWH’s facilities, will be labeled with signs to remind workers to be aware of who’s coming with them.
  • Reminder cards. Workers will be issued additional cards that bear the slogan “Stop, Challenge, Assist,” with a phone number for hospital security, as a reminder to use their privileged access with caution and care.
  • Policies. Employees who are followed by an unauthorized person are now required to abide by two updated policies: Either question the person directly, or contact security to do so. There’s no option to merely dismiss the unauthorized access as nonthreatening.
  • Training. After hospital employees screen the two videos, they will role-play related scenarios with a security team, then follow-up to session with a Q-and-A to discuss what they learned.

In addition to training its own staff, BWH has opted to share the components of this campaign far and wide—a helpful gesture, considering that tailgating and piggybacking are a safety consideration in every healthcare facility.

“People who work in the healthcare setting have a natural inclination to help others,” said Dave Corbin, BWH’s director of security and parking, in the statement. “Our campaign emphasizes that being aware is one of the best ways for them to ensure the wellbeing of patients, their families and each other.”

Don't Hold the Door from BWH Public Affairs on Vimeo.

Worker sleep cycles could be a safety concern

By: June 22nd, 2017 Email This Post Print This Post

When researchers asked nearly 180,000 workers about their sleeping habits a few years ago, they found that those in healthcare rank among the top occupational groups that sleep too little. About 40% of healthcare workers reported sleeping less than seven hours per night.

Nursing, psychiatric, and home health aides exhibited the highest rates of short sleep duration among healthcare professionals. More than 43% of them reported getting less than their recommended share of shuteye, according to research published by the CDC earlier this year. And those numbers could pose a potential safety risk at work.

“Workers in occupations where alternative shiftwork is common, such as production, healthcare, and some transportation jobs, were more likely to have a higher adjusted prevalence of short sleep duration,” study author Taylor M. Shockey, MPH, said in a press release.

“Short sleep duration has been linked to various negative health outcomes including cardiovascular disease, obesity, and depression, as well as to safety issues related to drowsy driving and injuries,” Shockey added. “This research suggests that there are occupational differences in sleep duration making occupation an important factor to consider in sleep research and interventions.”

That’s why the National Safety Council featured fatigue among four key topics to highlight during June, which is National Safety Month, offering safety professionals and the public access to social media graphics and downloadable tip-sheets to promote awareness. (That’s also why the topic was featured in the April edition of HCPro’s Medical Environment Update.)

Workers who sleep between seven and 10 hours per night have shown significantly lower estimated annual injury rates than workers who sleep less. The results of one survey published in 2010 showed that workers who slept less than five hours per night suffered more than three times as many injuries as those who slept enough.

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Kim Olszewski, DNP, CRNP, COHN-S/CM, FAAOHN, vice president of Mid-State Occupational Health Services in Lewisburg, Pa., said employers are taking notice of the dangers fatigue can pose, Safety+Health magazine reported.

“The key is the proactive piece,” Olszewski said, “driving it from the top down, talking about fatigue, how it can be managed, how it impacts all aspects—not just work.”

Safety of healthcare workers and their patients ‘two sides of the same coin’

By: May 30th, 2017 Email This Post Print This Post

Feds push Safe+Sound Week: June 12-18, 2017

Healthcare employers should promote worker safety for a number of reasons, not the least of which being that keeping doctors and nurses safe helps to keep patients safe as well, according to federal OSHA officials.

“Worker safety and patient safety really are two sides of the same coin,” OSHA Deputy Director Andy Levinson said during a webinar last week encouraging participation in Safe + Sound Week 2017. The nationwide event, scheduled for June 12-18, aims to promote health and safety programs on the local organizational level.

“In our work with healthcare institutions, particularly hospitals, there is good linkage between safety health programs and the high-reliability culture activities that are going on in healthcare,” Levinson added, responding to a question from a nurse in Louisville, Ky.

Organizations of all sizes and industries are encouraged to participate in the special emphasis week by coming up with one or more ways to demonstrate their commitment to safety. These could include public events, employee training sessions, new graphics and signs, social media posts, and more.

Major partners for the event include the American Association of Occupational Health Nurses (AAOHN), American Nurses Association (ANA), Association of Occupational health Professionals in Healthcare (AOHP), The Joint Commission, and others.

Nurses held hostage at Ill. hospital accuse deputy of fleeing scene

By: May 26th, 2017 Email This Post Print This Post

Two nurses who were held hostage earlier this month by an inmate receiving medical care at an Illinois hospital, filed a federal lawsuit Thursday accusing a security guard of putting them in danger then running away.

Instead of protecting medical staff from 21-year-old Tywon Salters, who was being cared for at Delnor Community Hospital in Geneva after swallowing liquid cleaner and a sandal at the jail, security guard Shawn Loomis left the inmate “totally unrestrained in the hospital room” for at least 30 minutes, the suit alleges.

Salters then grabbed a handgun from Loomis about 12:30 p.m. May 13, before finding the nurses and holding them at gunpoint. Salters forced one of the nurses into a first-floor “decontamination room,” where he sexually assaulted her for the next three hours, until a SWAT team broke in and killed him, according to the lawsuit.

Loomis, a corrections officer employed by the Kane County Sheriff’s Office and the private firm APEX3 Security LLC, allegedly fled the room when Salters took his weapon. Loomis shut himself in another room and “took no action whatsoever to protect hospital staff and nurses after he lost control” of Salters, the suit states. He and both of his employers were named as defendants.

The nurses accuse Kane County, APEX3, and Loomis of failing to protect them from a known danger. Their husbands, who are also plaintiffs in the suit, raise “loss of consortium” claims against the three defendants.

Sean Murray, the attorney representing all four anonymous plaintiffs, said in a news conference Thursday that his clients have suffered significantly.

“I represent employees who just came to work that day to do their job, and they left traumatized for life,” Murray said, according to The Beacon-News. The hospital and its system, Northwestern Medicine, were not named as defendants.

The suit seeks unspecified compensatory damages and other relief. Officials with the Kane County Sheriff’s Office declined to comment on the specific allegations raised, Chicago Sun-Times reported.

This week: OSHA emphasizes fall prevention

By: 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?

By: 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

By: 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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