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Your action plan: What to do when OSHA comes knocking


February 1, 2018

Editor’s note: This is the second of a series of stories that will help medical clinics have a plan in place when certain emergencies occur. Use the tips in these stories to create your own protocols and inform employee training.

Few things in a safety professional’s life invoke more fear than the dreaded OSHA surprise inspection. It’s not likely to occur; there are only so many inspectors to go around, so OSHA can’t inspect all the workplaces in the U.S. But all it takes is one confidential employee complaint or safety issue to bring an inspector to your door, and the smart facility manager should know how to handle this if it occurs.

OSHA fines these days have a bit more of a bite. In August 2016, the agency increased its maximum penalty from $7,000 per violation to $12,471, plus an extra $12,471 for each day past the abatement date. Fines for repeated or willful violations have also grown: from $70,000 to a whopping $124,709 per violation.

The reality is that even if you won’t always know when a safety inspection will happen, you can still plan for it. If you keep good tabs on the safety game in your facility, you likely already have a good feel for the problems that may attract an OSHA inspection — most of them are triggered by a confidential employee complaint. Get your employees on board to report safety problems and be part of the solution (that’s the first tip), and you’ll be well on your way to having a safer workplace.

In the meantime, here’s your tip sheet full of advice on things you can do to get ready in case OSHA shows up, and what to do when they arrive.

Before OSHA shows up
Maintain a safety culture. The key to OSHA compliance is making sure leadership cultivates a culture of safety, says Rose Comstock, COHSM, risk manager at Southern Trinity Health Services in Scotia, California. For safety officers, that means making sure hospital executives understand why these regulations matter.

What does this mean? Well, you need to be present, for one thing. The most successful safety officers walk the floors, talk with employees, and watch for teachable moments to help workers become safer. Make sure your lab workers are wearing proper PPE, ensure that spills are properly mopped up, and make sure your employees know that noncompliance is not tolerated.

“Safety initiatives can be met with some resistance, but safety regulations are generally promulgated because someone, or many people, died or were seriously injured as a result of circumstances at a workplace,” Comstock says. “If you read the history behind OSHA, anyone would fully appreciate why workplace safety is where it is today.”

Clinics need to educate their entire staff about policy changes, especially the changes that apply directly to them. After all, updating policies doesn’t do any good if none of your staff know what the policies contain. Consistent education requires a clear, regular employee training schedule. Along with annually scheduled safety training, employees will need to be trained whenever changes are made to clinic policies or whenever there’s a safety incident. This goes for all employees, even temporary or part-time workers.

Schedule a mock inspection. This seems like common sense, but many facilities still don’t do it. There are plenty of consultants whose day job is to go into medical facilities and scrutinize their safety program the way an OSHA inspector would. The good news is that if they find something, you won’t get fined. Instead, you’ll get lots of feedback that will guide you in improving the safety issues that are found. You’ll also get educated: There are many things you probably don’t know about your rights, necessary paperwork, and obligations when an inspector shows up, but a consultant can walk you through these steps and give you helpful information.

Get your paperwork in order. One of the first things an OSHA inspector will ask you for during a visit is paperwork, and lots of it. Lack of preparation here is quite telling to the inspector, so get those papers in order now. Along with personnel records, the agency will be looking for OSHA 300 worker injury logs and hazardous chemical inventory sheets.

“A typical OSHA inspection begins with an opening conference (usually one hour long), during which the purpose for the visit is explained,” says Marge McFarlane, PhD, MT(ASCP), CHSP, CHFM, HEM, MEP, CHEP, principal of Superior Performance in Eau Claire, Wisconsin. “Documents such as the bloodborne pathogens exposure control plan, the written hazard communication program, and the overall safety program are evaluated to see whether they are complete (including signed annual reviews) and being implemented. Employee medical records and training records may be requested. A list of hazardous chemicals in the facility, along with safety data sheets (SDS) and chemical labels, may be reviewed now or during the facility tour.”

Whatever your thoughts on OSHA, the agency provides a lot of free online resources to help you comply with its regulations. Aside from looking up common citations in your field, you can also contact OSHA’s training institute, which provides educational courses and authorized trainers to teach staff about occupational safety and health.

Comstock recommends checking to see whether your workers’ compensation carrier or general liability carrier provides any health and safety training programs. Many insurance carriers employ loss control specialists to assist clients with safety programs. They may also have electronic training systems that generate certificates once they've been completed.

“Scanning existing records to establish a recordkeeping system is about the cheapest method to maintain a required recordkeeping system,” she says. “Safety meetings and training documents, OSHA 300 logs, variance and incident reports, etc. If OSHA comes in on an investigation or inspection, they will want to see everything, and electronic records can be copied to a thumb drive or disk and easily given to inspectors or attorneys when requested.”

During an OSHA inspection
Stay calm. If an inspector shows up at your facility, the first thing to do is relax. Inspectors are human, too, and they are not looking to make life miserable for you. In fact, their job is to make the workplace safer, and for the most part, inspectors will work with you and give you helpful advice on how to remain compliant. That being said, they have a job to do, and you have rights.

“Never let an inspector roam unescorted in your facility,” says McFarlane. “Have your receptionist politely ask him or her to take a seat and inform the OSHA inspector that the safety officer will be out in just a few minutes.” Additionally, she says, “ask them to display a photo identification. Verify that the person is actually an employee of the OSHA division of the U.S. Department of Labor or your equivalent state agency (if you’re in a state with an OSHA-approved state program).”

Take lots of notes. Just as you have the right to know why OSHA is at your doorstep, you also have the right to accompany the inspectors while they are in your facility. It is never advised to leave inspectors unattended, as they will be taking notes and attempting to take as educated a look as possible at the goings-on in your workplace. The inspector will appreciate your willingness to cooperate, and things will go quicker if you show a willingness to tour the facility with the inspector. This ensures that you will be available to answer any questions, and your employees will know what’s going on when they see you touring with someone they don’t necessarily know.

According to McFarlane, the inspector may talk with employees, take notes, make instrument readings, take photos, and/or use a video camera. Take your own notes of what the inspector is doing and duplicate any photos the inspector takes for your records in case you need to contest the findings later. Write down everything said and done and by whom, the inspector’s name, applicable dates and times, measuring techniques, equipment used, calibration dates and procedures, and who was present.

Remember, you have the right to take notes, ask questions, take pictures, and stay quiet, just like the inspector does. In fact, it’s recommended that you do so — these are practices that will help you identify problem areas, as the inspector will, and rectify them later. Taking pictures also gives you evidence: If the inspector writes you up for a safety infraction, and the pictures prove otherwise, you have evidence to back you up.

Train your staff to talk a good game. This is the time when your training program should shine. The inspector will more than likely want to talk with some of your employees (which is why you want to be present, so the employees can have a heads-up). Employees will get questions about their training, how they do their jobs, and whether they know the information they need to be safe. Some of the questions they will be asked include the following:
·    Do you know how to report an illness or injury?
·    Do you know who the program administrator is?
·    What type of PPE do you wear to do your job, and where is it located?
·    Do you know what to do in case of a fire alarm?
·    Where is the chemical spill kit? Do you know where to find the SDS?

Clinics should also ensure facility inspections are regularly scheduled and properly recorded. When OSHA comes, you need to show that hazards have been identified and mitigated using proper documentation.

After OSHA leaves
Listen to the good guys. Yes, you are in the business of saving lives, and you do it well. But no one can pretend to know everything that OSHA expects. OSHA and its team of inspectors are aware of this, and for the most part are not out to get you. They will work with and educate you and your employees on how to create a safer workplace.

Your job is to listen. Show a willingness to cooperate, to learn, and yes, to pay any fairly levied fine, and you will come out on top. This experience can be used as a way to learn from your mistakes. Remember that because OSHA cannot realistically inspect every healthcare workplace in the country, you are actually one of the lucky ones.

Be honest, but know when to be quiet. Everything you say will be carefully noted by the inspector and could be used against you in a violation finding, says McFarlane. Because of this, it is important to be careful what you and your employees say during an inspection. Even an innocent comment may be perceived as an admission of a specific violation. When you do answer a question, be precise. Never give estimates if you do not have accurate information. If you have difficulty responding to a question, politely tell the inspector that you’ll need to consult your resources. You can also ask the inspector to take a break, and you can use that time to call an attorney if needed. If an inspector calls out an unsafe condition, do not admit a violation, as you could be cited even if you correct it on the spot.

Know your rights if the inspector finds a violation. When your inspection is over, you will sit down with the inspector, who will advise you of certain things. In this conversation, he or she will:
·    Discuss conditions observed in the facility
·    Discuss any possible citations that may be issued
·    Explain your right to appeal alleged violations and provide information on the appeal time limits
·    Answer your questions
·    Inform you of any apparent violations for which a citation may be issued or recommended; however, dollar amounts for the penalties will be on the final written citation you’ll receive in the mail

When an anonymous complaint is filed, OSHA typically contacts the employer in writing, via mail or fax, citing the allegations and requesting a written response within five days, McFarlane says. OSHA may use phone calls to investigate complaints as well. Take these investigations seriously, because an inadequate response or failure to correct the situation may trigger an on-site inspection or fines of $7,000 per day.

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