How to create a culture of safety in your clinic
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May 1, 2019
Many experts say that the key to safety in any healthcare workplace is to develop a culture of safety. What does this mean? Well, any safety officer can preach about training, PPE, and the like, but unless employees take ownership of the safety situation at work, the officer’s exhortations will just be rules they have to follow.
Developing a culture takes work—which there’s already plenty of. The best way to keep people accountable for their own safety is to have a plan in place, make learning fun, and use real-world examples to help them understand the consequences of their actions.
According to OSHA, there is an elevated incidence of work-related injury and illness among healthcare workers, and the impact of these incidents is staggering—affecting not only the workers themselves, but also their families, the institutions they work at, and ultimately the safety of the patients they serve. “It is not surprising that patient and worker safety often go hand-in-hand and share organizational safety culture as their foundation,” according to OSHA literature.
So, while the year is still young, get to work on creating your clinic’s safety culture—it’s much easier than you think. Here are some tips to get you started.
Be present, always. The most successful safety officers walk the floors, talk with employees, and watch for teachable moments to improve safety. Make sure your lab workers are wearing proper PPE, ensure that spills are properly mopped up, and tell your employees that noncompliance is not tolerated.
Any effort to reach workers starts with their boss. If the leader of the organization practices good habits and instills a culture of wellness in the workplace, employees will follow. What does this mean for your workplace? If your employees feel like you’re on their side and looking out for them, they’re more likely to be happy and healthy.
Make training a regular thing. Do you hold regular training meetings? Sometimes all it takes is a 30-minute meeting once a month with bagels and coffee to hold a discussion with your staff. Get that on the calendar now—you pick the topic. While you're at it, type up a quick agenda and attendance list. This is the best way to stay in regular contact with your employees, and it can help ensure any nascent issues get nipped in the bud before they grow out of control.
Your agenda can be repopulated with new information every month, and it can also be printed out to keep on file. This instantly gives you a document to show an OSHA inspector that proves you follow training regulations. 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 and whenever there’s a safety incident. This goes for everyone, even temporary or part-time workers.
Keep meticulous records. Your job as a safety officer is complex, requiring lots of paperwork. It’s important to stay organized, with a paper trail for everything—and everyone. Clinics get cited by OSHA for recordkeeping violations because they didn’t keep updated and thorough personnel records, or because they didn’t properly report workplace injuries or exposures. In larger medical systems, some safety personnel have site supervisors who work under them; if you do, make sure they are keeping meticulous records too, lest you be held accountable for them falling short.
Start from Day 1 of any staff member’s employment, from orientation. Create a file folder for each employee and drop in a signed checklist indicating the person has participated in training and understands company policies. After a thorough walk through the office, a checklist gets checked off and placed in the folder. The folder quickly gets filled up with an OSHA quiz testing employees’ knowledge (make sure you go over it with them), a hepatitis B vaccination record (or declination form), TB skin test records, exposure packets if they have been exposed to bloodborne pathogens, incident reports, and any other relevant forms.
Speaking of incident reports, you need to fill them out when someone gets injured, and you need to report those injuries or exposures to OSHA. If an inspector comes knocking to investigate an injury and you haven’t filled out those OSHA 300 reporting forms, you can bet you’ll be cited. Recordkeeping rules have changed as well. Employers with more than 250 workers (including hospitals and clinics attached to them) are required to report all injuries that require inpatient hospitalization within 24 hours. In addition, any amputation or loss of an eye also needs to be reported. All workplace fatalities must be reported within eight hours. Remember, if you are meticulous in safety-related matters, your employees will follow suit.
Make it OK to tattle. You can’t be everywhere, and you won’t see everything. It’s important to make sure that your employees act as your eyes and ears to help keep the workplace safe. That’s not always easy, as many employees just want to do their jobs and go home. But what happens if Dave in the lab sees his coworker Peggy smoking at her workstation or chewing gum—big no-nos in the lab setting?
Ideally, you will set up a culture where Dave can come to you with his concerns, or even better, one where Dave can talk to Peggy directly. In any case, the message has to get to Peggy—and everyone else—that smoking or chewing gum in the lab can’t happen.
Because personalities differ, you won’t be able to make everyone comfortable enough to say their piece. To circumvent this, consider establishing an anonymous way to let you know when things aren’t going right. A box in the break room with paper and pencil might be a solution for employees to discreetly write down suggestions or concerns. Then, of course, you must ensure that you act on those concerns.
Remember also that your employees should be able to tattle on you—after all, it’s the law. Make sure your OSHA posters are hung up prominently, and let employees know that it is their right and responsibility to report unsafe or uncomfortable working conditions.
Train your staff to talk a good game. Upon arriving at your facility, an OSHA inspector will likely want to talk with some of your employees. The inspector will ask questions about employees’ training, how they do their jobs, and whether they have a grasp of the information they need to know to be safe. Some of the questions employees will be asked include:
- 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 safety data sheets (SDS)?
Make sure your employees know the answers to these questions. Clinics should also ensure that facility inspections are regularly scheduled and properly recorded. When OSHA stops by, you need to show that hazards have been identified and mitigated using proper documentation.
Have some fun. Want your employees to enjoy training and bonding together? Make it a good time. Create a scavenger hunt or a 10-question quiz that tests them on where to find SDSs, fire extinguishers and exits, PPE, facility emergency plans, and other important safety-related items.
Download examples of SDSs and pictograms at www.osha.gov and refresh your staff's memories. Have your employees find these sheets and pictogram samples around the facility in teams, and have them sign off to create a training record. Where would your staff meet outside should the building be evacuated? Do they know how to use a fire extinguisher? You’d be surprised how many of them have never even picked one up. Call your local fire department and have a firefighter visit to give your staff a primer. Some fire departments will even let employees practice using an extinguisher to put a real fire out.
Make safety personal. If you’ve been in the healthcare safety business for a while, chances are you’ve had a near-miss or know someone who has suffered consequences from a bad safety call. Don’t be afraid to use those stories to help your employees learn a lesson. When you work the same job day after day, it’s easy to forget that mistakes can have major health and financial consequences for workers and patients, as well as their families.
If the threat of injury and illness isn’t enough, the threat of fines from OSHA should be. While OSHA surprise inspections are rare, an incident follow-up could mean serious financial consequences. Non-serious fines carry a levy of up to $1,000, but willful violations can cost a workplace up to $70,000 for every incident.