Hospitals reap benefits as OSHA safety stars
Fewer injuries, better morale come with award
Imagine having a health and safety program that’s so good, you invite inspectors from the Occupational Safety and Health Administration (OSHA) to come and see it. That’s what three hospitals did as a stepping stone to recognition in the agency’s Voluntary Protection Program (VPP).
They won’t receive a monetary award for gaining Star or Merit status in the VPP. But as participants that demonstrate commitment to safety from the top managers to the frontline staff, they reap a multitude of benefits, says Cathy Oliver, MS, chief of voluntary programs for OSHA.
"It’s a proven system that focuses managers and employees on those elements of a comprehensive safety and health program that have over time consistently demonstrated positive results: reductions in injuries, reductions in illnesses, reductions in workers’ compensation costs, improved employee morale, and just a better overall working environment," she says.
Begun in 1982, the VPP has 660 participants nationwide. While only three participants are hospitals, Oliver says she anticipates growing interest as hospitals learn about the benefits of achieving VPP status. For example, Samaritan Hospital in Ashland, OH, a VPP participant since 1994, had only four lost workdays due to injury last year among about 500 employees and received no Type 1 recommendations from the Joint Commission on Accreditation of Healthcare Organizations in the Environment of Care area.
An injury rate that low "was unheard of for hospitals," says Connie Cantrill, director of environmental health and safety for the Samaritan Regional Health System, "so we know the program works."
VPP sites begin by creating teams that will review the existing program and document systems for the application.
"The VPP process forces you to link all of your programs under a comprehensive management system," says Oliver. "If you have duplications, you can get rid of those. If you have gaps, you can fill those."
The VPP requires sites to demonstrate commitment from management as well as involvement from employees. For example, health and safety should be a part of every manager’s performance evaluation, Oliver says. "Through the VPP, you effect a culture change in which safety and health is everyone’s responsibility."
VPP managers from OSHA work with employers to make changes until the application is accepted, then OSHA inspectors schedule a visit. "Generally, when we show up, they’re ready and we’re pretty confident they’re ready," she says.
Sites first receive Merit status, which lasts for a year. With further improvements and another OSHA review, the site can be awarded Star status. OSHA revisits Star sites every three years. VPP participants also send OSHA annual reports and injury and illness statistics to demonstrate that they’re keeping on track.
"We require the sites to continually improve," says Oliver. "VPP is supposed to be about being on the cutting edge. We’re always trying to raise the bar to make sure the sites that get in are the best of the best."
Here is a snapshot of the experiences of the three hospital participants of VPP:
Joint Commission praises VPP hospital
Having Star status in the VPP has gotten Samaritan Hospital just the kind of attention it was hoping for — from the Joint Commission.
Last year, the Joint Commission made a film of the hospital’s safety program and broadcast it to 500 hospitals on the Joint Commission’s broadcast network.
The key to Samaritan’s program is its extensive involvement of managers and employees, whether through one of several safety teams or in special safety fairs. The safety hazardous management committee is made up of directors, senior directors, and physicians and reports directly to the hospital’s board of trustees. The safety circle is made up of hourly employees from virtually every department and reports to the safety hazardous management committee.
Quarterly, specialists conduct safety rounds of every department in the hospital. "Everyone looks for environment-of-care issues," explains Cantrill. "When we started out doing the rounds program, we had two or three pages of work orders that needed to be done. Now we usually find one or two things."
The VPP steering committee, which meets biweekly, includes the director of rehabilitation services (an expert in ergonomics), and an occupational health provider.
Samaritan first attained Merit status in 1994, then Star status in 1995. But maintaining that status means keeping a focus on safety and health, says Cantrill.
Every month, any employee having a birthday that month receives a full day of health and safety training. The hospital also holds an annual safety fair with catchy themes. One year, the fair featured a Halloween theme: "Nightmare on Center Street." (That’s the street the hospital is on.) Employees answered questions at safety stations, enjoyed refreshments, and entered a raffle for prizes.
Employees must feel a part of the safety program, says Cantrill. "Once people get involved, they take ownership, and that makes it work."
Managers commit money, not just words
Management commitment to a health and safety program goes beyond just attending committee meetings. It means providing the necessary resources to get the job done, says Dana Renner, RN, COHN, case manager in the occupational health department at Lima (OH) Memorial Hospital, another Star VPP site. "We were seeing latex allergies, and we wanted to go to a powderless system,"she says. "That cost about $100,000. Management had to be willing [to make the in-vestment], and it did."
Lima Memorial also replaced blood pressure cuffs with ones that don’t contain latex and replaced sharps containers throughout the hospital with safer models. A safety team replaced old equipment in the hospital that contained mercury to eliminate the possibility of contamination from the hazardous substance.
"These are all commitments that management has backed up by letting us purchase some of these things that actually create a safer environment for our people," says Renner.
Lima Memorial actually encourages employees to report near-accidents. The Close Call program rewards employees with a safety-related prize if they report an incident to the safety committee that didn’t result in an injury.
Meanwhile, each department conducts safety checks that are reported monthly to the safety committee, and safety committee members conduct quarterly safety checks.
Maintaining an injury rate that is substantially lower than the average is challenging, says Renner. When the hospital began working toward the VPP, the enhanced focus on safety actually led to an increase in reporting. With work on specific issues, the hospital gradually brought the rate down.
"It’s a continuous process of raising the awareness of safety and encouraging accident investigation," she says. "For people to actually take the time and investigate injuries to find out why they happened so they don’t happen again, that’s very difficult."
The VPP designation adds to the environment of safety, too, she says. "I feel it actually encourages a climate of pride; it heightens awareness within the hospital itself. People feel their safety concerns are addressed quickly and efficiently."
At Blake Medical Center in Bradenton, FL, the most recent VPP hospital site, everyone is encouraged to think about safety. In fact, every day, employees are selected at random to answer a safety question. If they get it right, one dollar goes into a Safety Pays bingo pot. Numbers are posted daily, and employees keep track with their own bingo cards. Each bingo winner can win $25 to $100. "It’s just to keep the level of awareness up," says Dorothy Lenz, RN, employee occupational health nurse, adding that the program was first implemented in departments with higher injury or incident rates.
Of course, gaining Merit status involved much more than setting up an attention-getting game. Blake Medical Center formalized its ergonomics assessment program and upgraded its needle safety devices. The hospital is working toward Star status by conducting a job hazard analysis.
"We started with what we thought were the highest-risk activities as far as injury goes," says Lenz. "Eventually we’ll get through all of them."
Each department has a safety liaison that conducts quarterly safety checks. Employees are represented on the hospital’s safety committee, and the VPP committee includes a cross section of managers.
Gaining VPP status sends an important message about the hospital, says Lenz. "It shows that you do as much as you can to provide a safe workplace for your employees," she says.
[For more information about VPP, contact the VPP manager in your regional OSHA office or visit the OSHA Web site at www.osha.gov. The VPP Partici-pants Association offers application workshops and links prospective VPP sites to those already in the program. Contact Stephanie Klare for mentoring information and Amy Hutto for workshop information at (703) 761-1146.]
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