[MCOH-EH] private sector practices

Cindy M. Hansen Chansen at mhg.com
Fri Aug 14 14:57:40 PDT 2020
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At my organization all of med staff (employed or contracted) or just credentialed to provide care at our hospital all follow our internal Inf Prevention practices.  They are given PPE as appropriate when performing inhouse / clinic care.  When we were fit testing annually, they are included in that as well although it is pretty hard to make a private practice come and do fit testing or flu shots etc, even though it is all free to them.   Employed providers can be challenging as well, but we have more control or directive authority since they are employed.  

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Today's Topics:

   1.  Leap Frog Survey - Hand washing standard (Cindy M. Hansen)
   2. Re:  private sector practices (Delclos, George)
   3. Re:  private sector practices (Hodgson, Michael - OSHA)
   4. Re:  private sector practices (Delclos, George)


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Message: 1
Date: Fri, 14 Aug 2020 19:15:14 +0000
From: "Cindy M. Hansen" <Chansen at mhg.com>
To: "mcoh-eh at mylist.net" <mcoh-eh at mylist.net>
Subject: [MCOH-EH] Leap Frog Survey - Hand washing standard
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        <DM6PR11MB2859DBF237B4FCC9D083F485AB400 at DM6PR11MB2859.namprd11.prod.outlook.com>

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Anyone on the list participating in the Leap Frog initiative for their facility??  If so, I am curious what you are doing to meet this standard at hire?
My thought is to do it during their onboarding health assessment, since we already do drug screening where they will be washing their hands, we would just need to "observe and educate" during the process.  Also hand sanitizer use requested upon entry into the nurses office prior to signing or completing any consents, etc., just looking for input.

Thanks
cindy

Cindy Hansen, RN, MSN
Employee Health Director
Ph:  228-867-4174
Fax:  228-867-4080

www.gulfportmemorial.com/<http://www.gulfportmemorial.com/>
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Message: 2
Date: Fri, 14 Aug 2020 20:09:36 +0000
From: "Delclos, George" <George.Delclos at uth.tmc.edu>
To: MCOH-EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] private sector practices
Message-ID: <72c6044e90c540608d1ce0eef110e127 at uth.tmc.edu>
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Hi, Mike.

The large hospitals we work with here in the Texas Medical Center (Houston) all have in-house environmental health and safety personnel (if not a full-fledged department) that takes care of all of this. And many of these hospitals are part of health systems that are city or statewide, so they should have access the same type of services. I'm less sure about smaller regional or stand-alone hospitals.

Best,
George.

From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Hodgson, Michael - OSHA via MCOH-EH
Sent: Friday, August 14, 2020 1:58 PM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: Hodgson, Michael - OSHA <Hodgson.Michael at dol.gov>
Subject: [MCOH-EH] private sector practices


**** EXTERNAL EMAIL ****
Hi, all
We've run into an interesting set of circumstances that differs from my experience in academic medical centers and the VA, where there was a very structured approach to this.  And it may be that private sector healthcare, with specialty physician groups and  hospitals, with  their mix of contractual relationships ("Russian nesting dolls" comes to mind, is just very very different.  There have been some problems with physician groups that have agreements / contracts with hospitals where there doesn't appear to be a structured approach to hazard identification and risk management, i.e., no one trains them, does fit-testing, or provides them with N95s when appropriate.  Do your hospitals do something like that?  Do your medical staff by laws address this?  The hospital infection control program?

Just curiosity whether this is a common problem out there, what you've tried,  and whether you've found solutions...

Michael Hodgson
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Message: 3
Date: Fri, 14 Aug 2020 20:12:31 +0000
From: "Hodgson, Michael - OSHA" <Hodgson.Michael at dol.gov>
To: "Delclos, George" <George.Delclos at uth.tmc.edu>, MCOH-EH
        <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] private sector practices
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        <DM6PR09MB51126F6361E2EE830330439FF2400 at DM6PR09MB5112.namprd09.prod.outlook.com>

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Thanks!

But how do they interact with private physician groups?  If there's a group of ED physicians, do the hospitals include them in their infection control plan?  Train / issue N95s?  Or are they viewed as "independent contractors" for whom the hospital has no responsibility?  And down there, do such groups have safetymanagers  / designated respirator program managers who help the MDs stay safe?

From: Delclos, George <George.Delclos at uth.tmc.edu>
Sent: Friday, August 14, 2020 4:10 PM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: Hodgson, Michael - OSHA <Hodgson.Michael at dol.gov>
Subject: RE: private sector practices

Hi, Mike.

The large hospitals we work with here in the Texas Medical Center (Houston) all have in-house environmental health and safety personnel (if not a full-fledged department) that takes care of all of this. And many of these hospitals are part of health systems that are city or statewide, so they should have access the same type of services. I'm less sure about smaller regional or stand-alone hospitals.

Best,
George.

From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> On Behalf Of Hodgson, Michael - OSHA via MCOH-EH
Sent: Friday, August 14, 2020 1:58 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Hodgson, Michael - OSHA <Hodgson.Michael at dol.gov<mailto:Hodgson.Michael at dol.gov>>
Subject: [MCOH-EH] private sector practices


**** EXTERNAL EMAIL ****
Hi, all
We've run into an interesting set of circumstances that differs from my experience in academic medical centers and the VA, where there was a very structured approach to this.  And it may be that private sector healthcare, with specialty physician groups and  hospitals, with  their mix of contractual relationships ("Russian nesting dolls" comes to mind, is just very very different.  There have been some problems with physician groups that have agreements / contracts with hospitals where there doesn't appear to be a structured approach to hazard identification and risk management, i.e., no one trains them, does fit-testing, or provides them with N95s when appropriate.  Do your hospitals do something like that?  Do your medical staff by laws address this?  The hospital infection control program?

Just curiosity whether this is a common problem out there, what you've tried,  and whether you've found solutions...

Michael Hodgson
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Message: 4
Date: Fri, 14 Aug 2020 20:14:42 +0000
From: "Delclos, George" <George.Delclos at uth.tmc.edu>
To: "'Hodgson, Michael - OSHA'" <Hodgson.Michael at dol.gov>, MCOH-EH
        <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] private sector practices
Message-ID: <d993f9e931144ffeb1ddddc2fa6df4c2 at uth.tmc.edu>
Content-Type: text/plain; charset="us-ascii"

Let me find out. I do know that, for all of the university-affiliated hospitals in the Texas Medical Center (which is all of them), our university or Baylor College of Medicine provide these services (there are some exceptions, such as our pediatric hospital, where the hospital offers this service to Baylor medical staff as well). But I'll find out what the deal is for hospitals that are not university-affiliated.

George L. Delclos, MD, MPH, PhD
Professor and Marcus M. Key, M.D. - Shell Occupational and Environmental Health Endowed Chair Department of Epidemiology, Human Genetics and Environmental Sciences Distinguished Teaching Professor, The University of Texas System Associate Director, Occupational and Environmental Medicine Residency Program The University of Texas School of Public Health P.O. Box 20186 Houston, Texas 77225-0186
Phone:   713 500 9459
FAX:        713 500 9442
Email:     George.Delclos at uth.tmc.edu<mailto:George.Delclos at uth.tmc.edu>

From: Hodgson, Michael - OSHA <Hodgson.Michael at dol.gov>
Sent: Friday, August 14, 2020 3:13 PM
To: Delclos, George <George.Delclos at uth.tmc.edu>; MCOH-EH <mcoh-eh at mylist.net>
Subject: RE: private sector practices


**** EXTERNAL EMAIL ****
Thanks!

But how do they interact with private physician groups?  If there's a group of ED physicians, do the hospitals include them in their infection control plan?  Train / issue N95s?  Or are they viewed as "independent contractors" for whom the hospital has no responsibility?  And down there, do such groups have safetymanagers  / designated respirator program managers who help the MDs stay safe?

From: Delclos, George <George.Delclos at uth.tmc.edu<mailto:George.Delclos at uth.tmc.edu>>
Sent: Friday, August 14, 2020 4:10 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Hodgson, Michael - OSHA <Hodgson.Michael at dol.gov<mailto:Hodgson.Michael at dol.gov>>
Subject: RE: private sector practices

Hi, Mike.

The large hospitals we work with here in the Texas Medical Center (Houston) all have in-house environmental health and safety personnel (if not a full-fledged department) that takes care of all of this. And many of these hospitals are part of health systems that are city or statewide, so they should have access the same type of services. I'm less sure about smaller regional or stand-alone hospitals.

Best,
George.

From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> On Behalf Of Hodgson, Michael - OSHA via MCOH-EH
Sent: Friday, August 14, 2020 1:58 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Hodgson, Michael - OSHA <Hodgson.Michael at dol.gov<mailto:Hodgson.Michael at dol.gov>>
Subject: [MCOH-EH] private sector practices


**** EXTERNAL EMAIL ****
Hi, all
We've run into an interesting set of circumstances that differs from my experience in academic medical centers and the VA, where there was a very structured approach to this.  And it may be that private sector healthcare, with specialty physician groups and  hospitals, with  their mix of contractual relationships ("Russian nesting dolls" comes to mind, is just very very different.  There have been some problems with physician groups that have agreements / contracts with hospitals where there doesn't appear to be a structured approach to hazard identification and risk management, i.e., no one trains them, does fit-testing, or provides them with N95s when appropriate.  Do your hospitals do something like that?  Do your medical staff by laws address this?  The hospital infection control program?

Just curiosity whether this is a common problem out there, what you've tried,  and whether you've found solutions...

Michael Hodgson
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