[MCOH-EH] Health system safety measures

[Olson, Amy]

Matt, would you have an example of your rounding audit tool that you could share?

Amy Olson COHN-S, MS, RN
Director- Occupational Health

[cid:image002.png at 01DB838D.358B9890]
1919 E. Thomas Rd. Phoenix, AZ 85016
aolson3 at phoenixchildrens.com<mailto:aolson3 at phoenixchildrens.com>
(602) 933-5647



From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf Of Thompson, Matthew via MCOH-EH
Sent: Wednesday, February 19, 2025 1:56 PM
To: MCOH-EH <mcoh-eh at mylist.net>
Cc: Thompson, Matthew <Matthew.Thompson2 at wellstar.org>
Subject: [EXTERNAL] Re: [MCOH-EH] Health system safety measures

I wholeheartedly agree that focusing exclusively on lagging indicators such as TCIR/DART is not the best approach for evaluating and improving your team member safety program. I’d like to give some insight into what we look at which focuses

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________________________________
I wholeheartedly agree that focusing exclusively on lagging indicators such as TCIR/DART is not the best approach for evaluating and improving your team member safety program. I’d like to give some insight into what we look at which focuses on what I call pre-loss, point of loss, and post-loss metrics. These are designed to be entered into a weighted scorecard so we can complete a comprehensive evaluation of the program efforts.

Pre-Loss Metrics (What actions and efforts are implemented to proactively reduce employee exposure to hazards and subsequent injuries)

  *   Employee Engagement Score – Trust Survey
     *   We focus on the question, “This is a safe place to work.” and have a goal associated with improving this YOY.
  *   Average Internal Audit Score
     *   We conduct ongoing rounding throughout our entire hospital system and of each department. We also conduct an annual System Audit of the entire operation.
     *   Each report is Yes/No answers and each report is scored.
  *   Closed Action Items from Audits
     *   This is tracked in our audit software tool and allows us to see how many of the identified action items have been closed within the expected time frame.
  *   Completion of Employee Fit Testing
     *   As in most hospitals, respiratory protection fit testing and annual medical evaluation questionnaires are critical not only to compliance but protection of workers from airborne diseases. This metric allows us to judge the level of conformance to this expectation as a percentage and we have found this is indicative of other efforts around workplace safety.
  *   On-time completion of required employee training for safety related topics such as respiratory protection, ionizing radiation, and bloodborne pathogens

Point of Loss Metrics (What happens when an incident occurs)

  *   Employee Report of Injury Lag Time
     *   Our expectation is that near misses and incidents are reported in our online reporting system within 24 hours.
     *   We track the number of injuries which were reported within this 24 time period as a percentage of the total number of injuries.
  *   Employee Manager Incident Report Completion
     *   Managers are required to complete an incident report and investigation and identify root causes and corrective actions within 7 days of the event.
     *   This metric tracks how frequently the incident report is completed by the manager within that time frame.

Post-Loss Metrics (Historical evaluation of the improvements we are making)

  *   TCIR
  *   DART
  *   Workers compensation cost
  *   OSHA Citations during the time period

We weight these 40/40/20 to put more emphasis to our teams on what is done before and when an incident occurs. We want to encourage a more proactive approach rather than just looking back at historical trends and hoping that the TCIR/DART does down. Theoretically, and in actuality, we see a decrease in the lagging metrics when we are being proactive at addressing hazards before injuries occur.

I hope this is helpful. It is just my $.02 as an OSHA compliance expert and workplace safety professional for over 18 years.

Matt Thompson, CSP
Executive Director of Occupational Safety and Health

Wellstar Health System - Legal Services
793 Sawyer Road
Marietta, GA 30062
770-289-9077
[cid:image003.png at 01DB838D.358B9890]

From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> On Behalf Of Smith, Kevin
Sent: Wednesday, February 19, 2025 8:58 AM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Subject: Re: [MCOH-EH] Health system safety measures




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Laura,

This is done commonly in industry, but I'm not sure it is the best approach.

I think the biggest pitfall with this approach is that it uses the OSHA recordable metrics for something it was not designed to do.

OSHA designed this system to collect data from employment sectors for purposes of seeing if there were excess cases of "xyz" in a particular sector that might warrant a closer look or potential rule making.

To avoid skewing the data, they want everyone following the same rules the same way. But they are also clear that an incident being OSHA recordable does not imply that anyone was at fault for causing the incident. Too often people assume that a recordable is due to a safety violation, etc, when that is not always the case.

Once you start measuring and reporting this metric, there will be measures put in place to reduce the metric. This can lead to pressure (overt, covert, or unconscious) to minimize recordables. If taken too far, it can lead to violations of the OSHA recordkeeping standards, or underreporting of injuries.

You may want to consider a different metric that has a more cause and effect. While WC is designed as a no-fault system, it may better reflect a workplace safety issue. So perhaps WC$/x work hrs?

Even this is a bit of a stretch, but probably better than OSHA recordables.

A good one would be management safety rounds looking for violations of safety rules (gloving, masking, eye protection, gowning, gel use, use of safer sharps, etc), which can be tallied by department, supervisor, shift, etc. This then focuses on improving following safety rules.

Hope this helps.

Kevin M. Smith, MD, MPH, FACOEM
Medical Director
Phoebe Corporate Health
Phoebe Employee Health Services
229-312-9220
229-889-7074 Fax
________________________________
From: MCOH-EH <mcoh-eh-bounces at mylist.net<mailto:mcoh-eh-bounces at mylist.net>> on behalf of RADKE, LAURA via MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Sent: Monday, February 17, 2025 12:02 PM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: RADKE, LAURA <laura.radke at froedtert.com<mailto:laura.radke at froedtert.com>>
Subject: [MCOH-EH] Health system safety measures


Our safety team is working on measures that they can report on regularly and have suggested this as one of them:   OSHA recordables/10,000 hours worked.  Our employee health leadership team has been asked to comment on the value of this metric and whether others in healthcare are using something similar when looking at safety.



Are other medical centers using this or a similar metric to look at their employee safety?  Appreciate any input others can share!



Laura L Radke, MD

Adjunct Assistant Professor of Medicine

Senior Medical Director, F&MCW Occupational Health Services

Phone: 262-253-8197 | Fax: 262-253-5152 Cell Phone: 414-530-0723

E-mail: laura.radke at froedtert.com<mailto:laura.radke at froedtert.com>

Froedtert & the Medical College of Wisconsin Workforce Health / North Hills Health Center

Building B First Floor

W129 N7055 Northfield Dr.

Menomonee Falls, WI 53051




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