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 $.02 as an OSHA compliance expert and workplace safety professional for over 18 years.
Matt Thompson, CSP
Executive Director of Occupational Safety and Health
Wellstar Health System - Legal Services
793 Sawyer Road
Marietta, GA 30062
770-289-9077
From: MCOH-EH <mcoh-eh-bounces@mylist.net>
On Behalf Of Smith, Kevin
Sent: Wednesday, February 19, 2025 8:58 AM
To: MCOH-EH <mcoh-eh@mylist.net>
Subject: Re: [MCOH-EH] Health system safety measures
|
|
*WARNING: EXTERNAL EMAIL*
This message was sent from outside
Wellstar. Please do not click links or open attachments unless you recognize the sender
and know the content is safe. |
Laura,
This is done commonly in industry, but I'm not sure it is the best approach.
I think the biggest pitfall with this approach is that it uses the OSHA recordable metrics for something it was not designed to do.
OSHA designed this system to collect data from employment sectors for purposes of seeing if there were excess cases of "xyz" in a particular sector that might warrant a closer look or potential rule making.
To avoid skewing the data, they want everyone following the same rules the same way. But they are also clear that an incident being OSHA recordable does not imply that anyone was at fault for causing the incident.
Too often people assume that a recordable is due to a safety violation, etc, when that is not always the case.
Once you start measuring and reporting this metric, there will be measures put in place to reduce the metric. This can lead to pressure (overt, covert, or unconscious) to minimize recordables. If taken too far,
it can lead to violations of the OSHA recordkeeping standards, or underreporting of injuries.
You may want to consider a different metric that has a more cause and effect. While WC is designed as a no-fault system, it may better reflect a workplace safety issue. So perhaps WC$/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@mylist.net>
on behalf of RADKE, LAURA via MCOH-EH <mcoh-eh@mylist.net>
Sent: Monday, February 17, 2025 12:02 PM
To: MCOH-EH <mcoh-eh@mylist.net>
Cc: RADKE, LAURA <laura.radke@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@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
Confidentiality Notice
This e-mail message, including any attachments, is for the sole use of the intended recipient(s) and may contain confidential and privileged information.
Any unauthorized review, use, disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply e-mail and destroy all copies of the original message.
Disclaimer: The HIPAA Final Privacy Rule requires covered entities to safeguard certain Protected Health Information (PHI) related to a person’s healthcare. Information being emailed to you may include PHI after appropriate authorization
from the patient or under circumstances that do not require patient authorization. You, the recipient, are obligated to maintain PHI in a safe and secure manner. You may not re-disclose without additional patient consent or as required by law. Unauthorized
re-disclosure or failure to safeguard PHI could subject you to penalties described in federal (HIPAA) and state law. If you, the reader of this message are not the intended recipient, or the employee or agent responsible to deliver it to the intended recipient,
please notify us immediately and destroy.