I wish to “upvote” Kevin’s answer! Thank you Kevin!

Totally agree that OSHA recordables are problematic as a metric to follow internally. Supervisors can influence reporting, even subconsciously. Everyone wants to look good so underreporting becomes a big problem. Just like those big signs that say “143 Days Since an Injury” – people don’t report the thing that will ruin everyone’s bonus. Also some employers pressure treating clinicians to provide only “first aid” – as defined by OSHA - for things that should receive a higher level of care, all in the name of keeping down their OSHA recordables.

I love the process metrics Kevin outlines. Set positive goals for behaviors, so you can “catch people doing the right thing” and reinforce that. Hospitals do that with handwashing data for example – everyone wants a high score on their handwashing audits.

Some of these process metrics can be incorporated into existing systems so they don’t have to be labor-intensive. Environment of care rounds are one way you can get attention to safety issues. Even if you can get one employee safety question on the EOC survey, it goes on a dashboard that has lots of eyes on it. Obviously look at your data and where/how preventable injuries or near misses occur.

Good luck Laura!

Melanie

Melanie Swift, MD, MPH

Vice Chair, Division of Public Health, Infectious Diseases and Occupational Medicine

Medical Director, Mayo Clinic Physician Health Center

Associate Medical Director, Occupational Health Service

_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905

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.

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

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