Many hospitals are focusing on patient safety while employee safety slips off the radar. But improving employee safety and health boosts patient safety as well as the bottom line.
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| Linda Chaff |
According to the Bureau of Labor Statistics, more health care workers become ill or injured than in any other industry sector with at least 100,000 employees. In fact, more than 250,000 health care workers are injured on the job each year. The health care industry spends $20 billion annually in workers’ compensation and related costs due to employee injuries and illnesses. Clearly, elevating employee safety and health to the same level as patient safety is overdue.
A joint project between the U.S. Occupational Safety and Health Administration and the National Council on Compensation Insurance revealed that a simple medical-only claim of $500 also incurs indirect costs of $2,250 and at a 3 percent profit margin would require an additional collection of $91,666 in billable charges to recover.
Placing the same emphasis on employee safety and health as hospitals currently place on patient safety can change this costly pattern. Quality patient care requires quality employee care, and the emphasis on each must be equal. Such a philosophy forms the core of a total health and safety program described in a recent copublication of the American Hospital Association and Joint Commission Resources, Total Health and Safety for Health Care Facilities (Chicago: Health Forum, 2006).
A Hospital Improves Worker Safety and Cuts Costs
In a recent pilot of the Total Health and Safety for Health Care Facilities program, Valley General Hospital (VGH) in Monroe, Wash., not only dramatically improved worker health and safety but significantly reduced related costs as well.
The program employs the best elements of functional and motivational programs from around the world to bridge the gap between the safety and health for employees and that for patients. The program is based on the concept that exceptional workplace health and safety outcomes rely on a strong partnership between managers and employees who share responsibility for the program’s success. Caring values that are demonstrated by respect, courteous treatment and a positive attitude create an environment that leads to improved patient care. Quality of life issues, such as personal health and well-being, also have a positive influence on worker health and safety and patient care.
In the first year of the program, the hospital:
Both managers and employees fully embraced the program. In doing so, they created a culture of safety that extended to their homes, families and community, complementing their existing health promotion activities. Departments previously working independently of each other on health and safety activities began interacting and sharing information, thus reducing duplication of effort. The employees and the administrators began to reap the benefits of the connection between employee health and safety, the environment they worked in, patient care, the well-being of the employees’ families and the corporate bottom line.
Three Components of Total Health and Safety
A principal goal of the Total Health and Safety program is to create a self-sustaining, in-house employee health and safety organization and culture using existing hospital employees.
The Total Health and Safety program includes three interwoven components. The first component is the functional basis of any successful and profitable health and safety program, which includes:
The second component promotes worker involvement by recruiting and training liaisons to interact with the health and safety department as well as other departments.
The third component instills confidence in employees and is based on the caring values employees, patients and their families deserve. It is this third component that provides energy to the program.
Taken together, these concepts, in conjunction with the hospital’s existing health promotion activities, create a powerful tool that improves the health and safety experience of employees and patients as well as the hospital’s bottom line.
Implementing the Program
The program’s success depends on managers and employees assuming equal responsibility for it.
To begin implementing the program, Chaff & Co. conducted a needs analysis (on-site evaluation) of the hospital’s current health and safety program. This established baselines by which improvements could be measured. Chaff & Co. team experts visited each department from surgery to the kitchen—talking with workers, asking questions, observing and, most importantly, listening to their concerns and their ideas.
The result was a comprehensive document that identified problems and provided solutions for their remediation. For example, VGH, like many hospitals, met the Joint Commission and other accrediting agencies standards for patient safety, but it was not complying with many state and federal regulations that are designed to protect worker health and safety.
After the needs analysis, each department chose one person to be a liaison for the program. The liaisons received comprehensive training in the principles and practices of Occupational Safety and Health and took their new knowledge and skills back to their departments to train their co-workers. Because of their participation, VGH gained an in-house staff of 20 trained safety and health liaisons who work with the hospital’s safety officer, administrators and other employees to identify problems and propose solutions.
As a result of their training, the liaisons helped identify risks in their departments and worked with their department managers and the safety officer to eliminate those risks. The liaisons also conducted comprehensive personal protective equipment hazard assessments and developed detailed job hazard analyses in their respective departments. All of this was done without hiring a single new employee for the program.
Key Support from the Hospital
VGH took several critical actions that demonstrated how the hospital embraced the concept of caring values:
Another critical action demonstrating the accountability of the team implementing the program were quarterly and annual progress reports that were submitted to the hospital’s board, administrators and management council and were openly available to all employees. The reports measured progress against timelines established prior to implementation, detailing specific actions and their outcomes.
By the time the pilot program concluded, management and labor expressed their pleasure that the seesaw once holding patient safety up in the air at one end and worker safety down on the ground at the other had become level. VGH met the principal goal of having a self-sustaining, in-house, employee health and safety program. By improving worker health and safety, costs were driven down in many areas, and quality of patient care was improved.
A Three-to-One Return on Investment
The Total Health and Safety program can reverse the pattern of an unacceptably high employee injury and illness rate in the health care industry. When the rate of employee injuries and illnesses declines, there will be a simultaneous improvement in the quality of patient care, and operating costs will be driven down.
Return on investment at VGH exceeded $3 for each $1 spent on the implementation of the Total Health and Safety program. By implementing the program, the ROI was achieved in a number of ways: requiring competency-based training, implementing audit recommendations, decreasing the number and severity of recordable injuries and illnesses, reducing the number of days away from work, improving claims management, and reducing administrative overhead.
Linda Chaff is the owner of Chaff & Co. in Chattanooga, Tenn., and author of Total Health and Safety for Health Care Facilities (Chicago: Health Forum, 2006).
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