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June 2017

When Anger Erupts (Violence in the Workplace)

LarochellePosted by Greg LaRochelle, WCP

Any act in which one person seeks to hurt or intimidate another through the use of physical contact, verbal harassment, or manipulation, can be defined as workplace violence and is a risk common to all employers.  Violence in any form is always offensive and in the extreme is tragic and costly.  According to the Bureau of Labor Statistics, nearly five percent of 7.1 million private businesses experienced an incident of workplace violence in the previous year.  The National Safe Workplace Institute reports that each act of workplace violence costs $250,000 on average, factoring in legal expenses, lost work time, and decreased productivity associated with a decline in employee morale.  Nationally, this adds up to an estimated annual cost exceeding a billion dollars and includes increased costs for workers’ compensation insurance.   

Employers also face legal liability with OSHA’s General Duty Clause that states that each employer shall furnish a place of employment free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees.  OSHA’s website contains a workplace violence overview section with information on risk factors, prevention programs, training resources, and enforcement letters of interpretation.  Employers need to address the threat of workplace violence through the following measures.  

Establish a Workplace Violence Policy – Incorporate a workplace violence policy in an employee handbook which defines violence and states that all concerns will be investigated with appropriate action taken (up to and including dismissal).  An acknowledgement form should be used for employee signature attesting they have reviewed, understand, and will comply with the policy.

Applicant Screening – The application process should include contact with all listed references on the application form, an extensive interview, and a criminal background and motor vehicle record check.  A zero-tolerance stance on workplace violence should be reiterated upon hire. 

Employee Education – Provide awareness training on workplace violence with an emphasis on the early reporting of potential concerns of violence.  Involve all employees and hold managers and supervisors responsible for instructing their assigned employees on reporting procedures and emergency response. The MEMIC Safety Director contains a wide array of training resources on violence in the workplace.

Employee Counseling – Establish an Employee Assistance Program for employee access to qualified professionals trained to provide support, assistance, and resolution in a confidential manner. 

Enhance Security – Install video surveillance equipment, provide ID badges to employees, have all visitors sign in and out of the building, discourage employees from working alone, and ensure parking lot lighting is adequate.

Response Planning – Establish a plan for emergency response in the event of an escalating situation or actual incident and review the plan with employees at least annually.

Program Evaluation – Conduct an evaluation of any incident response for improvement opportunity including the threat assessment protocol and methods of communication to local and state authorities.

Take prudent action now to reduce the danger of anger erupting in your workplace so no one is left saying, “If only I had done something sooner!” 


Caregivers: First Do No Harm To Yourselves

WrightPosted by Laurette Wright, RN, MPH, COHN-S, CSPHP

Caregivers often put the needs of others before their own regardless of what exposures they may face while doing their nurturing tasks. One of the most important tips to give both informal and professional caregivers is to ensure that THEIR SAFETY COMES FIRST so they can support their residents, patients, and loved ones.   

When you fly on an airplane, the flight attendant instructs everyone to put on your oxygen mask first before you assist others. If caregivers don’t take care of themselves first, they may experience work related injuries and illnesses.  These can contribute to lost work days, reduced income, physical limitations impacting their family and work life, or job dissatisfaction.  Without being able to function as caregivers, who will be around to provide the nurturing support they desire for their care recipients?

If there’s any doubt about the injury potential in the health care industry, just take a look at the U.S. Department of Labor 2015 statistics below.  Over 20% of all recordable injuries in the private sector occurred in health care (more than any industry at over 562,000), and the 4.0 incident rate is near the top of all industries.

Hc chart

While healthcare workers, regardless of their setting, are exposed to numerous risks, caregivers in home environments face heightened challenges as a result of uncontrolled and non-regulated conditions.  Home health caregiver exposures can include poorly designed bathrooms, non-adjustable furniture/beds, slippery walkways that aren’t maintained, unsanitary conditions, dangerous pets, motor vehicle dangers, exposure to poor air quality, and the threat of violence. Another big concern for caregivers working in home care environments is the lack of staff support. Often home care assistance is provided by one caregiver, therefore in the event of a conflict or emergency, there is no one else to help.

It is important that caregivers ensure they have the right tools, devices, and equipment to support the needs of themselves and their care recipients in a safe and healthful manner. For professional caregivers working with an employer, reach out to that employer for the proper equipment and education on how to safely perform the tasks at hand.  For informal caregivers taking care of loved ones, resources such as durable medical equipment suppliers, trusted internet sources, and local social assistance agencies may be able to provide the support necessary to ensure a safer working environment. If you find yourself in a situation where you feel alone, unprepared or in over your head, you must ask for help. There are no short-cuts to ensuring a safe and healthful environment for care givers and recipients. Caregivers working more safely is a win-win for themselves and their patients/residents/loved ones.

Find more information on the top risks caregivers and healthcare workers are exposed to in the MEMIC Safety Director or the MEMIC Safety Net Blog, like slips, trips, and falls; lifting and moving patients/residents/loved ones; and agitated or combative patients/residents/loved ones.   

Additional resources are available from the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA).  




OSHA Delays Online Injury Reporting Rule

DarnleyPosted by David Darnley, MS, CHSP

On May 17, OSHA announced that employers will not have to electronically file injury and illness information by July 1, as the rule had stated. As of the date of this announcement, OSHA still had not opened the online portal for employers to file their injury data from the previous calendar year.  OSHA did not offer a reason for the postponement and has delayed other standards this year including a standard on beryllium and a standard on silica dust which our Manager of Industrial Hygiene, Luis Pieretti, has written about. 

The rule is currently being challenged in federal court by the U.S. Chamber of Commerce, among others. Several unions and worker advocacy groups, including the AFL-CIO and the American Public Health Association, have asked to intervene and defend the rule, as reported by Bruce Rolfsen, Occupational Safety & Health Reporter, Bloomberg BNA.

For more information on all aspects of OSHA injury reporting and regular updates to the new electronic submission rule, check out OSHA’s electronic recordkeeping webpage.  MEMIC policyholders can view in the Safety Director a webinar I presented earlier this year titled OSHA & Healthcare Update 2017 which features information on OSHA’s new Online Injury Reporting RuleYou can also review the details of the proposed rule on OSHA’s site or Adam Levesque’s February post on the electronic recordkeeping rule.

Risk Compensation & The Peltzman Effect

JonesPosted by Anthony G. Jones, R.N., COHN

While watching television several months ago I came across an author promoting his book.  As a safety person, I immediately took note as he was directly speaking about safety.  The author was Greg Ip, and the title of the book was “FOOLPROOF: Why Safety Can Be Dangerous and How Danger Makes Us Safe.” I was so intrigued by the subject matter I immediately ordered the book.    

In the discussion and subsequent reading of his book, the concept of risk compensation was set forth. For the sake of brevity, I went to the internet for a more concise description.  Sometimes we focus on, and address, the “hard science” of safety such as rules, regulations, and procedures. But that can lead to neglecting the “soft science” of safety - human behavior.  After all, safety is a “people problem.”  Unsafe acts are a more common injury cause than unsafe conditions.

According to Wikipedia:

Risk compensation is a theory which suggests that people typically adjust their behavior in response to the perceived level of risk, becoming more careful where they sense greater risk and less careful if they feel more protected. Although usually small in comparison to the fundamental benefits of safety interventions, it may result in a lower net benefit than expected.

The reduction of predicted benefit from regulations that intend to increase safety is sometimes referred to as the Peltzman Effect in recognition of Sam Peltzman, a professor of economics at the University of Chicago Booth School of Business.

“People feel safe, and the feeling of safety allowed danger to reemerge, often hidden from view… The more vivid our sense of danger the greater care we take,” says Greg Ip.

Clearly, we can’t afford to let our guard down simply because we have made things “safer.” As we focus in on better safety equipment, procedures, engineering controls, and personal protective equipment we cannot lose sight of the human behavioral aspect.  Ask yourself, are my employees using equipment correctly and following procedures effectively?  Is proper use allowing safety equipment, procedures, and PPE to work as intended to eliminate accidents?

The real danger appears to be complacency.  If a worker senses no danger, then unnecessary risks may be taken.  Often this theory is used as an excuse to limit safety steps or equipment.  But that is counterproductive.  Safety initiatives are beneficial and do provide protection for those employees who have become complacent.  Left unchecked, complacency will set in regardless of any other safety elements present.  So it is far better to address hazards and implement controls than to hope the employees will be more careful if there is more hazard.  Here are some suggestions to avoid complacency:

  • Remind staff during training and tool box talks the possible consequences of pushing the envelope, or walking too close to the edge, so to speak.
  • Attempt to change a person’s behavior to further enhance safety performance, rather than solely relying on equipment and procedures.
  • Observe employees doing their jobs. Are they demonstrating safe behaviors, with safety equipment and procedures in place? Do not assume because all guards and other controls are in place that they are being used correctly.
  • Are effective accountability policies in place?

Focusing safety efforts on behavior will lead to fewer unsafe acts, fewer injuries, and more productive workplaces.  Risk compensation is real, but with proper supervision the compensation and complacency can be kept to a minimum and safety systems will work as designed.   

National CPR and AED Awareness Week

KlattPosted by Randy Klatt, WCP®

Each year, June 1-7 is designated National CPR and AED Awareness Week.  This is a collaborative effort between the American Red Cross, American Heart Association, and the National Safety Council.  This is an important campaign for public safety, workplace safety, and personal safety and health.  MEMIC urges all employers to get involved by installing AED’s (automated external defibrillator) in common spaces, encouraging employees to learn how to perform CPR (Cardiopulmonary Resuscitation), and to get involved with local efforts to raise awareness of these life saving techniques and devices. Join us for a day of AED & CPR awareness on June 8.

Each year more than 350,000 people in the U.S. suffer out-of-hospital cardiac arrest.  This disruption of the heart’s electrical system is a leading cause of death.  Calling 911 for a person suffering cardiac arrest is the first step, but that alone will not likely save a life.  Immediate intervention is needed to provide blood flow to the vital organs and every second counts.  Providing CPR can temporarily circulate that much needed blood, while using an AED can restore the normal heart rhythm.  Unfortunately, only about 46% of people who experience out-of-hospital cardiac arrest get the immediate help needed before emergency medical personnel arrive. 

CPR was first developed for medical professionals in the early 1960s.  The first mass citizen training occurred in the Seattle area in the early 1970s.  The 1980s saw emergency dispatchers beginning to provide CPR instructions by telephone while emergency personnel responded to calls for help.  Early public access defibrillators were developed in the 1990s; these have now become the modern day AEDs.  Much has occurred over the last 58 years or so, but the fundamental principle remains:  early intervention is critical to saving lives.    

CPR courses are available from many entities including fire departments, ambulance services, hospitals, organizations such as the American Heart Association, National Safety Council, American Red Cross, and by many other consultants and health care professionals.  The basic techniques are easy to learn and remember.  Over the years the methodology has changed.  CPR is no longer complicated or intimidating.  It is a simple technique that could very well save the life of another human being.  It might even be someone you love. 

With improved technology and lower costs, AEDs have become ubiquitous in our society.  They are now available for around $1,000 and found in many airports, shopping malls, and schools.  Does your business have one?  Do you know where it is located?  Do you know how to use it?  The equipment is simple to use, it even talks you through every step.  But someone has to take the initiative, find the AED, and use it to save someone’s life.  The AED won’t help anyone if it isn’t used! 

We hope you will join us in a day of CPR & AED awareness and education for your coworkers.  It only takes a minute to watch a Hands-Only CPR video at www.handsonlycpr.orgClick here for more info on AEDs and check out these resources from the American Heart Association, American Red Cross, and the National Safety Council.