Safety and Ergonomics for Extended Care Facilities

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Safety and Ergonomics for Extended Care
Facilities
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Course Development Team

• Mike Rienerth, Ergonomics Consultant, BWC
• Mike Donohue, Safety Consultant, BWC
• Greg Nartker, Ergonomics Consultant, BWC
• George Kunz, Safety Consultant, BWC
• Rick Hughes, Manager of Occupational Safety
  Health, Ohio Masonic Homes
• Mel Tobias, Safety Compliance Manager, Sprenger
  Retirement Centers
• Marty Grant, Curriculum Designer, BWC

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BWC - Safety Hygiene Services

• Consultative services to assist with safety,
  ergonomics, and occupational health issues
• Already paid for through WC premiums
• Nonregulatory no enforcement power
• No reporting to enforcement agencies

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Definition

• Extended-care facilities include
• Nursing homes
• Mental health facilities
• Full-time care facilities
• Long-term care facilities
• Other?

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COURSE OBJECTIVES

• Gain a better appreciation for the benefits of an
  effective safety health process
• Learn about tools and resources that can be used
  to enhance safety management systems
• Review common OSHA compliance requirements for
  extended care facilities

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COURSE OBJECTIVES

• Learn about tools and resources that can be used
  to assist with OSHA compliance
• Review common ergonomic issues and control
  measures for extended care facilities
• Discuss management strategies that can assist in
  the implementation of safety and ergonomics
  improvements

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What are your objectives?

• Introduce yourself
• Name
• Occupation
• Facility
• Mention one of your objectives for attending this
  course

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Key Questions

• Who is responsible for safety at your facility?
• Who is accountable for safety performance at your
  facility?

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Regulatory Compliance

• Ohio Department of Health (ODH)
• Resident safety
• Joint Commission for Accreditation of Health
  Organizations (JCAHO)
• Resident safety
• Occupational Safety Health Administration
  (OSHA)
• Staff safety

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OSHA 5(a)(1) General Duty Clause

• 1970 OSH Act
• Each employer shall furnish a workplace free of
  recognized hazards

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OSHA Recordable Injury/Illness Incidence Rates
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What is Your Facilitys OSHA Recordable Incidence
Rate?

• IR of OSHA Recordables x 200,000 of
  exposure hours (hrs. worked)
• The IR represents the number of OSHA recordable
  injuries/illnesses per 100 full time workers over
  a given period of time

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Days Away, Restricted and/or Transferred (DART
Rate) (BLS)
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Estimate your Experience
Type of injury Your percentage Possible Causes
Overexertion
Slips/Falls
Contact with
Struck by
Caught in/on or between
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Types of Injuries in EC Facilities
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Money Matters

• What does your facility currently pay?
• Workers compensation coverage
• Healthcare insurance
• Liability insurance
• Property insurance
• Other

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What are the Costs of an Ineffective Safety
Process?

• The average cost for a medical only injury in
  Ohio is 800
• The average cost for a lost-time injury in Ohio
  is 44,000 (medical indemnity reserves)
• Average workers comp premiums for a base rated
  100-bed facility are about 160,000/year
• Average workers comp premiums for a group rated
  100-bed facility are about 80,000/year

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Average Annual Workers Comp Premiums for EC
Facilities
Experience Modifier (EM)
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Employer Rating Plan History
Payroll period beginning date Payroll period ending date Experience rate Employer rating plan
7/1/2004 12/31/2004 44 GROUP
7/1/2003 12/31/2003 57 GROUP
7/1/2002 12/31/2002 82 EXP
7/1/2001 12/31/2001 110 EXP
7/1/2000 12/31/2000 127 EXP
7/1/1999 12/31/1999 143 EXP
7/1/1998 12/31/1998 172 EXP
7/1/1997 12/31/1997 220 EXP
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What are Some Other Costs of an Ineffective
Safety Process?

• 10 to 20 of people leave the nursing profession
  due to injury
• Average turnover rate of STNAs in nursing homes
  is 50-60
• Average cost to recruit, hire, and train a STNA
  2,000 - 3,000
• The average cost of OSHA citations for HC
  facilities is approximately 10,000 to 15,000
  per inspection

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Iceberg AnalogyAccident Cost
Direct Costs

• Medical Payments
• Compensation

Breaking in substitute
Temporary workers
Poor efficiency due to break-up of crew
Indirect or Hidden Costs
Loss of good will
Supervisor time to investigate
Damaged equipment
Overtime by employees
Administrative costs
Change in WC rating
Lost time by fellow workers
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What motivates safety activities in your facility?
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Safety Ergonomics ProcessThe Benefits

• Compliance and hazard prevention
• Reduced injuries and lost time
• Lower worker compensation costs
• Lower absenteeism and turnover
• Better employee relations and morale
• Better Quality Care!

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Strengths and Weaknesses

• What is one thing that your facility does well to
  ensure staff safety?
• What is one thing that you feel your facility
  needs to address to improve staff safety?

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Elements of an Effective Safety Ergonomics
Process

• Management Commitment
• Employee Involvement
• Accountability
• Documentation
• Integration
• Communication
• Monitoring/Evaluation
• Flexibility
• Continuous Improvement