Workplace injuries

Doctor Makes House Calls to Help Teams Avoid Injuries

Submitted by Laureen Lazarovici on Thu, 10/06/2016 - 17:25
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styslideshow_tiger team_workplace safety
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Inspired by his father's workplace injury, a Southern California physician helps foster a partnership approach to reducing workplace injuries. 

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Sherry Crosby
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Tyra Ferlatte
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Doctor Makes House Calls to Help Teams Avoid Injuries
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Father’s trauma inspires joint effort to create safer workplace
Story body part 1

Quan Nguyen, DO, learned in seventh grade how devastating a workplace injury can be. His father, a carpenter, severed part of his thumb when he lost control of the power saw he was using. The accident put him out of work for a time and forced the family to stretch its skintight budget even further.

Years later, the memory inspired him to join Orange County’s Workplace Safety Steering Committee, says Dr. Nguyen.

“I’ve witnessed, firsthand, how things at work can lead to pain and suffering for the person and his family,” says Dr. Nguyen, a physical medicine and rehabilitation physician at the Chapman Medical Offices in Orange, California. “We’re like a big family at work and I don’t want to see people hurt.”

Team visits worksites to improve safety

As the sole physician on the 12-member committee, Dr. Nguyen uses his singular perspective to engage physicians and others to build a culture of workplace health and safety.

“He’s very unique,” says Jim Ovieda, assistant medical group administrator and the committee’s management tri-chair. “He brings another voice of authority to the conversation.”

Four years ago, Dr. Nguyen helped form the Tiger Team, a task force of union members and managers who visit units with high injury rates and offer expert advice on how to reduce risks. They developed a simple process to identify and address workplace hazards at the local level (see “Five Tips for Workplace Safety Site Visits”).

“It’s not a punishment. We’re there to help departments succeed and to help our staff and physicians to be safe,” says Dr. Nguyen, who named the Tiger Team in honor of “Tigger,” the fictional tiger character who bounces around and helps others.

Collaborating with frontline union members is vital to keeping everyone safe, says Dr. Nguyen.

“There seems to be two cultures inside the hospital – the physician and non-physician. We’re trying to bridge those two cultures by bringing together a diversity of voices to improve the culture of health and safety for everyone,” says Dr. Nguyen. 

Host teams say the visits and ensuing discussions help create an environment where everyone feels comfortable speaking up—essential to building safety into daily work.

Partnership approach gets results

The team aims for six site visits a year and had conducted 31 visits as of November 2015. Most of those departments reported significantly fewer injuries in the months after the visit; many reduced injuries by 50 percent or more. The approach has gained attention region-wide and other medical centers in Southern California are adopting the practice. The team also presented its partnership approach at the 2016 National Workplace Safety Summit.

“It’s a way of taking the pulse of the department,” Ronald Jackson, a medical assistant, SEIU-UHW member and the steering committee’s labor tri-chair, says of the team's site visits.

“We bring a fresh set of eyes to the department,” says Albert Alota, workplace safety coordinator for Orange County.

Three practical solutions

Recently, the committee’s labor and management members sat side by side reviewing workplace safety records for the Irvine Medical Center’s recovery room. The department had accrued nine injuries in as many months, three of them involving employees and gurneys. The team identified several hazards related to work space and storage and recommended ways to fix them. For example:

  • To address heavy traffic down narrow hallways and around blind corners: Provide standardized traffic flow for gurneys, mirrors at key intersections and a recognized verbal cue to alert bystanders to passing gurneys and equipment
  • To unclog crowded patient bays that forced staff to work at laptops in busy hallways: Install wall-mounted computers and exam stools to replace the office chairs in the room
  • To reduce injuries caused by incorrect use of new gurneys: Ask vendors to help train staff how to safely operate new equipment

Employees appreciate the attention. “It’s good to have the team come in,” says Sol Estrella, RN, a staff nurse and UNAC/UHCP member. “It shows that management and higher-ups are responding to our staff needs.”

 

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Creating an Injury-Free Workplace

Submitted by Paul Cohen on Tue, 04/29/2014 - 17:25
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sty_leonard_hayes q&a.doc
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An Environmental Services manager recognized for his workplace safety results talks about keys to building a culture of safety.

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Jennifer Gladwell
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Non-LMP
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For Catalyst. Photo is a close up, needs reframing
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Leonard Hayes, EVS culture and training manager
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Practical Tips for Building a Culture of Safety

A safe workplace starts with you, and the environment you create.

Here are some ideas.

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A manager's tips for leading on safety
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Leonard Hayes, manager of Environmental Services culture and training in the Northwest, oversees workplace safety for 125 outpatient EVS workers in five service areas. This includes the East Side service area, whose EVS unit he directly supervises and which has recorded no injuries for nearly five years. In February 2014, Hayes won the National Workplace Safety Individual Award. He spoke recently with Jennifer Gladwell, LMP communications consultant, about how he engages teams to work more safely.

Q. You and your department have achieved a great turnaround in workplace safety. How did you do it?

A. You have to give people information and recognition. Workplace safety is a standing item on our UBT agendas. We talk about working safely, acknowledge how well our teams do and tell them “thank you.” I’ve been put in this job to take away the myths that injuries are inevitable, so people can go home at the end of their shift and enjoy their time outside of KP.

Q. What do you do personally to engage your staff on safety?

A. I’m in there with them physically.  I’ve been a worker and I take interest in what the teams are doing. I try to make sure people know I care for them by being available to them and making sure they have the tools to do their job. I am committed to responding to issues as quickly as possible and resolving them. I have a great labor partner and co-lead, Sherri Pang. She’s been my anchor with the campus and the (East Side) team. She helps me a lot by sending emails, creating fliers, understanding and encouraging the team.

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Making Health Care Safe

Submitted by Paul Cohen on Thu, 04/11/2013 - 14:06
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sty_making healthcare safe_Catalyst_pc.doc
Long Teaser

A report by the Lucian Leape Institute finds a lack of psychological safety and respect at the workplace is one factor making health care a dangerous profession.

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Non-LMP
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An Ontario EVS team stands together.
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Making Health Care Safe
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Why a corrosive work environment is harmful to caregivers and patients
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Bringing joy and meaning to work may sound like a lofty aspiration. But if your workplace is lacking these things, it's more than dreary—it’s also dangerous, according to the Lucian Leape Institute at the National Patient Safety Foundation.

Start with the fact that health care itself is dangerous. The institute’s March 2013 report on workplace injuries in health care, “Through the Eyes of the Workforce: Creating Joy, Meaning and Safer Health Care,” noted that:

  • Health care workforce injuries are 30 times higher than other industries
  • More work days are lost due to occupational illness and injury in health care than in such industries as mining, machinery, manufacturing and construction
  • Seventy-six percent of nurses in a national survey said unsafe working conditions interfere with the delivery of care
  • An RN or MD has a five to six times higher risk of being assaulted than a city cab driver
  • Emotional abuse, bullying, threats and learning by humiliation often are accepted as “normal” conditions of the health care workplace

These conditions are harmful to patients, caregivers and the organization, according to the report:

“Workplace safety is inextricably linked to patient safety. Unless caregivers are given the protection, respect, and support they need, they are more likely to make errors, fail to follow safe practices, and not work well in teams.”

Role of leaders

The authors conclude, “The basic precondition of a safe workplace is the protection of the physical and psychological safety of the workforce.”

Physical and psychological safety is also a precondition to “reconnecting health care workers to the meaning and joy that drew them to health care originally,” said Lucian Leape Institute President Diane Pinakiewicz, at Kaiser Permanente’s second annual Workplace Safety Summit February 12.

“These preconditions enable employers to pursue excellence and continuous learning,” she said. “The purposeful maintenance of these preconditions is the primary role of leadership and governance.”

Systemic causes of harm

While pointed in their assessments, Pinakiewicz and the report’s authors refrain from finger-pointing. Pinakiewicz outlined systemic organizational stresses that work against workforce and patient safety. These include:

  • People feeling overwhelmed (58 percent of workers surveyed by the American Society of Professionals in Patient Safety cited overwork as an issue)
  • The volume of non-value adding work
  • Workforce safety and patient safety being managed separately and non-systemically
  • Operating pressures exacerbating traditional behavioral norms

The report identifies several “exemplar organizations,” including the Mayo Clinic, Virginia Mason Medical Center, Kaiser Permanente and the Coalition of Kaiser Permanente Unions, that are working to “create cultures of safety and respect.” KP’s 2012 National Agreement provisions for workforce total health and interest-based problem solving are cited as contributors to that culture.

Seven strategies for improvement

The Lucian Leape Institute offers seven strategies for improving safety and restoring joy and meaning to the health care workplace:

  1. Develop and embody shared core values of mutual respect and civility; transparency and truth telling; safety of all workers and patients; and alignment and accountability from the boardroom through the front lines.
  2. Adopt the explicit aim to eliminate harm to the workforce and to patients.
  3. Commit to creating a high-reliability organization and demonstrate the discipline to achieve highly reliable performance.
  4. Create a learning and improvement system.
  5. Establish data capture, database and performance metrics for accountability and improvement.
  6. Recognize and celebrate the work and accomplishments of the workforce, regularly and with high visibility.
  7. Support industry-wide research to design and conduct studies that will explore issues and conditions in health care that are harming our workforce and our patients.

“Through the Eyes of the Workforce: Creating Joy, Meaning and Safer Health Care” is available online from the Lucian Leape Institute at the National Patient Safety Foundation.

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Powerpoint: How a Contest Can Lead to Safety Kellie Applen Wed, 11/02/2011 - 14:07
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Content Section

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PPT

Size:
8.5" x 11"

Intended audience:
LMP staff, UBT consultants, performance improvement advisers

Best used:
This poster highlights a team that went nearly a year without any accepted claims for workplace injuries, after being one of the top 10 most injury-prone departments at its facility. Use in presentations to show some of the methods used and the measurable results being achieved by unit-based teams across Kaiser Permanente.

ppt_contest_lead_safety

This poster highlights a team that went nearly a year without any accepted claims for workplace injuries, after being one of the top 10 most injury-prone departments at its facility.

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Checklist for Turn Team Captains cassandra.braun Tue, 11/16/2010 - 16:18
tips (checklist, etc.)
PDF
Southern California
lmpartnership.org
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Checklist for Turn Team Captains
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Taxonomy upgrade extras

Format: 
PDF and Word DOC

Size:
8.5” x 11”

Intended audience:
Captains of turn teams

Best used:
Use this checklist when turning a patient to ensure the procedure is done safely and the chance of injury is minimized. 
 

 

 

cklist_TurnCaptain

Checklist used by turn team captains in San Diego's 2 North/South Med-Surg units when the team turns or lifts a patient, to ensure the procedure is done safely and the chance of injury is minimized.

 

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Tyra Ferlatte
pdf of tool attached; jpeg in artwork section is for listings. tlf 12/7
Released

Keep It Clean

Submitted by Laureen Lazarovici on Fri, 06/04/2010 - 08:59
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sty_EVS_WPS
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EVS workers and managers are tasked with keeping KP's facilities clean and germ free, but these departments are prone to lots of injuries. Find out in this story from the Summer 2010 issue of Hank how some of these departments are doing what it takes improve workplace safety.

Communicator (reporters)
Laureen Lazarovici
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Panorama EVS attendant Rosemary Mercado, an SEIU UHW steward, says the department’s unit-based team helped reduce the number of needlestick injuries.
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Keeping It Clean
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How EVS departments are building a culture of safety with partnership—and cutting injury rates
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The lady who talks to you from inside your GPS has found a new home, it seems, in the robotic carts deployed in the newly rebuilt Los Angeles Medical Center.

Instead of guiding you to your destination, she’s moving linen and trash along the long hallways and underground tunnels. By herself. Her gentle yet firm computerized voice tells workers in a docking room when the cart is ready to be filled, and sensors ensure she doesn’t run anyone over. She even can detect whether there are passengers in the staff elevators and patiently waits for the next empty one.

The robotic carts reduce wear and tear on the muscles and joints of the medical center’s Environmental Services (EVS) attendants. They are just one example of how managers and union members at this Southern California hospital are taking the lead in improving workplace safety for EVS departments.

Historically, EVS is a high-injury department because the job involves a lot of bending, lifting and moving equipment—not to mention working with hazardous chemicals. But the EVS department at Los Angeles Medical Center made such remarkable progress in reducing workplace injuries in 2009, its members earned a special bonus as part of the Performance Sharing Program (PSP). So did the EVS departments in Riverside and in Panorama City, which boasts the lowest injury rate in the region.

“Everyone wants to beat Panorama City,” laughs Manuel Covarrubias, the building services manager there. “It’s a friendly competition.”

But more important than the good-humored rivalry is the confidence these teams inspire in their counterparts. “They know it can be done,” Covarrubias says.

Even Kaiser Permanente’s oft-stated goal of a workplace free of injuries isn’t as far off as might be thought: The EVS department at the Eastside Service area in the Northwest region hasn’t had a single injury for two straight years. Regionwide, the EVS departments improved their collective injury rate by a remarkable 65 percent for the reporting year ending Sept. 30, 2009.

Management and union co-leads on these successful unit-based teams credit specific safety techniques, such as pre-shift stretching, and better equipment, such as microfiber mops and motorized carts. But they also say the communication and team-building skills they use by working in partnership are crucial to building not only systems of safety, but a culture of safety.

What works

Based on the experiences of successful EVS departments in Southern California and the Northwest, here’s what’s working to improve workplace safety.

Conduct safety observations: At Riverside Medical Center in Southern California, the management and labor co-leads of the EVS unit-based team conduct safety observations together. “We walk the units and look for safety hazards,” explains Cora McCarthy, EVS manager.

Evidence from Sunnyside hospital in the Northwest shows the effect this kind of effort can have. After the injury rate jumped up in the first half of 2009, Curtis Daniels, the medical safety coordinator, challenged UBT members to see how many safety conversations they could have to raise awareness of potential hazards. More than 6,000 conversations were reported in one month alone—and during the second half of 2009, the inpatient teams had only two workplace injuries.

By the numbers: The successful teams collect, track and—most importantly—share data, information and tips about workplace safety.

In Southern California, for instance, where there has been a 33 percent reduction of accepted workers’ compensation claims since 2005, the regional Workplace Safety department has built a customized incident investigation database, harnessing data that helps teams spot trends and come up with solutions. The database is only useful because employees are willing to report the injuries they suffer.

“At first, people were afraid,” says Eva Gonzalez, an EVS attendant at Panorama City and an SEIU UHW-West steward. “We assure them there is not going to be a backlash. Incident investigations helped, because people would show us how they got hurt and we let them say what happened. We ask, ‘What do you think we should do differently?’ ”

Ofelia Leon, the day shift supervisor who has worked at Kaiser Permanente for about three years, notes the fear of reporting was not unfounded: “At other (non-KP) hospitals, if you got injured, you got a caution or discipline, so people were afraid to report them.”

Employees also get regular updates about their progress toward their workplace safety goal. “We share information and let our members know where we’re at and where we need to be,” says Edwin Pierre, a 26-year EVS worker at LAMC. A huddle at the beginning of each shift includes a safety tip shared by an employee —creating a climate where workers get accustomed to speaking up and gain confidence that their voices are being heard.

Floor it, safely: To reduce injuries from lifting bulky mop buckets, EVS departments are buying more efficient microfiber mops that don’t require as many trips to empty, are wringerless, and use less water and cleaning solution. To keep those long hallways at LAMC clean while keeping workers safe, the EVS department replaced autoscrubbers with “chariots” that workers ride. “They have improved quality and morale, as well as safety,” says Abraham Villalobos, the hospital’s director of Environmental Services.

Maximize the micro: Microfiber is not just for mops. EVS departments in the Northwest now are using microfiber dusters with extendable handles proven to reduce worker strain. The new dusters also clean 45 percent faster than traditional methods and reduce chemical and water consumption up to 90 percent.

Tamper with hampers: The lids on trash cans and hampers were falling on workers’ arms and causing injuries—so the Panorama City EVS department bought new bins with hydraulic lids. They also put signs above hampers asking staff members not to overload the bins, because too-heavy loads were causing lifting injuries.

In a similar vein, “when needlestick injuries were up, we brought it to the table,” says Rosemary Mercado, an EVS attendant at Panorama City. The unit-based team decided to coach workers to hold the bags away from their bodies when taking them out of the laundry hampers. And they borrowed an idea from colleagues at nearby Woodland Hills Medical Center: They moved the hampers away from the sharps containers.

Take your time, take time off: “Be careful and take your time,” is the advice from Rebeca MacLoughlin, a housekeeper in the Northwest for seven years. Mindful of the link between fagtigue, morale and injuries, building services manager Manuel Covarrubias in Panorama City encourages employees to take time off when they seem to be getting sluggish. “I look for ways to cover people during summer to ensure people with less seniority can get some time off when they really want it,” he says.

Starting with stretching: Without exception, every EVS department that’s been successful at reducing the injury rate starts every shift with stretching. “Sometimes we dance and make it fun,” says Ofelia Leon, the day shift supervisor at Panorama City. The dance music of choice at LAMC is Michael Jackson. “I mean, who can’t dance to Michael Jackson?” wonders Pierre, the Pierre, the LAMC EVS attendant.

The bottom line: Investigating incidents, sharing safety tips, having on-the-spot conversations about working safely: These things are possible in large part because of the communication and team-building foundation fostered by the Labor Management Partnership.

'Our opinons matter'

Before, “It was just coming to work, doing whatever, and then leaving,” says Sandra Pena, the EVS labor co-lead at Riverside and United Steelworkers Local 7600 member.

“Now, it’s like there’s feedback back and forth all the time. It’s more of a team.”

“It makes you feel good as an employee to make improvements,” says Eva Gonzalez of Panorama City. “We know our opinions matter. We know we are not talking to the wall.”

Dilcie Parker, the labor co-lead at the LAMC EVS department, recalls how things were in 1999, when partnership started taking hold at her facility. “When we first began meeting, it was, ‘You sit on that side of the table, I sit on this side.’ I once arrived at a meeting and said, ‘I don’t sit next to management.’ You could feel the hate in the room.”

Management co-lead Villalobos doesn’t disagree. “Before, we couldn’t stand each other,” he says. “There was screaming.”

The turnaround, both say, came as a result of the LMP training the whole team received—from mapping root causes to issue resolution—and persistence.

“We started seeing the benefits in better quality and better attendance,” says Abraham Villalobos. “The reduction in injuries didn’t just happen this year. It’s about understanding the things we need. If we don’t get along, we can’t come up with projects to work on.”

This doesn’t mean everyone is holding hands and singing “Kumbaya.”

“There are still issues we disagree about,” says Parker. “But before, we used to get nothing solved. Now, issues get solved and they are off the table.” Recently, Parker, Villalobos and the team were in a meeting, crammed together in a tiny conference. The woman who once refused to even sit next to a manager found herself saying, “Look, Abraham, we’re actually touching.”

For information about EVS teams in Southern California, contact Dave Greenwood, workplace safety program director, at Dave.B.Greenwood@kp.org; for more information about workplace safety for EVS teams in the Northwest, contact Lori Beth Bliss, regional EVS manager, at Lori.B.Bliss@kp.org.

 

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