Workplace Injuries: Identification and Prevention – Risk Management Tips

Workplace Safety Goals. One of the most challenging aspects of occupational safety is goal setting. Goals that will be achievable and sustainable seem to be a mystery to many organizations. Historically in safety, setting a goal of having zero injuries was always seen as the obvious step to take, but think this through. Decades of worker injury statistics under the goal of “zero” has shown it is not “the” goal. Instead, organizations should place “the goal” as implementation of a successful safety management system. This is truly the path to sustainable safety success. It takes disciplined actions by many resources. The summation of the quantifiable actions of the system will help an organization achieve safety results.

Organizational safety success is achieved through establishing what are called, “leading indicator” goals, and these need to be the primary focus and emphasis by management. They are the road map of how an organization will achieve safety success. The other safety goals are “lagging indicator” goals, which are the results an organization will achieve, and these should not be the primary goal; rather, they are the secondary goals. Workplace hazard assessments will prioritize the safety goals an organization establishes. The work areas with the greatest occupational hazards, and greatest historical injury trends, will pin point where the primary actionable safety goals will be taking place.

For example, in a skilled nursing facility, back injuries are the leading cause of workplace injuries during transfers from surface to surface manually. In such a setting, a goal should be to conduct real-time observations for safe work practices. This is done by getting out on the floor and quietly observing bed-side care by front line staff with their residents, seeing first-hand what are the most common types of assistance and transfers conducted and listening for and witnessing the barriers to safety success for the staff.

By seeing and hearing the real time safety challenges of staff we can then establish other goals, such as building the business case for a safety budget increase to purchase important safety equipment to do the work with no harm. Set safety goals such as 100% completion of 12 safety committee meetings per year, 100% safety training completed for all new employees in the most high risk department plus 100% completion of shift starting safety talks for all new employees in their first 6 months of employment. Action drives safety success. Zero is not the goal; rather, it’s the result of many, disciplined and goal established safety actions completed by as many employees as possible so safety is truly everyone’s job.

The Art and Science of Prevention. One study researched the most common patient transfers in healthcare in 1999 and determined the majority of the manual assistance is not safe (Marras, 1999). Healthcare employers have the added challenge of moving individuals when they are not able to help themselves. Common assistance is needed in healthcare during such common tasks as lowering oneself to sit, or raise oneself to stand. Healthcare employees extend the hand, bend their bodies forward and assist to lift bodies millions of times per day in every care setting across the United States. With patient and employee obesity on the rise in the U.S., one may commonly encounter needing to assist or lift weights of 200+ pounds routinely.

Employers OSHA recordable rates in Healthcare have been at an alarming level. OSHA recognized this injury to healthcare workers epidemic and in 2009 developed a National Emphasis Program (NEP) on skilled nursing and it now even includes the hospital sector. The purpose of the NEP is to help curb the statistics of healthcare employee mobility related injuries. Because of the resounding data recognizing patient handling as a high risk task, it is imperative to healthcare systems to adopt the evidenced based best practice of Safe Patient Handling and Mobility. Adoption of the American Nurses Association (ANA) Safe Patient Handling and Mobility Guidelines is the path to reduction in this injury category. (http://www.nursingworld.org/handlewithcare)

Direct and Indirect Costs. Demystify the occupational injury process for employees through an efficiently written policy and process that is communicated easily several times through their career. Alay their fears and challenges, because it has great returns to all involved. An Injury and Disability Management policy should clearly define the role a management team takes with regard to occupational injuries that the immediate supervisor is in charge of the reporting process and what to expect, and the front line employee’s role and expectations from the minute an injury occurs to the end and the employee’s return to work. Each organization should designate an injury management lead, a "go to” person, to help oversee the process.

Through this procedure being applied, expectations are communicated from the hiring process, again during routine department meetings and upon every injury. Being consistent in the application is imperative. Each injury will be unique but the guiding principles of reporting, investigating, and assisting employees to maximum medical improvement are worth being invested in to ensure optimal outcomes. An organization should invest in its injured employees, be positive and helpful and encouraging. An injury is stressful but not the end of an employee’s career if communication is frequent, collegial and with established goals.

Injured Worker Outcomes. Transparent and well communicated injury management programs should begin early in an employee/employer relationship. Employers should communicate their injury management reporting and expectations during an occupational injury in the hiring process, again during new employee orientation and upon any minor to major incident being reported. A consistent and fair message helps set the tone the organization has and conveys the importance the organization has on prevention and care for all involved. When and if a supervisory relationship is not positive, employers can consider assigning a different supervisor to help keep the communication lines open and positive.

Accident Causation. In the profession of occupational safety, Mr. Herbert William Heinrich is credited as the pioneer of accident causation. In his retrospective review of 75,000 accident reports while at Traveler’s Insurance he concluded accidents are largely caused by human error. He concluded that in a group of 330 accidents, 300 will result in no injuries, 29 will result in minor injuries and one will result in a major injury. He placed these statistics in what became his famous “Accident Triangle” and this human error, focused view of safety guided the safety profession for decades. His theory led us to believe it was important to run safety programs by focusing on the many minor incidents this prevention work would automatically lead to fewer major incidents (Heinrich, 1931). But this theory has since been challenged (Manuele, 2002). Because, for high risk, low probability industries this is not the case. Severe injuries are not always the result of human error and more often are due to an error in the operation, culture, observations, versus the errant employee. As a profession, we need to assess workplaces for system errors that allow workplace injuries to happen.

Workplace Hazard Controls. A key step in implementing a Safety Management system, is conducting Job Hazard Analyses (JHA’s) of the most high risk job tasks. The JHA is completed in three steps. First, one lists the step by step tasks an employee must take to complete a job properly and safely. Second, the JHA analysis is to outline the common hazards associated with each task. Finally, the JHA defines through the hierarchy of safety controls, which engineering, administrative, or personal protective equipment will be required. A safety management professional then routinely re-evaluates the JHA’s to sustain the system. JHA’s are also an excellent form of supervisory guided job training tools as they can be the written and verbal confirmation of on the job instruction.

© Copyright 2017 LexisNexis. All rights reserved. These risk management tips were reprinted from an upcoming edition of Occupational Injuries and Illnesses (LexisNexis).