Safety and Health Management Systems A Road Map for Hospitals 1 Caring for Our Caregivers Safety and Health Management Systems A Road Map for Hospitals September 2013 U S Department of Labor www osha[.]
Introduction
How does a safety and health management system work? An overview
A safety and health management system is a systematic approach that enables employers and employees to collaboratively identify and mitigate workplace hazards before they lead to injuries or illnesses This framework supports the planning, implementation, evaluation, and enhancement of a hospital's safety and health initiatives It complements existing hazard-specific programs, such as those addressing bloodborne pathogens, safe patient handling, and workplace violence prevention, by integrating and strengthening them Importantly, this system addresses all workplace hazards, extending beyond the scope of OSHA standards.
The foundation of all safety and health management systems is the Plan-Do-Check-Act (PDCA) 3 cycle, popularized by W
Edwards Deming's principles are widely adopted by employers to enhance various business processes, including product quality and environmental protection Effective management systems are founded on essential concepts such as planning, process understanding, necessary adjustments, and ongoing evaluation of outcomes A safety and health management system integrates fundamental PDCA methods within a comprehensive framework of core elements.
A safety and health management system is essential for hospitals to align with and implement modern quality improvement practices The high reliability principles advocated by organizations like the Joint Commission and the Agency for Healthcare Research and Quality closely resemble those of an effective safety and health management system This publication emphasizes how hospitals can adapt practices that meet Joint Commission requirements to enhance worker safety and health.
The safety and health management system is an established concept, predating OSHA, with various industry consensus standards that are globally recognized and voluntarily embraced by numerous businesses.
The ANSI/AIHA/ASSE Z10-2012 standard, developed by the American National Standards Institute, the American Industrial Hygiene Association, and the American Society of Safety Engineers, provides a voluntary consensus framework for Occupational Safety and Health Management Systems.
2 The Occupational Health and Safety Assessment Series (OHSAS) Project Group, a consortium of selected Regis- trars, national standards bodies, professional associations and research institutes, has produced a similar document,
The Plan-Do-Check-Act Cycle
To enhance safety and health performance, organizations should define their commitments, goals, and expectations This involves creating a structured framework to manage and meet performance objectives, assessing workplace hazards and risks, and selecting effective control measures to mitigate these risks Additionally, it is essential to identify the necessary activities, processes, procedures, programs, and resources required to achieve these objectives.
Do: Implement plans, programs, and procedures throughout the organization in a systematic and controlled manner.
Regularly monitor and assess the implementation of plans to ensure they are executed as intended Evaluate the effectiveness of these plans in achieving safety and health objectives, and conduct periodic reviews to determine the suitability and effectiveness of the safety and health management system.
To ensure continuous improvement, it is essential to take corrective actions and regularly update the safety and health management system along with the organization's goals and objectives Implementing the entire Plan-Do-Check-Act (PDCA) cycle on a consistent basis is crucial for maintaining effective management practices.
Adapted from Deming, W.E 1986 Out of the Crisis MIT Center for Advanced Engineering Study.
OHSAS 18001:2007, Occupational Health and Safety
Management Systems—Requirements (OHSAS Project
In addition, the International Organization for Standardiza- tion (ISO) plans to develop an occupational safety and health management system standard, Occupational Health and
Safety Management Systems—Requirements Announced in
June 2013 and expected in 2016, the standard will replace country-specific standards, including ANSI Z10 and OHSAS
What are the core elements of a safety and health management system?
Most successful safety and health management systems have six “core elements,” all interrelated, each necessary to the success of the overall system:
Effective management leadership is crucial for fostering a culture of safety and health within an organization Managers at all levels must actively demonstrate their commitment by prioritizing safety, clearly communicating their dedication, and documenting performance outcomes By establishing clear goals and objectives, providing necessary resources, and leading by example, managers can significantly enhance workplace safety and health initiatives.
Employee participation is crucial in safety and health management systems, as employees possess unique insights into the workplace Their involvement is essential in goal setting, hazard identification, incident investigation, and progress tracking It is important for all employees to understand their roles and responsibilities within the system and to know how to execute them effectively Open communication with management is encouraged, allowing employees to report safety and health concerns without hesitation Addressing barriers to participation is vital for fostering a safe work environment.
(e.g., language, lack of information, or disincentives) are removed.
Effective hazard identification and assessment involve implementing processes to continuously recognize workplace hazards and evaluate associated risks This begins with an initial assessment of existing hazards and control measures, followed by regular reassessments to uncover new hazards and monitor the effectiveness of prevention and control strategies.
Effective hazard prevention and control involves the development and implementation of processes, procedures, and programs aimed at eliminating or managing workplace hazards This approach is essential for achieving safety and health goals Additionally, it is important to monitor and track the progress of these control measures to ensure ongoing effectiveness.
All employees receive essential education and training to effectively fulfill their roles within the safety and health management system This training includes recognizing workplace hazards and understanding the necessary control measures to mitigate risks.
To enhance safety and health management systems, it is essential to establish processes that monitor performance, verify implementation, and identify deficiencies By recognizing opportunities for improvement and taking necessary actions, organizations can significantly boost their overall safety and health performance.
Section 2 elaborates on the essential elements, offering implementation examples and demonstrating their alignment with hospitals' continuous initiatives to foster a culture of safety in patient care.
Safety and health management systems in hospitals: best practices and examples
Safety and health management system success stories from VPP hospitals
The Core Elements
Management leadership
Management leadership means that top administrators and the entire hospital’s management team:
• Are fully committed to improving workplace safety and health performance.
• Make safety and health performance a top organizational value.
• Provide sufficient resources to implement the safety and health management system.
• Visibly demonstrate and communicate their safety and health commitment to employees and others.
Effective leadership by managers, supported by meaningful actions, leads to substantial enhancements in an organization's safety and health performance This results in lower rates of injuries, illnesses, and fatalities, along with improved safety and health indicators.
Why management leadership is important
Effective safety and health management systems rely heavily on strong, visible, and sincere management leadership An evaluation of over 270 safety and health experts revealed that management leadership and employee involvement are the two most crucial elements in these systems Research indicates that initiatives to boost management involvement can result in significant improvements in safety and health activities A committed management team typically fosters better worker safety, reduces hazardous conditions, lowers insurance costs, enhances productivity and efficiency, improves employee morale, and decreases turnover rates.
Effective management leadership is crucial for fostering a strong safety and health culture within an organization It sets the foundation for superior safety performance and reinforces essential system elements Without the commitment of top management, employee participation in safety initiatives is unlikely, as a lack of support can signal to staff that the organization does not prioritize these efforts This discouragement can hinder overall engagement in safety and health responsibilities.
The core element of management leadership emphasizes that the responsibility for ensuring employee safety and health lies with the employer, aligning with the Occupational Safety and Health Act This principle underscores that management has control over the resources—time, budget, and personnel—needed to achieve organizational objectives Therefore, a strong commitment from management is crucial for meeting the organization's safety and health goals.
Effective management leadership prioritizes safety and health as essential business objectives, placing them on par with productivity, profitability, service quality, and patient satisfaction This necessitates management's recognition of the importance of a safe and healthful workplace, as well as the costs associated with neglecting these aspects A formal safety and health policy often serves as a means for management to convey and document their commitment to these principles.
An effective safety and health policy should encompass overarching goals like establishing a safety and health management system, ensuring compliance, and fostering continuous improvement in safety and health performance These general objectives serve as a foundation for formulating specific goals and priorities as hazards are recognized and actions are prioritized.
Management should refrain from establishing specific goals until a thorough hazard assessment is conducted, as this process often reveals hidden issues or problems By employing a systematic approach, potential problems that were not immediately obvious can be identified and addressed effectively.
4 OSHA 1998 OSHA Consultation Evaluation Tool Final Report Prepared under contract to OSHA Directorate of Federal and
5 LaMontagne, A.D., E Barbeau, R.A Youngstrom, M Lewiton, A.M Stoddard, D McLellan, L.M Wallace, and G Sorensen 2004
The goals and objectives established after the hazard assessment must be realistic and achievable They should focus on measurable or verifiable performance areas to ensure they can be evaluated within the Plan-Do-Check-Act cycle.
Management plays a crucial role in supplying and guiding the resources necessary for the effective implementation of an organization's safety and health management system The required resources, which may differ based on the organization's size and complexity, must be adequate to enable both managers and employees to meet their safety and health obligations These resource needs extend beyond financial aspects, encompassing access to information, personnel, time, training, tools, and equipment.
Management sets and upholds safety and health perfor- mance expectations in several ways:
• Holding managers and employees accountable for safety and health responsibilities in the workplace, and giving them the authority to do so.
• Communicating to managers and employees about safety and health issues.
• Discussing worker safety metrics, benchmarks, and goals with the board of directors.
Top-level management must designate individuals responsible for implementing each aspect of the safety and health management system It is crucial for management to empower these individuals with sufficient authority to perform their roles effectively Without this authority, employees may lack the motivation and empowerment needed to meet their responsibilities, while supervisors without authority may struggle to inspire action.
Authority can be established both formally, through written responsibilities in position descriptions and performance agreements, and informally, via verbal instructions Regardless of the method, it is crucial that these authorities and the division of responsibilities are clearly communicated and understood by everyone involved.
In organizations with various management levels, top management shows its dedication by holding middle managers, supervisors, and employees responsible for the effective implementation and success of the safety and health management system This approach fosters active participation and inspires individuals to become innovative problem solvers in safety and health matters.
To effectively lead by example, managers must be well-versed in the safety and health operating procedures that employees are required to follow, understanding their significance It is crucial for managers to adhere to the same safety practices expected of their staff; for example, employees are more likely to notice when management uses hearing protection in high-noise areas like the hospital laundry or utility room When managers neglect these safety protocols, it undermines the credibility of the entire safety and health management system.
Managers show their dedication by effectively communicating each employee's role in the safety and health management system and the significance of their contributions A successful system ensures that both managers and employees are held accountable for fulfilling their responsibilities, often assessed through formal performance evaluations.
Management leadership can be demonstrated in many ways For example, managers can:
• Conduct safety rounds and ask individual workers if they have any safety concerns or issues.
• Follow proper handwashing procedures and other standard precautions.
• Lead investigations of any incidents
• Approve purchases or expenditures that will improve safety, and communicate the reasons for doing so.
• Walk around the hospital and stop to compliment em- ployees who are following safe procedures, such as using patient lifting equipment.
• Keep employees from taking dangerous shortcuts, such as failing to use standard precautions to prevent bloodborne pathogen exposure.
• Halt work immediately to investigate or correct a serious hazard.
• Conduct housekeeping inspections of work areas.
• Ask workers informally about their safety and health concerns.
• Involve contractor and temporary workers in all aspects of the safety and health management system.
• Respond in person to employees’ concerns.
• Provide access to occupational health services for any workplace-related injuries and illnesses, including i nfections.
• Begin meetings with discussions of the safety and health management system and what it is achieving.
• Attend meetings of the safety and health committee
• Become a visible proponent of safety and health manage- ment system outside the organization.
• Include safety and health messages and reminders in their public statements, written products, and web page.
Managers can effectively showcase their commitment to safety and health leadership by consistently demonstrating their dedication to the safety and health management system It is essential for this commitment to be visible and regular, emphasizing that employee safety and health are top priorities.
Special considerations for worksites with multiple employers
Employee participation
Employee participation in a safety and health management system means that:
• Employees participate in designing, implementing, and evaluating the system, investigating incidents, and making recommendations for improvement.
• The safety and health management system incorporates employees’ distinct understanding of workplace hazards and how to protect employees from those hazards.
• The safety and health management system clearly spells out management’s responsibilities for supporting employee involvement.
• Employees trust that management will take their concerns seriously They do not fear reprisal for voicing concerns.
Effective management leadership and active employee participation are essential for cultivating a workplace culture that prioritizes safety and health These two elements are considered the most crucial components of a successful safety and health management system.
Why employee participation is important
The success of any safety and health management system depends on employee support because:
• All employees in the organization play a crucial role in safety and health.
• Employees are a tremendous safety and health resource— they have a distinct perspective about safety and health hazards in their workplace.
• Employees are more likely to support and use a system that they helped to build.
• Employee involvement in safety and health decisions results in better decisions and more effective protection.
Employee participation is crucial for saving lives and preventing injuries and illnesses, as agreed upon by employers, employees, and safety professionals across sectors Involvement in safety and health management systems significantly enhances their effectiveness, as employees possess firsthand knowledge of workplace hazards and potential solutions They are also more motivated to create and implement effective safety practices, given their personal stake in avoiding injuries Furthermore, employees are best positioned to assess the effectiveness of these systems By actively participating, employees gain a sense of responsibility and ownership, fostering a consistent commitment to their own safety and that of their coworkers.
Encouraging employee participation can lead to significant organizational benefits, as satisfied and productive employees are more likely to share their ideas when they feel valued Engaging in dialogue about safety and health fosters improved relationships and communication within the workplace By actively listening to workers, employers can gain valuable insights that may surpass the information obtained from costly safety and health professionals.
The optimal method for employee involvement in a safety and health management system differs across workplaces, influenced by factors such as hazard types, workplace size and structure, safety culture, previous participation experiences, available resources, union presence, and applicable OSHA standards and local regulations Management must engage with employees to identify the most effective ways for them to participate in safety initiatives.
At unionized workplaces, union support is critical for mean- ingful employee involvement Experience has shown that conditions for employee participation are optimal when:
• Both management and employees are committed to elevating workplace safety and health to the highest priority and to building a culture of safety throughout the organization 10
6 LaMontagne, A.D., E Barbeau, R.A Youngstrom, M Lewiton, A.M Stoddard, D McLellan, L.M Wallace, and G Sorensen 2004
Assessing and intervening on OSH programmes: effectiveness evaluation of the Wellworks-2 intervention in 15 manufacturing worksites Occupational and Environmental Medicine 61(8): 651-660.
7 Huang, Y.H., M Ho, G.S Smith, and P.Y Chen 2006 Safety climate and self-reported injury: Assessing the mediating role of employee safety control Accident Analysis and Prevention 38(3): 425-433.
8 Huang, Y.H., M Ho, G.S Smith, and P.Y Chen 2006 Safety climate and self-reported injury: Assessing the mediating role of employee safety control Accident Analysis and Prevention 38(3): 425-433.
9 Braun, T., and C Bauroth 2007 Evaluate your safety program Food Logistics September
• Management and employees can work in an atmosphere of mutual respect and trust.
• Employees are involved in the safety and health manage- ment system as broadly as possible from the very begin- ning.
• Employee participation is active—for example, they develop system goals and objectives, develop rules and procedures, identify and resolve issues, and make presenta- tions at safety and health meetings.
• Employees are convinced that management wants their participation and will take their input seriously.
• At unionized sites, authorized representatives work jointly with managers and employees to develop and implement the safety and health management system.
• Employees are aware of their rights of protection from harassment or retaliation when they get involved in safety and health activities or report safety and health concerns.
Incorporating contractor and temporary employees into the safety and health management system at worksites is essential This inclusion not only ensures that these workers benefit from the system but also allows their valuable insights to enhance its overall effectiveness.
Employees are more inclined to engage in safety and health initiatives when they perceive genuine commitment from management and value placed on their contributions They can easily sense insincerity, making it difficult for them to participate if they believe their involvement is merely superficial Section 1, “Management Leadership,” outlines ways for management to showcase their dedication to establishing a robust safety and health management system.
In addition to demonstrating commitment, managers may need to explicitly encourage employees to participate They can do this by:
• Reassuring employees that their input is important and valued, and will be considered.
To enhance employee engagement in workplace safety and health, organizations should implement mechanisms such as a standing safety and health committee, an open-door policy for discussing safety concerns with management, and a reporting system for near misses It is crucial for management to actively follow up on employee input to foster a culture of participation and ensure that employees feel valued in contributing to safety initiatives.
Finally, employees should participate not only in designing the safety and health management system but also in imple- menting it in response to workplace changes and lessons learned.
Involve employees in all aspects of the safety and health management system
Employee involvement is essential for the success of a safety and health management system, particularly in areas like hazard identification, control, and incident investigation Management must foster an environment that encourages employees to participate actively in all stages of the design and implementation of the safety and health management system.
Employee involvement can take many forms, depending on the situation and needs of the workplace For example, employees can:
• Report hazards and be involved in finding ways to correct problems.
• Serve on joint labor-management safety committees and other advisory groups.
• Analyze routine hazards in each step of a job or process.
• Develop and revise safety rules.
• Participate in injury and close-call incident investigations.
• Train current coworkers and new hires.
• Develop, implement, and evaluate training programs (see
Give employees access to safety and health information
Where possible, employers should offer employees every piece of information they can use to understand safety and health hazards and risks and identify protective measures
Employers must ensure that employees have easy access to the latest information necessary for safeguarding against workplace hazards This includes Safety Data Sheets, safety recommendations from chemical and equipment manufacturers, aggregated data on injuries, illnesses, and infections, as well as results from any environmental exposure monitoring This access is crucial in environments where changes in materials, processes, or procedures may introduce new risks or heighten existing ones.
Employers should provide employees with access to management-level information, such as incident investigation results, to foster trust and enable informed analyses This transparency empowers employees to confidently contribute ideas and promotes a shared understanding of key safety and health risks and protective measures Ultimately, this approach enhances the effectiveness of the safety and health management system and encourages greater employee participation in its implementation.
Encourage reporting of safety and health concerns
Employees play a crucial role in identifying safety and health issues, such as workplace hazards and unsafe practices, as well as reporting incidents like accidents and near misses For a safety and health management system to function effectively, it is essential for employees to report these concerns Therefore, management should establish clear channels for employees to communicate their safety and health issues, fostering an environment that encourages reporting.
To break down this barrier, management should cultivate a culture where employees feel assured that reported information will solely be utilized to enhance workplace safety and health, without fear of retribution This can be achieved by promptly addressing employee concerns, effectively communicating responses, and actively involving employees in problem-solving efforts.
Engaging in prejudicial treatment of employees for reporting safety and health problems is illegal: see Section 11(c) of the
The Occupational Safety and Health Act emphasizes the importance of employee participation in safety and health management systems For meaningful involvement, employees must trust that the process is transparent and free from retaliation for expressing safety concerns They should feel that their ideas are valued and considered During incident investigations, employees are more likely to engage and provide input when they believe the investigation seeks to identify the true "root cause," even if it implicates management failures.
To foster a culture of safety and health within the organization, managers must ensure that all employees, regardless of their skill level, education, or language proficiency, can participate without facing barriers from existing programs and policies For instance, incentive programs that reward injury-free workplaces may inadvertently discourage injury reporting due to fears of retaliation or negative impacts on performance evaluations It is crucial to review and adjust such programs to avoid sending the wrong message Conversely, incentivizing employee involvement in safety initiatives, such as participation in safety committees and reporting near misses, can promote a positive safety culture and enhance overall engagement.
Employers often encounter challenges in engaging marginalized workers, particularly in hospital settings where service and support staff may hesitate to interact with medical and administrative personnel Acknowledging existing hierarchical relationships is crucial, as they can compromise both patient and worker safety Encouraging professional staff to involve support staff in discussions about safety and health issues fosters a more inclusive environment Additionally, recognizing and valuing contributions from those who participate sends a strong message that the organization values input from all employees.
Finally, employers should authorize sufficient resources to facilitate participation—for example, by holding safety and health meetings during an employee’s regular working hours.
Employee participation: best practices and examples
St Vincent’s Hospital: looking out for each other
Hazard identification and assessment
What hazard identification and assessment means
In identifying and assessing hazards, an organization:
• Provides access to and makes use of all available sources of information on hazards and potential hazards in the workplace.
• Combines this information with the results of workplace inspections, job hazard analyses, injury and illness investi- gations, input from workers, and other techniques used to identify hazards.
• Assesses and prioritizes hazards, taking into account the effectiveness of current controls.
• Continually monitors for and responds to the introduction of new hazards.
The prioritized hazards are addressed using the strategies described under the next core element, Hazard Prevention and Control.
Why hazard identification and assessment is important
Under the General Duty Clause of the Occupational Safety and Health Act, employers are required to keep employees
To ensure a safe workplace free from recognized hazards that could lead to death or serious injury, management must evaluate facilities, equipment, materials, and work processes for potential risks Neglecting to identify these hazards is often a primary cause of workplace injuries and illnesses, resulting in significant business repercussions Therefore, it is essential to maintain a proactive and continuous approach to identifying and assessing hazards to safeguard employee safety and health.
Effective hazard identification and assessment are crucial for establishing a robust safety and health management system Recognizing hazards and comprehending their characteristics enable informed decisions regarding their prevention, elimination, or control Additionally, this awareness is vital for developing comprehensive employee education and training programs.
Effective hazard identification and assessment depend on the active collaboration between management and employees While management holds the responsibility for controlling hazards, employees play a vital role in recognizing and evaluating workplace risks due to their in-depth knowledge of operations This partnership is essential for fostering a strong safety and health culture, which is fundamental to a successful safety and health management system.
What hazard identification and assessment involves
To identify and assess hazards, an organization:
• Reviews its information on hazards present and then, typi- cally, conducts a walkthrough of the workplace to identify, confirm, and document all hazards.
• Analyzes hazards to understand their source, nature, and seriousness; the number of employees who may be exposed to them; and the frequency of the exposures.
A systematic approach to hazard identification and assessment is crucial for organizations, as it enables them to recognize workplace hazards and evaluate the severity of each hazard in relation to others.
Collect information about workplace hazards
Organizations typically possess existing information regarding the types of hazards present and the employees who may be exposed The initial step involves gathering, organizing, and reviewing this information For reference, Table 2-1 outlines examples of sources that may provide relevant information.
An effective hazard identification and assessment should cover the entire worksite, incorporating ancillary activities like facility maintenance, equipment upkeep, purchasing, office functions, and contractor operations Common methods for conducting these assessments include facility walkthroughs and worksite inspections, typically utilizing checklists to emphasize key safety concerns.
“things to look for.” Table 2-2 provides suggestions of things to check for during the walkthroughs.
Table 2-1 Examples of Information Sources for Hazard Identification and Assessment
OSHA offers various resources for identifying and evaluating hazards, including hazard information bulletins, eTools, standards, and guidance documents available on its website (www.osha.gov).
OSHA's regional and area offices provide guidance on identifying and managing workplace hazards Additionally, their On-site Consultation Service offers free and confidential hazard identification assistance specifically for small and medium-sized businesses For more information, visit www.osha.gov/dcsp/smallbusiness/consult.html.
Employee safety and health con- cerns
Employees possess essential insights into workplace hazards, as they are directly aware of safety and health conditions Both past and present concerns, whether expressed formally or informally, highlight potential risks Engaging in conversations with individual employees can uncover both hazards and effective solutions Their daily experiences with work practices provide invaluable knowledge that can enhance workplace safety.
The National Institute for Occupational Safety and Health (NIOSH) offers valuable resources on hospital-related hazards through its website at www.cdc.gov/niosh/topics/healthcare/ Additionally, NIOSH provides a complimentary Health Hazard Evaluation (HHE) program to assist in identifying and mitigating health risks in healthcare settings.
Centers for Disease Control and
The CDC’s National Healthcare Safety Network (NHSN) is a vital system for tracking healthcare-associated infections, enabling facilities to identify problem areas and measure the effectiveness of prevention efforts This network also facilitates the monitoring of blood safety errors and key healthcare process measures, including the influenza vaccination status of healthcare personnel and adherence rates to infection control protocols.
Equipment and machinery manu- facturers
Owner and operator manuals typically include warnings of hazards that may be pres- ent during operation and instructions, as well as precautions for safely operating the equipment or machinery.
Chemical manufacturers, importers, and distributors must provide downstream users with Safety Data Sheets (SDSs), which outline health hazards and offer guidance for the safe handling and use of chemicals Additionally, chemical suppliers may include extra safety and health information alongside the SDSs.
Trade associations, insurance carri- ers, manufacturers, and government agencies
Trade associations and insurance carriers often release safety and health information through magazines and newsletters Additionally, manufacturers and government agencies like the CDC and the Consumer Product Safety Commission provide safety warnings and hazard alerts focused on specific products, work practices, or hazards.
Data and reports on workplace injuries, illnesses, infections, and fatalities highlight the seriousness of hazards present in the work environment Employers are mandated to keep logs and summaries of "recordable" occupational injuries and illnesses, reporting incidents to OSHA using Forms 300, 300A, and 301 Conducting incident investigations can reveal hidden hazards and ineffective control measures, while serious cases may prompt external authorities to carry out their own investigations.
In any event, the employer should conduct such an investigation either in-house or using third-party experts.
Aggregated results of medical screening, medical surveillance activities, and employee exposure data
These results can alert employers to hazards posed by chemical, physical, and biologi- cal agents Use of aggregated results is important to maintain the confidentiality of employee medical information.
Project planning Project hazard analysis at initiation and at critical stages of a project evaluates the sequence, procedures, and people responsible for safety and health.
Conducting a "what-if" analysis of both natural and man-made disasters is essential for disaster preparedness, as it helps identify low-probability hazards that could lead to catastrophic outcomes Such hazards may include explosions from flammable chemicals or combustible dust, risks associated with severe weather events, and incidents stemming from criminal or terrorist activities.
Hazard prevention and control
What hazard prevention and control means
Under this core element, organizations take several steps to prevent and control workplace hazards On an ongoing basis, they:
• Identify and evaluate control options for workplace haz- ards.
• Select effective and feasible controls to eliminate, reduce, or contain these hazards.
• Implement these controls in the workplace.
• Follow up to confirm that these controls are being used and maintained properly.
• Evaluate the effectiveness of controls and improve, expand, or update them as needed.
Why hazard prevention and control is important
Effective workplace hazard prevention and control are essential for safeguarding employee safety and health while preventing incidents By minimizing or eliminating risks, employers fulfill their legal obligations to provide a safe work environment This proactive approach not only reduces costs and enhances efficiency but also improves the quality of products or services Additionally, it fosters better relationships with stakeholders and bolsters the organization's reputation as a responsible entity.
What hazard prevention and control involves
Effective hazard prevention and control can only occur once hazards have been identified Consequently, the majority of hazard management efforts are implemented following a systematic identification and assessment of workplace hazards.
Employers must promptly implement interim controls if the hazard identification process reveals serious, uncontrolled hazards, while also exploring additional options during the hazard prevention and control process.
Hazard prevention and control is a continuous process that requires regular assessment of measures in place To maintain effectiveness, these measures are updated as necessary, adapting to advancements in control technologies and evolving workplace conditions.
Effective control techniques are often easy to identify and implement for common, well-understood workplace hazards
Effective control options for serious and complex hazards may not be immediately clear In these situations, it is essential to implement and select more permanent control measures Whenever possible, the chosen methods should target root causes and demonstrate effectiveness both at the time of implementation and over the long term.
Identify control options and select controls
Effective hazard prevention and control starts with collecting information to understand how to mitigate identified workplace hazards Various control options are typically available, making it essential to evaluate the advantages and disadvantages of each Valuable prevention and control information can be sourced from OSHA standards, industry associations, safety publications, and equipment vendors Additionally, employees can offer significant insights, as they may have encountered successful control measures in other settings and can propose innovative solutions based on their knowledge of the facility and work processes.
Once employers understand available options, they can choose the most effective and feasible measures for their workplace This involves considering questions such as:
• What safety and health risks exist in the workplace?
• Where and how do these risks occur?
• What types of emergencies could arise, and what safety and health risks would they pose?
• What do federal and state standards require?
• What are appropriate risk reduction goals?
• What risk control technologies are available?
• How cost-effective are these technologies?
• What internal standards does our organization have?
• What are current best practices within our industry?
• How do employees perceive the intervention?
Employers often seek guidance from qualified safety and health professionals, including specialists from OSHA’s On-Site Consultation Service, to gain valuable insights and explore options related to workplace safety and health.
Organizations must adhere to all hazard prevention and control measures mandated by OSHA standards and the General Duty Clause, including controls to prevent the spread of infectious diseases as outlined in OSHA’s bloodborne pathogen standard (1910.1030) Employers are encouraged to implement measures that exceed these OSHA requirements when feasible According to OSHA and established safety principles, hazard prevention and control measures should follow a specific hierarchy, with engineering controls being the most effective as they minimize reliance on human factors for protection Additional types of controls should be considered in the specified order to enhance protection when engineering controls are inadequate.
The hazard prevention and control hierarchy
Engineering controls are essential for enhancing workplace safety by redesigning processes to eliminate or minimize hazards These strategies involve removing hazardous processes, substituting safer materials or equipment, and implementing physical barriers or ventilation systems to reduce employee exposure For instance, in hospitals, effective engineering controls for managing glutaraldehyde exposure may include general ventilation, local exhaust systems at the point of release, local exhaust hoods for capture and conveyance, or ductless fume hoods that filter harmful substances.
Safe work practices are essential when engineering controls are impractical, insufficient, or temporarily unavailable, such as during maintenance These practices encompass guidelines outlined in both general and process-specific OSHA regulations, including those related to hazard communication, bloodborne pathogens, and laboratory chemical hygiene.
Administrative controls encompass various strategies aimed at minimizing employee exposure to hazards These measures include physical conditioning programs, exercise or stretching breaks, the use of additional relief personnel, and employee rotation Typically, these controls are implemented alongside other methods that more directly mitigate or manage exposure to risks.
Personal protective equipment (PPE) encompasses both clothing and equipment designed to protect workers from hazards when engineering and administrative controls are insufficient It is essential to select appropriate PPE tailored to the specific work environment and hazards, with certain items, like respirators, requiring individual fit testing Regular maintenance of PPE is crucial for its effectiveness, and involving employees in the selection process can enhance compliance with PPE policies For detailed OSHA requirements regarding PPE, refer to OSHA’s standard, Part 1910.132 Subpart I.
In situations where individual protective methods fail to provide complete safety for employees, a combination of control strategies, including engineering controls and additional personal protective equipment (PPE), is implemented to enhance protection.
Select controls to protect employees during emergencies
Effective hazard prevention and control involves strategic planning to safeguard employees from potential emergencies, including fires, explosions, chemical spills, unplanned equipment failures, natural disasters, severe weather events, medical crises, and incidents of workplace violence.
Many workplaces are mandated to have formal written emergency response plans in compliance with regulations from local fire and emergency response departments, state agencies, the U.S Environmental Protection Agency, and OSHA Specifically, OSHA regulations under §1910.38 and §1910.39 outline the requirements for Emergency Action Plans and Fire Prevention Plans.
Education and training
What safety and health management system education and training means
Education and training are crucial components of an effective safety and health management system, equipping employees with the necessary knowledge and skills to perform their tasks safely while achieving the organization's safety and health objectives.
An effective education and training program:
• Ensures that employers, managers and supervisors, and employees have the knowledge and skills needed to work safely and avoid creating hazards that could place them or others at risk.
• Enhances awareness and understanding of workplace hazards, and how to identify, report, and eliminate or control them.
• Provides specialized training, where needed, to employees whose work involves particular hazards or to those with specific roles in managing or operating the safety and health management system
• Includes periodic checks to assess whether training is effective, timely, up-to-date, and applicable based on the current roles and responsibilities of managers, supervisors, and employees.
Why safety and health management system education and training is important
Organizations that neglect proper workforce training face substantial costs and various business risks, including unsafe working conditions Insufficient education and training often lead to workplace accidents and injuries By equipping all employees, including supervisors and managers, with the necessary knowledge and skills for safe operations, organizations can significantly reduce the likelihood of incidents that result in injuries, illnesses, equipment damage, production losses, and downtime.
Training enhances workforce knowledge on safety and health, equipping employees with the necessary tools to proactively identify and resolve potential issues This education fosters breakthroughs in understanding, leading to significant improvements in safety and health performance, as well as advancements in processes, products, and overall productivity.
By training employees in safety and health management system processes, programs, and procedures, an organization will be better able to ensure that they are:
• Aware of the organization’s safety and health goals.
• Familiar with individual roles and responsibilities under the safety and health management system.
• Capable of recognizing, controlling, and mitigating haz- ards found in the workplace.
Education and training are essential for enhancing the effectiveness of safety and health management systems By equipping employees and managers with the necessary skills, organizations can systematically address safety and health issues, ultimately reducing on-the-job injuries, illnesses, and fatalities A robust safety and health education and training program is crucial for improving overall performance and minimizing costs related to poor health and safety practices.
• Reducing occupational injury rates, the severity of injuries, days away from work, and employee healthcare costs.
• Reducing employee concerns about on-the-job safety and health.
• Reducing employee absenteeism and turnover.
• Decreasing workers’ compensation and general liability insurance premiums 15
• Increasing employees’ skill and motivation, which can bring increased product quality and productivity.
• Improving compliance with OSHA standards, many of which contain specific training requirements.
What safety and health management system education and training involves
Education and training are crucial for all individuals in the workplace, encompassing managers, supervisors, non-supervisory employees, contractors, temporary staff, and even visitors who may face hazards on-site.
• To promote workplace safety and health and enforce safe work practices, supervisors need to understand workplace hazards and controls.
13 Godkewitsch, M n.d The dollars and sense of corporate training Training.
• Managers need to understand their responsibilities for implementing and running the safety and health manage- ment system.
• Managers, supervisors, nonsupervisory employees, contrac- tors, and temporary employees all need to understand their roles and responsibilities in the safety and health management system.
• Contractors, temporary employees, and visitors may need instruction related to the hazards or risks they could encounter during their time in the workplace and the necessary protective measures
Provide safety and health management system awareness training
All employees must receive comprehensive training on the organization's safety and health policy, including its goals, basic operations, and the functions of the safety and health management system They should be familiar with hazard recognition and avoidance techniques, as well as emergency response procedures Understanding the principles of the system, their specific roles and responsibilities, and the methods of communicating safety and health information in the workplace is essential The frequency and timing of this training will depend on the organization's size and nature, and it should also extend to contractors and temporary employees.
Train employees on their specific roles in the safety and health management system
Employees play crucial roles in the safety and health management system, including inspecting for hazards, conducting audits, implementing hazard controls, and investigating incidents It is essential for these employees to understand their responsibilities and adhere to both internal and legally mandated procedures Training should focus on the direct impact of their actions on the system's effectiveness For instance, an employee tasked with receiving hazard reports must know how to respond appropriately and identify who is responsible for implementing control measures.
As safety and health management systems advance, it becomes essential to establish a formal process for identifying the training requirements of employees tasked with developing, implementing, and maintaining these systems.
Train employees on hazard identification and controls
Employee training is essential for recognizing workplace hazards, including both job-specific and general risks Understanding the employer's control measures is crucial, as it highlights their importance and the necessity for compliance For instance, without awareness of noise exposure hazards in environments like hospital laundries or heliports, employees are less likely to utilize protective measures such as hearing protection.
An effective safety and health management system identifies and addresses the training needs specific to each job These requirements are fulfilled through a blend of education, experience, and training Post-training, it is essential to monitor employees during their work to ensure adherence to safe work practices and necessary procedures.
Every workplace, regardless of its type or size, aims to equip employees with the necessary training, knowledge, and skills to effectively implement safety and health management systems while performing their jobs safely Employers must identify the training needs of employees with English as a second language, physical limitations, or other special requirements, and adapt training materials and delivery methods to meet these needs.
Education and training requirements, methods, and program content vary across different workplaces These choices are influenced by the unique aspects of an organization's safety and health management system, the complexity of the tasks performed, the nature and level of workplace hazards, and the specific characteristics of the employees.
Education and training: best practices and examples
University Medical Center at Brackenridge: speaking out for safety
UMC Brackenridge in Austin, Texas, acknowledged the challenge of encouraging all staff to adopt high reliability safety behaviors This initiative necessitates that associates feel empowered to communicate openly, even addressing concerns with colleagues or superiors.
Despite all associates receiving high reliability safety training, the hospital recognized the need for further action To enhance safety practices across the organization, a group of passionate employees was selected to become "Safety Coaches." These coaches underwent additional training to develop the skills necessary for fostering alignment and building consensus on safety initiatives.
Coaches meet regularly to discuss situations, share ideas, and learn from each other UMC Brackenridge credits its Safety
Fostering a supportive environment where every employee feels empowered to address behaviors, processes, or procedures is essential Encouraging non-threatening and non-judgmental interventions promotes open communication and collaboration among team members This initiative allows employees to question one another constructively, leading to improved workplace dynamics and enhanced overall performance.
System evaluation and improvement
What system evaluation and improvement means
System evaluation and improvement is one of the most important—and often neglected—elements of an effective safety and health management system It involves:
• Activities and processes to determine whether a safety and health management system is operating as intended and achieving the organization’s goals.
• Continually improving safety and health management system performance.
Effective system evaluation and improvement involves several critical management processes and activities These include:
• Monitoring and measuring to track whether workplace safety and health conditions are improving and goals are achieved.
• Monitoring injury and illness experience to identify prob- lem areas.
• Conducting inspections to determine if controls, processes, and other elements in the safety and health management system are being consistently implemented.
• Investigating safety and health management system deficiencies.
• Ensuring that effective corrective and preventive actions are promptly chosen and implemented.
• Evaluating the safety and health management system as a whole and by its components to determine whether it operates and functions effectively.
• Top management review of the safety and health manage- ment system’s effectiveness and its continued ability to meet the organization’s evolving needs.
Why system evaluation and improvement is important
Evaluating and improving a safety and health management system is essential for its effectiveness By implementing structured processes, programs, and procedures, organizations can ensure their system operates as intended, meets goals, reduces employee risks, and fosters continuous improvement This evaluation process also helps identify implementation issues, rectify deficiencies, and enhance the overall system.
All safety and health management systems face challenges and inconsistencies, particularly in their initial phases The implementation process often uncovers unforeseen weaknesses that were not anticipated during the design stage Additionally, it is essential to refine the system in response to evolving workplace conditions and to seize opportunities for enhancing its performance.
System evaluation and improvement provide management with a chance to showcase leadership and accountability When employees observe that their leaders prioritize safety through regular inspections and transparent communication of results, they are more inclined to trust the leadership and engage actively in the safety and health management system.
What system evaluation and improvement involves
Monitor safety and health management system performance
To effectively monitor a safety and health management system, organizations should track various indicators related to safety and health Lagging indicators, such as the frequency and severity of injuries, employee exposure to hazards, and workers' compensation costs, provide insights into past performance Leading indicators, including employee participation in safety activities, management walkthroughs, and response times to hazard reports, help predict future safety outcomes Analyzing changes in these measures post-implementation can reveal improvements in workplace safety Additionally, administrative measures, such as inspection deficiencies, completion rates of safety training, and response times for corrective actions, are crucial for evaluating the system's effectiveness.
Indicators can be classified as either quantitative or qualitative, but it is crucial to choose measurable indicators that align with the goals of the safety and health management system, as well as the interests of both management and employees Organizations should also document their monitoring activities and outcomes when applicable.
Incidents are key indicators of deficiencies in safety and health management systems Conducting thorough investigations into these incidents enhances system performance and creates a roadmap to prevent future fatalities, injuries, and illnesses The primary goal of any investigation should be to uncover the root cause of the incident.
Effective investigations necessitate proactive planning before any incident occurs Establish a comprehensive strategy that outlines the types of incidents to investigate, the personnel involved, communication protocols, and the necessary materials and equipment Ensure that specific supplies, such as a digital camera, barrier tape, tape measure, and notepads, are designated solely for investigative purposes and readily available.
To ensure a thorough investigation, it is crucial for all participants to maintain objectivity and an open mind Ideally, the investigation team should comprise both management and employee representatives, fostering a balanced perspective Participants should have a good understanding of the relevant operations without being directly involved in the incident that occurred.
In the aftermath of an incident, the priority is to administer first aid and emergency care to the injured workers while implementing measures to prevent further injuries Emergency response plans must outline procedures for medical emergencies Following the immediate response, a prompt investigation should be initiated, overseen by qualified personnel or responding authorities The fundamental steps in conducting an incident investigation are essential for ensuring safety and compliance.
1 Report as required Determine who needs to be notified, both within the organization and outside (e.g., authorities) Understand what types of incidents must be reported, and what information needs to be included
If the incident involves hazardous materials, additional reporting requirements may apply
2 Isolate witnesses Eyewitnesses to the incident will be a critical source of information Where possible, prevent witnesses from discussing the incident with each other until you have had a chance to interview them individually (see below)
3 Preserve the scene The condition of the workplace at the time of the incident needs to be documented Avoid any disturbance to the site until investigators have had a chance to go over it.
4 Collect physical evidence and make observations
Documenting the workplace condition at the time of the incident is crucial, focusing on the specific location and arrangement of key elements such as equipment, the position of the injured employee, and the proximity of other employees to doorways Effective documentation tools include photos, videotapes, measurements, and sketches or scale drawings Additionally, it is important to collect samples of any materials, such as liquids or dust, that may be involved, ensuring that containers are clearly labeled with the time and location of sample collection.
5 Conduct interviews When it is appropriate to do so, and as soon as possible, the injured employee(s) should be interviewed and their statement(s) taken Eyewitnesses should also be interviewed as soon as possible Put the interviewee(s) at ease, and reassure them that the objec- tive of the interview is to find facts and determine what needs to be fixed, not to assess blame Use open ended questions to elicit more information
6 Collect and review other information Depending on the nature of the incident, records related to training, maintenance, inspections, audits, and past incident reports may be relevant to review
Most root causes are linked to management system failures Finding and fixing the root cause will affect not only the incident being investigated, but many future incidents as well
An investigation should go beyond merely identifying mistakes and assigning blame; it must also uncover the root causes that created the conditions for the incident While the immediate cause explains what happened, understanding the underlying factors is crucial for preventing future occurrences If root causes are not addressed, the same conditions are likely to lead to another incident.