IMA RisKScore

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Management Leadership and Employee Participation.

• Management clearly demonstrates, (by involvement, support and example) the importance of safety and health for everyone in the organization. Safety and health issues are regularly included on agendas of management operations meetings.

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Management clearly demonstrates, (by involvement, support and example) the importance of safety and health for everyone in the organization. Safety and health issues are regularly included on agendas of management operations meetings.

• The workforce participate fully in the development and implementation of the safety and health program and content of training and education. Workers participate in audits, program reviews conducted by management and have the necessary formal training and education to participate in such reviews.

• Tools necessary to supplement a good safety and health program are available and effectively used.

• The workplace safety and health program reliably ensures protection of everyone employed at the work site including full-time employees, contractors, and temporary part-time workers.

• Executives provide goal setting (using leading as well as trailing indicator measurements) and leadership to the safety effort.

• A safety coordinator or safety committee is supported and is provided adequate resources, including the periodic use of outside experts, to be effective.

• Occupational medical provider assists with on site hazard analysis.

• Safety and health budgets and funding procedures are reviewed periodically for adequacy.

• Analyses (gap analysis, safety perception surveys, etc). done periodically to assess the safety climate and results used at the executive level.

• Safety incentive programs, if used, measure leading indicators and are used narrowly to create safety safety awareness.

Workplace Analysis

• Regular, written surveys included documented comprehensive workplace hazard evaluations are conducted by qualified safety people. Corrective action is documented and tracked.

• Workplace inspections are planned and overseen by a qualified safety professional. Random compliance audits are conducted with all elements of the safety and health program being evaluated. Observations are analyzed to evaluate progress.

• Job hazard analyses are used to evaluate hazards and identify controls both from a major operations standpoint as well as an individual worker 's daily hazard assessment.

• Management responds to reports of hazards in writing within specific time frames. The workforce readily identifies and self corrects hazards with full support of management.

Hazard Prevention and Control

• Hazard controls are in place, known and supported by the work force, with a focus on, engineering controls.

• There is a comprehensive, written and enforced safety and preventive maintnance program in place.

• Supervisors participate fully in the work site hazard analysis, ensure physical protection, reinforce training, and enforce discipline.

• Ergonomic injury prevention efforts are integrated into the work habits. (Such as MoveSMART, ErgoMed or Stretch n Flex)

• Healthcare providers provide follow-up on employee treatment protocols and/or involved in the hazard identification and control process.

• Employer requires pre-employment, post injury, for-cause as well as random drug and alcohol testing.

Contractor, vendor and subcontractor management.

• All contracts are reviewed by a competent resource before signing.

• checks and balances in place to ensure desired indemnity language and hold harmless provisions

• A formal system in place for monitoring certificates of insurance for desired limits and additional insured provisions.

• A thorough system is in place for the pre-qualification of contractors, including safety metrics such as EMR, safety program, OSHA recordable rates, OSHA citation history, etc.

Emergency Response

• There is a designated emergency response team with adequate training in the workplace. The plan is formally reviewed by the local fire department and reevaluated at least annually

• Medical treatment providers are identified in advance and site personnel are trained in first aid and/or emergency medical care.

• A crisis management plan is in place and employees are aware of the protocol/procedures as well as their personal responsibilities in the event of a crisis.

Safety and Health Training

• Knowledgeable persons conduct safety and health training that is scheduled, assessed and documented. Retrievable record keeping system provides for appropriate employee retraining, makeup training and modifications to training as a result of formal evaluations.

• New hires and transfer employees are provided substantial formal safety training prior to starting their job.

• On going safety training is provided for all production employees on a frequent basis.

• managers/supervisors are provided with an increased breadth and depth of safety training than that provided to production employees.

Financial and Incident Record Analyses

• All incidences and "near misses" are investigated for root causes by trained teams.

• The incident investigation is formal and thorough with written follow up until root causes are identified and corrected.

• All levels of management and the workforce are aware of results of data analysis.

• worker's compensation EMR analysis is completed annually to verify accuracy and evaluate the effect of deductibles.

• OSHA frequency and severity rate is well below industry average

• Data trends are fully analyzed and communicated.

Population health status

• integrated efforts with internal wellness/health Risk management program.

• Leadership and management education on link between safety and internal wellness/health wellness program.

• measure health status on annual basis (on site blood screening and health assessment questionnaire.

• Address health screening results through targeted interventions for health risks, such as asthma control, depression management, back safety, weight management and tobacco-cessation.

• Implement company policies that support healthy lifestyles, (e.g. tobacco free workplace, stretching breaks)

• Provide work environment that supports a healthy lifestyle (e.g. healthy vending machines, ergonomic assessments)

• Distribute annual company health status progress report.

Hiring procedures

• Written job applications required and reference checked of all desired candidates.

• Pre-employment testing includes "psychometric" testing such as Integrity testing, Job Candidate Profiling or other predictive analytics.

• Pre-placement testing such as physicals, functional capacity analyses, range of motion testing, CRT, etc.

Post injury procedures

• Post injury drug/alcohol testing in place for all medical clinic cases.

• An aggressive return-to-work procedure in place with a designated person on staff to handle such.

• Supervisor accompanies the injured worker to the treatment clinic.

• Staff person forces communication with clinic and claims adjuster.

Automobile liability analysis

• Drivers of company vehicles are selected after a review of past MVR history and checked against a minimally acceptable criteria.

• MVR's are checked quarterly and compared to acceptable criteria and drivers are periodically instructed of the criteria.

• Drivers of company vehicles are provided with driver training at least annually.

• There is a written driver safety program that includes a cell phone use policy, minimum MVR criteria, driver responsibilities, etc.

• The hired and non owned liability exposure is managed in the same manner as best practices for company vehicles.

• Technology solutions are used to evaluate driver safety performance. ( DriveCam, OBDI port monitoring, Geomonitoring, etc