Workers Compensation & Safety Audit 1.0

• Document No.2018-1d

• Workers Compensation & Safety Audit

• Client / Site

• Conducted on

  Date

• Risk Consultant

• Location
  Address

• Date of Last Survey Conducted.

• Persons Interviewed

GENERAL DATA

• What department oversees the workers compensation program?

• Who is responsible for employee safety?

  Facility Management/Plant Ops

  Human Resources

  Quality

  Employee health

• Are Safety Huddles or department directors meetings held daily?

  Yes

  No

  N/A

• Is employee safety discussed at Safety Huddles or department directors meetings?

  Yes

  No

  N/A

HUMAN RESOURCES

• Is this a UNION hospital?

  Yes

  No

  N/A

• If so, name of unions and what departments are part of the union.

• Are there issues REGARDING SAFETY that the union(s) are concerned with?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Average current turnover rate.(annual)

• Department with the highest turnover rate.

• Is there a policy for Workers Compensation that is SPECIFIC to the hospital?

  Yes

  No

  N/A

• Are all accidents reported within 24 hours?

  Yes

  No

  N/A

• What is the average lag time (time from accident occurrence to time received by the TPA)?

• Is there a procedure required for accident investigation and/or follow up for causes of the accident?

  Yes

  No

  N/A

• Is the follow up procedure enforced for EACH accident?

  Yes

  No

  N/A

• Does Human Resources process On-the-job injuries?

  Select Yes No N/A

  • Yes
  • No
  • N/A

• Does the employee health function review on-the-job accidents?

  Yes

  No

  N/A

• Is there a current policy that addresses the Return-to-Work program?

  Yes

  No

  N/A

• Is the third part administrator (TPA) contacted for assistance with the WC program.?

  Yes

  No

  N/A

• Is every employee injury seen by the employee health nurse or a physician?

  Yes

  No

  N/A

• Is the employee health nurse involved in accident prevention program?

  Yes

  No

  N/A

• Is there a dedicated staff member within the Human Resources department that manages and monitors the employee claims?

  Yes

  No

  N/A

• Are the employees on lost-time status MONITORED for medical treatment and rehabilitation?

  Yes

  No

  N/A

• Is accident trending performed?

  Yes

  No

  N/A

• Are the physical requirements of each job included in the job description?

  Yes

  No

  N/A

• Are employees that have repeat accidents evaluated for safety violations?

  Yes

  No

  N/A

• What is the HRD's rating of the morale?

EDUCATION

• Is there a hospital education department/function?

  Yes

  No

  N/A

• Who does the education director report to?

  Facility Management/Plant Ops

  Human Resources

  Quality

  Employee health

• Who provides hospital safety in the new employee orientation?

• Who is responsible for NEW employee orientation?

• Who provides employee safe work practices and workers compensation to new employee orientation?

• Is reporting accidents/Illnesses provided at new employee orientation?

  Yes

  No

  N/A

• Are accident trends discussed at new employee orientation?

  Yes

  No

  N/A

• Are safe work practices addressed and include the following: Patient lifting equipment, personal protective equipment and proper lifting techniques?

  Yes

  No

  N/A

• Is ANNUAL education provided to the hospital staff that includes employee safety

  Yes

  No

  N/A

• How are safety topics chosen to provide to employees annually?

  Yes

  No

  N/A

• What basis or subject matter used to address safety and accident prevention?

• Are there programs designed for individuals needing specific safety education such as proper lifting techniques, back injury prevention, etc., on-going?

  Yes

  No

  N/A

SAFETY PROGRAM- LOSS PREVENTION

• How often does the Safety Committee meet?

  Select Monthly Bimonthly Quarterly

  • Monthly
  • Bimonthly
  • Quarterly

• Are accident issues AND accident trends discussed at Safety Committee meetings?

  Yes

  No

  N/A

• Is PATIENT TRANSFER EQUIPMENT available throughout the facility?

  Yes

  No

  N/A

• Does the hospital offer bariatric services?

  Yes

  No

  N/A

• Is there any specific training provided for moving obese patients

  Yes

  No

  N/A

• Is there a hospital code for lifting assistance?

  Yes

  No

  N/A

• Does the hospital utilize lifting teams?

  Yes

  No

  N/A

• Does the Environmental Tours include questions to the staff regarding safety practices?

  Yes

  No

  N/A

• Are there specific methods to communicate safety issues to the staff? (hospital bulletins, newsletters, etc.)

  Yes

  No

  N/A

• Is there a method to obtain safety suggestions from the staff? (e.g., suggestion box, electronically, etc.)

  Yes

  No

  N/A

• Is there a representative from the physical therapy department on the Safety Committee?

  Yes

  No

  N/A

• Is the employee health nurse a member of the Safety Committee?

  Yes

  No

  N/A

• Is weather a factor that may cause slippery conditions?

  Yes

  No

  N/A

• Are any special safeguards used to minimize slips during icy or snow conditions?

  Yes

  No

  N/A

• Is personal protection equipment provided for hazardous jobs (dietary, lab, housekeeping)?

  Yes

  No

  N/A

• Is Crisis Prevention Institute (CPI) or deescalation training provided for all of the staff?

  Yes

  No

  N/A

• Is CPI or extensive deescalation training provided to the following departments: Emergency, Behavioral Health, Security, Special Care Units?

  Yes

  No

  N/A

• Is department accidents included as part of the annual performance evaluations to supervisors?

  Yes

  No

  N/A

• Are nursing representatives included on the Safety Committee?

  Yes

  No

  N/A

• Is there a formal Security program?

  Yes

  No

  N/A

• Describe the security function.

• Is the a formal back prevention program?

  Yes

  No

  N/A

• Are Job Safety Analysis performed on positions requiring lifting?

  Yes

  No

  N/A

CHIEF NURSING OFFICER

• Is communication to the CNO regarding employee accidents provided ?

  Yes

  No

  N/A

• Are accident trends that address units or nursing departments provided?

  Yes

  No

  N/A

• Is the CNO familiar with the hospital return-to-work/light duty program?

  Yes

  No

  N/A

• Is the CNO knowledgeable of which nursing department/unit has a high frequency of accidents?

  Yes

  No

  N/A

• Are nursing supervisors provided with education regarding accident investigation and follow up?

  Yes

  No

  N/A

• Is loss prevention or accident reduction a part of annual nursing training?

  Yes

  No

  N/A

• Is nursing representatives included on the Safety Committee?

  Yes

  No

  N/A

• Is patient transfer equipment available?

  Yes

  No

  N/A

• Is there a back injury prevention program available and specific to the nursing staff?

  Yes

  No

  N/A

• Is de-escalation training provided to the nursing staff?

  Yes

  No

  N/A

• Are nursing services responsible for patient discharge and assist patients to their vehicle?

  Yes

  No

  N/A

• Has nursing personnel been specifically trained on patient discharge and assisting into their vehicle?

  Yes

  No

  N/A

• Rate the morale of the nursing staff.

General

• Are waking surfaces kept in good order to minimize trips and falls?

  Yes

  No

  N/A

• Are wet ares identified and cleaned?

  Yes

  No

  N/A

• Are outside grounds and parking lots in good condition?

  Yes

  No

  N/A

• Are corridors clear for proper egress?

  Yes

  No

  N/A

• Are directional signs, including exit markings clear and visible?

  Yes

  No

  N/A

• Are general storage areas properly maintained?

  Yes

  No

  N/A

• Yes

  No

  N/A

Material Management

• Are storage areas properly maintained?

  Good

  Fair

  Poor

  N/A

• Are heavy items stored at lower levels to minimize reaching

  Yes

  No

  N/A

• Are storage items properly stored to allow proper egress throughout the storage areas?

  Yes

  No

  N/A

• Are the loading areas, including the dock, properly maintained to minimize trips and falls?

  Yes

  No

  N/A

• Are trash containers easily accessible and kept in order?

  Yes

  No

  N/A

• Does the trash compactor utilize an automatic shut-down device (dead-man switch) to cease operation immediately?

  Yes

  No

  N/A

• Are personal protective equipment used in the storage area to include hard-toe shoes, bump hats, gloves, etc.?

  Yes

  No

  N/A

• Are lifting devices to lift and move heavy items available in the warehouse?

  Yes

  No

  N/A

• Is education on proper lifting techniques provided to all employees that manage storage areas?

  Yes

  No

  N/A

Dietary

• Are work areas within the kitchen provided with mats or other devices to minimize slips and falls from water?

  Good

  Fair

  Poor

  N/A

• Are hot water pipes properly wrapped or blocked to prevent burns?

  Yes

  No

  N/A

• Are knives or other sharp items properly stored or protected to minimize cuts?

  Yes

  No

  N/A

• Are personal protective equipment provided, such as protective gloves, eye protection and protective aprons provided?

  Yes

  No

  N/A

• Are cleaning supplies used for ovens/stoves properly stored and protective clothing provided when cleaning that includes protective eye wear, gloves, etc.?

  Yes

  No

  N/A

• Are the dish washer areas maintained with matts and proper drainage to reduce slippery services?

  Yes

  No

  N/A

• Is food storage areas properly maintained to minimize food items from falling and heavy bulk food at floor level?

  Yes

  No

  N/A

• Are dietary personnel required to wear non-slip shoes in wet/slippery areas of the department?

  Yes

  No

  N/A

Radiology

• Is there a department policy regarding pregnant employees working within the departments where radiation may cause harm to unborn fetus?

  Yes

  No

  N/A

• Are dosimeter badges worn by ALL employees and evaluated regularly for excessive exposures?

  Yes

  No

  N/A

• Is annual education on proper techniques provided to all employees responsible for patient transfer or patient movement to and from tables or other equipment where body mechanics are needed?

  Yes

  No

  N/A

Physical Therapy

• Is equipment available on the units to assist the handling of patients by the PT department?

  Yes

  No

  N/A

• Is there representation on the safety or EOC committee by the PT department?

  Yes

  No

  N/A

• Is the Physical therapy department part of the employee education program to minimize back, shoulder, etc. injury?

  Yes

  No

  N/A

• When strains or sprains occur, is the physical therapy department involved with specific training to injured employees?

  Yes

  No

  N/A

• Is the Physical Therapy department well spaced for equipment use?

  Yes

  No

  N/A

Respiratory Care

• Describe cleaning procedures and include all chemicals used to clean equipment.

• Are there any cleaning chemicals used within the department that personal protective equipment is needed?

  Yes

  No

  N/A

Plant Operations/Maintenace

• Are maintenance shops in good order and equipment spaced properly?

  Good

  Fair

  Poor

  N/A

• Are machines provided with safety guards? (bench grinders, table saws, etc.)

  Yes

  No

  N/A

• Has there been a noise assessment in HVAC areas that would require ear protection?

  Yes

  No

  N/A

• Is there a requirement for special footwear where there is heavy material that create foot injury?

  Yes

  No

  N/A

• Is there a Lock Out/Tag Out policy that is current and enforced?

  Yes

  No

  N/A

• Are there areas within the facility that would be considered a confined space?

  Yes

  No

  N/A

• Is there a Confined Space policy?

  Yes

  No

  N/A

• Are plant operations part of the hospital security response team?

  Yes

  No

  N/A

• Has specific training provide to plant operations that respond to security issues?

  Yes

  No

  N/A

• Do plant operations respond to patient transfer or lifting needs?

  Yes

  No

  N/A

• Are plant operations provided with training on patient lifting/transfer techniques?

  Yes

  No

  N/A

• Are ladders OSHA approved and properly maintained?

  Yes

  No

  N/A

• Is personal protective equipment (PPE) such as eye protection, gloves, hardhats, etc., provided and worn by maintenance personnel?

  Yes

  No

  N/A

Special Care Units (ICU, CCU, etc.)

• Are electric equipment cords in special care units secured to minimize entanglement and trips?

  Yes

  No

  N/A

• Is equipment within patient areas well spaced to minimize tripping?

  Yes

  No

  N/A

Emergency Department

• Are ALL employees trained to handle aggressive behavior patients?

  Yes

  No

  N/A

• Are there specific codes for the emergency department personnel to use when there is patient disruption and assistance needed?

  Yes

  No

  N/A

Operating/Surgery, Obstetrics PACU,Anesthesia

• Good

  Fair

  Poor

  N/A

Behavioral Health

• Good

  Fair

  Poor

  N/A

Patient Units

• Is lifting equipment properly storage and easily obtainable?

  Yes

  No

  N/A

Administration

• Has there been an ergonomics evaluation performed in all admin areas that focuses on repetitive motion to reduce carpal tunnel situations?

  Yes

  No

  N/A

CHIEF EXECUTIVE OFFICER

• Is there a “Safety Champion “ that provides a positive approach to accident prevention?

  Yes

  No

  N/A

• Who is the "person" (safety champion) ultimately responsible for employee safety?

• Does the CEO know how the hospital compares to other facilities in regard to employee accidents?

  Yes

  No

  N/A

• Is the CEO aware of the expenses of employee accidents/Workers Compensation expense?

  Yes

  No

  N/A

• What does the CEO rate the morale of the hospital?

SAFETY CULTURE

• Describe the overall Safety culture.

MORALE

• Rate overall morale

• Morale issues if applicable.