Harborview Medical Center Incident/Accident Reports via PSN 2007

1. Harborview Medical CenterIncident/Accident Reports via PSN 2007 Kathryn Maher RN MSN Mary Dirksen RN COHN-s

2. Incident Totals – Caveats HMC Employee Health Service HMC Employee Health Service HMC Employee Health Service • All totals are based only on incidents reported to PSN • Event totals and/or Harm Score totalsmay change from quarter to quarter if : • Incidents are reported in a later quarter • Further harm resulting from an incident becomes known • Except where specifically indicated, all totals exclude incidents of violence, which are reported elsewhere

3. Harm Score Guidelines HMC Employee Health Service HMC Employee Health Service HMC Employee Health Service

4. Incident Categorization

5. Incident Totals – General

6. Employee Incidents and Resultant Harm by Event Type : 2007 (N = 640) D = Monitoring or treatment required to prevent harm E = Temporary harm; intervention or treatment required F or > = Hospitalization short or extended ; Permanent harm HMC Employee Health Service HMC Employee Health Service

7. Incidents with Harm Score ≥ D : Trend HMC Employee Health Service

8. Workers Compensation HMC Employee Health Service

9. Worker Compensation Claims Filed from HMC in 2007 (N = 241) HMC Employee Health Service

10. WC claims reported to PSN 2007 TL = Time Loss (measured in days) RD = Restricted Duty aka Light Duty HMC Employee Health Service

11. Examples of Specific Hazards and Risk Reduction Stragegies Patient Lift / Move Incidents Slips, Trips, Falls Blood and Body Fluid

12. Patient Lifting Incidents by Location of Event and Pt Weight : 2007 Lift Team was present in 2 Acute Care and 1 ICU events Other locations = Outside, Elevator, Hallway, Psych units HMC Employee Health Service HMC Employee Health Service

13. Patient Lifting Incidents and Harm Level by Employee Category : 2007 1 RN w/ disc dislocation / radiculopathy HMC Employee Health Service HMC Employee Health Service

14. Incidents involving motorized beds / stretchers : 2007 (N = 14) HMC Employee Health Service

15. Injury Reduction Strategy • Administrative: Safe Patient Handling Committee. Multi-disciplinary, frontline>mgt. • Lift Team Protocols, equipment eval, • Engineering: Motorized beds and stretchers and ceiling lifts • Education: Demonstrated competency with motorized beds-obstacle course driving

16. Falls – Slips – Trips

17. Falls-Slips-Trips by Job Category : 2007 Others : Office worker ; Pharmacist ; Rehab Ther ; Maint/Eng ; Pt Svcs/Liais ; Resources (MM, Stores) ; HMC Employee Health Service HMC Employee Health Service

18. Falls-Slips-Trips by Event Location : 2007 HMC Employee Health Service HMC Employee Health Service All Other = ED ; hallways ; elevators ; offices

19. Variables Contributing to Falls-Slips-Trips : 2007 Other reasons : avoiding collision w/ other ; etiol unclear (fainting, etc.) ; HMC Employee Health Service

20. Other Reported Incidents – 2007 HMC Employee Health Service

21. Injury Reduction Strategy • Administrative: Reports to EOC, EnvSvc, OR Safety • Review Safety Work practices • Engineering: Evaluate floor surfaces, cleaning and polishing slip factors, cord bundle • Education: Spill clean up, shoe selection, work practice,

22. Bloodborne Pathogen • Administrative: Bloodborne Pathogen Plan: • Reports to Infection Control Committee, Needle Safety Committee, Product Evaluation Committee • Education on safer devices, new products, and • Reporting to FDA on failure of devices

23. Safety Structures at HMC • Environment of Care • Health and Safety Committee • Laser Safety Committee • Patient Safety Committee • Infection Control Committee • TB sub committee • Bloodborne Pathogen review • Workplace Violence Committee • Product Evaluation Committee • Safe Patient Handling Committee

24. Incident Reporting via PSN and Safety Summary • Allows rapid identification of potential hazards and communication with stakeholders • Injury data and incident investigation requires personal follow up but allows for better service to individual employee and better safety information for hazard reduction. • PSN provides a real-time easy notification of all incidents or near misses