Hey! There’s a Department of Labor & Industries Inspector to see you!

1. Hey! There’s a Department of Labor & Industries Inspector to see you! Concurrent Session B Washington Hospitals Workers Compensation Program Tuesday, June 29 11:00a.m. to:12:15p.m. 6/21/2010 g:/Suzanne/2010/LakeChelanfinalsm 1 1

2. Two Trusts for membership began in 1984 Provides workers’ compensation claims management to members Provides safety services to members Board oversight by your peers About the Washington Hospitals Workers’ Compensation (W.C.) Program

3. About Washington Hospitals W.C. Program • Vision of the Program as adopted by the two Boards of Trustees: “To lead our membership to create and maintain the safest work environment.”

4. Promotes a safe environment for employees and this creates a safer environment for patients. Works closely with employee safety committees and employee safety officers. Develops Innovative programs such our Zero Lift - that began in 2000 -now known as “Safe Patient Handling.” Promotes executive managements’ direct involvement in employee safety. About Washington Hospitals W.C. Program

5. About Washington Hospitals W.C. Program Executive management involvement is key! • CEO Walkaround Contest • 2010 Top Performer Contest 6/21/2010

6. About Washington Hospitals W.C. Program Samaritan Hospital CEO Walkaround 2010 Ben Meyers (Safety Officer) & Andrew Bair (CEO of Samaritan -Hospital)

7. About Washington Hospitals W.C. Program Lake Chelan CEO Walkaround 2010 Karl Jonasson (Safety Director), Kevin Abel (Lake Chelan CEO), Ray Eickyeyer (Safety Committee Chair), and Carolyn Hood (H.R.)

8. About Washington Hospitals W.C. Program Ferry County Memorial Hospital CEO Walkaround Ron O’Halloran ( Administrator), Mike Jager (Safety Officer /Maintenance), & Debra Michael (Safety Committee Chair).

9. About Washington Hospitals W.C. Program • Willapa Harbor Hospital CEO Walkaround Natalie Dawson, RN & Carole Halsan (Willapa Harbor Hospital CEO).

10. About Washington Hospitals WC Program Executive Support and preparatory action is the key to readiness for an inspection. Let’s now take a closer look at the inspection process.

11. The inspection challenge: Labor & Industries (L& I) Division of Occupational Safety & Health (DOSH) industrial hygienists are inspecting hospitals for employee safety violations under RCW 49.17.050(6). -We are here to tell you about a DOSH hospital inspection and how to prepare for this. *FYI: DOSH is our state’s equivalent to OSHA.

12. Typesof Inspections Complaint:Typically anonymous employee Planned:Part of L&I safety enforcement Referral:From other agencies, like DOH Imminent danger: Risk of serious injury/death Follow-up:Verify corrections were made Serious injury: One or more hospitalized Death:Death of an employee

13. DOSH Inspections: Areas of Focus • Safer sharps devices and handling • Formaldehyde & hazardous chemical exposures • Anesthetic gas exposure • Respiratory Protection and disease isolation • Workplace violence prevention • Antineoplastic agent & carcinogen exposure • Safe Patient Handling Program Implementation

14. Focus #1: Safety system failures – like this overfull sharps container.

15. Focus #2: Contaminated sharps handling procedures - not followed in all areas. From Central Processing … …to clinic exam rooms.

16. Focus #3: Incorrect chemical storage and labeling.

17. Focus #4: Health hazards in labs… Where the unsafe use of formalin, a carcinogen, and sharps handling could cost the employer tens of thousands of dollars in citations.

18. Focus #5: Respiratory Protection Plan - with emphasis on the new H1N1 Influenzaregulation: DOSH Directive 11.70

19. Focus #6: Workplace Violence Log… Is the program fully implemented with all elements in place? 6/21/2010

20. Focus #7: Improperly set machine guards. In violation of Machine Safety - Chapter 296-806, WAC

21. Focus #8: Fire hazards from improper storage. Like all these containers of gasoline, stored outside the flammable safety storage cabinet.

22. Focus #9: Access to shut-off switches & control panels. Employees need safe, quick access to panels for shut-off in the event of an emergency.

23. Focus #10: Emergency wash stations located where there is potential for eye and skin injuries. It must deliver tepid water at 1.5 liters (or 0.4 gal)/minute for a minimum of 15 minutes!

24. Our first priority – tell our members!

25. It was a fine morning…. Carole Halsan, CEO of Willapa Harbor Hospital, had her cup of coffee and was sitting at her desk getting ready for a long day, when she heard several members of her staff call out to her, with great urgency in their voices …. “Carole…Carole… CAROLE!!!”

26. “Hey – There’s a Department of Labor and Industries Safety Inspector here to see you!” 26

27. OH, NO! This is bad timing!

28. According to the plan…we moved forward, together… Carole called Suzanne Metz, the WC safety coordinator assigned to Willapa Harbor Hospital.

29. Carole did what every good CEO does in a moment of crisis… She thought fast, knew her plan and swiftly took action. 29

30. We are not ready for this inspection!

31. FLASH BACK! How did Carole and her team work with Suzanne?

32. Using the checklists provided by the Program, Carole’s staff began to gather their plans, policies and procedures into binders. They knew they had to produce all the required 19 Documents that are likely to be requested by L&I inspectors!

33. Spill kits must have sufficient neutralizer and absorbent material and have appropriate Personal Protection Equipment (PPE) for the hazard.

34. Employees were involved! Supervisors checked their areas for good housekeeping practices and checked the levels of chemicals.

35. Supervisors & staff assessed & discussed hazards. Supervisors Hazard Assessment and PPE Certification.

36. Supervisors conducted respirator training. OR Manager, nurse anesthesiologist and surgical technician.

37. They evaluated handling sharps. Tammy, OR Tech, processing surgery sets.

38. “Being thorough and systematic.”

39. They found issues and fixed them.

40. “Hearing Protection” Gary Spoor, Willapa Harbor Safety Officer, dons hearing protection prior to performing a generator test.

41. Managers had reviewed and assembled their material safety data sheets. MSDS information for hazardous chemicals were up-to-date and available to all employees and on all shifts where the hazards exist.

42. Appropriate spill kits for hazardous chemicals- …were readily available in the event of a spill.

43. The dietary manager trained staff on new chemicals!

44. During the inspection, issues were immediately resolved! During the inspection, an alternative had to be found for a caustic oven cleaner – steam cleaning!

45. Safe Patient Handling Committee: -Completed their Annual Program Review!

46. Willapa Harbor Hospital Safety Committee Celebrates Their Achievement

47. Flashback– Closing conference:

48. Lessons learned • DOSH Inspectors are not DOH inspectors • Never let an inspector out of sight! • Document every action, each day. • Note areas inspected & ask questions. • Have more than one observer available. • De-brief and inform supervisors & employees constantly of the inspection process. • Don’t assume independent contractors have everything covered – check!

49. “We are you – you are us!” • New challenges = New solutions • New solutions = New knowledge to share • Meeting the DOSH inspection challenge helped us grow as an organization.

50. Moving Forward Together… QUESTIONS? 50 -0-