OSH ISSUES IN THE HEALTHCARE SECTOR AND STAFF EMPOWERMENT

1. OSH ISSUES IN THE HEALTHCARE SECTOR AND STAFF EMPOWERMENT Sarah Copsey

2. The Agency: www.agency.osha.eu.int • Provides information • Networking • Coordinates • Information services • Information projects • Agency website –dissemination means

3. Why the health care sector? • European concern • Sector has been highlighted as a priority by the Member States • Common risks across Europe

4. Most frequently identified sectors at risk by OSH Authorities (Agency 2000)

5. Healthcare sector: greater risks of • Violence • Stress • Bullying • Work directed by social demands • Reproductive hazards • Biological infections • Heavy loads, poor postures • Occupational ill health/diseases • Sickness absence

6. Plenary 1: The hospital –a staff empowering workplace Sarah Copsey Thursday 19th May 2005

7. Health care sector: other risk factors • Accidents • Chemicals • Shiftwork, hours • Work organisation • Content and forms of work Report by the Dublin Foundation, “Working conditions in hospitals in the European Union” 1995

8. Health care sector: risks • Risks arise from • Physical conditions • Organisational restrictions • Social environment • 3 groups most at risk • Nursing staff – includes assistents and students • Service and trade workers • Laboratory staff and anaesthetists Report by the Dublin Foundation, “Working conditions in hospitals in the European Union” 1995

9. Violence prevention – Dutch hospital Violence – Irish hospital Stress prevention – Spanish elderly care Stress audit tool – Irish hospital Stress – improving shift rotas, Finnish hospital All EU languages Good practice examples

10. Safe care plan: prevention of violence in hospitals - Netherlands • Cooperation between hospital, regional police and Public Prosecutors Department • Cooperation between the management board and works council • Survey– most incidents in reception, accident and emergency, psychiatry, evenings, nights and weekends • Working party from staff in at risk departments draw up risk inventory • On hospital room plan colour risk level -red –high, yellow – medium, green – low • Measures based on discussion of risk inventory • Links to tripartite hospital safety agreement

11. Safe Care Plan (2): No tolerance system • All incidents reported • Card system for serious aggression • Yellow card for serious threats, reported to police • Red card for physical violence – reported to police and brought before public prosecutor • Posters about policy in public places and media to inform public • Police provide information/advance notice • Staff carry alarms, to alert security staff • Cameras linked to alarms

12. Safe Care Plan (3) supporting measures based on risk analysis: • Patient environment measures – e.g. information about waiting times • Staff training about all aspects • On agenda of monthly management-staff consulting meetings, police invited • After incident counselling

13. Violence to hospital staff - Ireland • Visible management commitment • New report form, reporting positively encouraged, electronic database • Multidisciplinary working group and h&s consultants --> risk assessment and prioritised recommendations • Comprehensive framework - Measures covering anticipation, prevention, intervention, support and evaluation

14. Violence to hospital staff – Ireland: measures (1) • Safety of physical environment and work practices • Non-violent crisis intervention programme – staff trained as trainers • Increased security presence • Alarm systems and better CCTV coverage • Closer working with the police. Police liaison officer to work with hospital • Prosecutions in serious cases • Information for staff, public awareness through local media

15. Improvements for patients, e.g. waiting time information Staff feedback system Violence to hospital staff – Ireland: measures (2)

16. Stress prevention in an old people’s home – Spain – (1) how: • Cooperation between management, trade unions and the local insurance organisation • Risk assessment of the work and a staff questionnaire • Problems found included: • High work load • Lack of information • Lack of decision making responsibility • Little possibility of promotion • Unforeseen events/changes of plan • Physical work conditions and physical effort

17. Stress prevention in an old people’s home – Spain – (2) solutions: • Increase staffing levels during peak hours • Staff training to deal with emotional stress • Specifying functions and competencies of nursing assistants –e.g drug dispensing • Communication protocol for risks • Increasing worker autonomy, discretion • Clear definitions of content of tasks and responsibilities, in an agreement • Providing lifting aids, hoists • Promoting worker participation

18. Stress prevention in an Irish hospital (1) Problem identification: • Workshops about stress and solutions • Anonymous questionnaire • Group discussions of the results Problems included: • Shifts and the starting time of shifts • Lack of showers and other facilities

19. Stress prevention in an Irish hospital (2) Solutions: • Change shift starting times • Consultation with an expert to establish a new shift system • Installation of showers in an unused area

20. Physiotherapist’s work rotas - Finland Objective – to increase employee control over their work rotas Solution • Supervisor set a framework for rotas • Employees plan own rotas within framework • Training on the system and planning rotas Result – better compatibility with home- life, improved services for the hospital

21. Success factors in psychosocial risk prevention initiatives • Adequate risk analysis • Thorough planning and a stepwise approach • Combination of measures covering anticipation, prevention, intervention, support and evaluation with main focus on collective prevention measures • Context-specific solutions • Experienced practitioners and evidence-based solutions • Social dialogue, partnership and workers’ involvement. Continuing staff feedback • Violence - liaison with external bodies – police, judiciary, local community – includes prosecution • Sustained prevention and top management support and resources

22. Elements of empowerment in OSH processes • Informed and Trained • Involved through participation • Given control, responsibility • Supported • No-blame approach • Commitment – to participation and prevention at source • Participatory arrangements • Involvement in: identifying problems and solutions, implementation, monitoring and feedback

23. http://europe.osha.eu.int/good_practice/sector/healthcare/