Safety Representatives Meeting July 22, 2009

1. Northwestern Memorial Hospital ENVIRONMENTAL & OCCUPATIONAL SAFETY Safety Representatives Meeting July 22, 2009

2. Meeting Agenda

3. NMH Goal- Back and Shoulder • Goal: - Reduce employee back and shoulder injuries by 10% from FY08 • Performance to Date: - We are currently 15 incidents above the goal which is 5.43% higher than June of FY 08.

4. Establishing a Zero Injury Culture at NMH An average of 650 occupational incidents occur at NMH per year 1 in 10 Creating a Zero Injury culture does take an investment in time, effort and money, but return on these investments significantly outweighs the cost.

5. Increased Incident Reporting

6. Incident TrendIncident Type Prevalence

7. Employee Safety = Patient Safety • Employees cannot focus on providing the best patient care if they feel they must be concerned with their own safety. • Employees put in the predicament of deciding between their safety and providing the best patient care can negatively affect the quality of care provided. • Compelling evidence exists that employee turnover can negatively affect the quality of patient care.

8. Safety Matters Highlights • Safety Topic of the Month • SAFE Forum • Educational Sheets • Tip of the Month • Marketing/Awareness • Safety Matters Department Page • Department Safety poster • NM Connect Special Edition • Medical Leadership standing agenda item • Slip/Trip/Fall Prevention Team • Fein EE Entrance (new flooring + mats) • Slip cones • Wet Umbrella Bags • Over the Spill pads • Hazardous Weather e-mail alert • Enhanced Safety Representative Program • Monthly meetings • Increased interactivity/education during meetings • Actionable items/accountability

9. DMAIC/Special Focus Groups • Safe Material Handling • EVS chute re-design • EVS bio-tub re-design • EVS microfiber mops/new cart system • Material Handling class [NM Academy]- next class end of July • MM & Distribution Svcs- new carts and powered tuggers • Blood/Body Fluid & Sharps Safety • Incident reporting training/education • Nurse sharps safety training • Procurement over-glasses PPE option • Device conversion (fragmin) • Safe Patient Handling • Needs assessment/Procurement 50 additional Hovermatts • Audit/re-energize super-user program • Work with Pat Care leadership to transition into nursing “model of care” • In person root cause assessment for all injuries

14. Take Aways • Make staff safety a visible part of everyday priorities • Recognize, support and utilize department safety representatives. • Promote transparency of all identified safety opportunities within your department. • Maintain safety matters poster/department-specific goals • Promote and educate on safety topic of month • Be a visible “Safety Matters” advocate • Accept that zero injuries can be a reality.

15. Environmental Stewardship Efforts • Pharmaceutical Waste • Recyclable Materials

16. Pharmaceutical Waste • NMH’s Pharmaceutical Waste Program consists of the identification, collection and management of all pharmaceutical wastes • In addition to ensuring compliance with US and Illinois Environmental Protection Agency regulations, this is NMH’s newest initiative toward being more “green” • Proper management of pharmaceuticals is part of NMH’s Environmental Stewardship / Green-health Initiative

17. Pharmaceutical Waste • Millions of pounds of unused pharmaceuticals are flushed down the drain each year. • These pharmaceuticals include antibiotics, anti-convulsants, mood stabilizers and sex hormones and consequently end up in drinking water supplies across the nation. • At least one pharmaceutical has been detected in finished drinking water supplies in 24 metropolitan areas in the US.

18. Other NMH Green Health InitiativesSpecial Waste Management • Fluorescent Light Bulbs Used lamps are hazardous due to their mercury content. Amount Recycled FY 08 = 11, 921 lbs FY 09 = 6,570 lbs • Batteries Batteries contain heavy metals such as lead, cadmium, mercury and nickel (and some contain sulfuric acid), which can contaminate the environment if improperly disposed. Amount Recycled FY 08 = 4,469 lbs FY 09 = 8,459 lbs • Metal with Lead NMH recycles lead aprons, electronic circuit boards and containers formerly holding radioactive isotopes. Amount Recycled FY 08 = 1,219 lbs FY 09 = 3,067 lbs

19. Organizational Risk Assessment April – June 2009 Risk Assessment is the cornerstone upon which a program is built

20. Intensive Care Units Antepartum/Postpartum Surgical Services Psychiatry Hematology/Oncology and Palliative Care Surgical/Neuro-/Ortho- Nursing Medicine Nursing Professional/Emergency Services Imaging Pharmacy Engineering Administration Laboratory Support Services Similar Exposure Groups

21. SEG Participation Participation Goal – 50%

22. Risk Risk = (Probability x Severity) – Mitigating Factors

24. Hazard Ranking Matrix HIGH SERIOUS MEDIUM LOW

25. Summary General Tasks – Patient Care

26. Highlights- Patient Care • IV Poles • Broken beds/wheelchairs • Patient movement • Eliminate “gray” areas • PPE • Patient Handling

27. Support Services and Non-Patient Care Trends were not as evident between these groups because of the unique nature of the work performed by each

28. Organizational Trends • Material handling was identified as a high risk task. • Push/Pull and carpet • Lack of Equipment Preventive Maintenance • Lack of usage of safety equipment (PPE, Patient Handling, etc…) • Cord management • Lack of understanding/compliance with policy. • Overall, department representatives identified the risks, but underestimated the severity.

29. Organizational 3 Year Employee Safety Plan • Incorporated data from Risk Assessment • Incorporated incident data (FY08 – current) • Incorporated hazard surveillance(EOC Rounds) trends • Incorporated safety officer perception/evaluation • Currently in draft be presented to Sr. Leadership later this month.

30. Safety RepresentativeSkill Set DevelopmentOffice Ergonomics

31. Office Ergonomics Major Job Factors • The Job/Task • The Tools/Equipment • The Environment • The Worker

32. Office Ergonomics • Workstation Tips • Maintain the “S-Shape” of your Spine: check to make sure your ear, shoulder and hip stay in alignment. • Monitor Height: Top of monitor should be at or just below eye level; unless user wears bifocals – then height should be slightly lower. • Monitor Distance: 18-24” from eyes. • Keyboard: Recommend it be adjusted to elbow height. Upper arms should rest at user’s sides, forearms, wrists and hands should be parallel to the floor when keying. • Chair: Feet should rest flat on a footrest or the floor, thighs parallel to the floor. The lumbar support should fit user’s lower back, seat should fully support users thighs with approximately 2” clearance between seat edge and back of calves. • Reaches: Frequently used items should be within a 6-14” reach to avoid over reaching. • Exercises/Stretches: To break up static activity, stretch or exercise once every 1-2 hours.

33. Reduce Reaches Frequent reaches between 6-14”

34. Wrist Positioning Extension Deviation Neutral

35. Final Conclusions... • Listen to your body • Stretch/Exercise regularly • Set-Up your workstation for the primary job tasks you do. • Eliminate the clutter • Alternate activities. THANK YOU!!!

36. Open DiscussionQuestions?? 36