Risk Management; Are we covered?

Risk Management; Are we covered? Mike SchneiderDirector of Campus Recreation Centers LLC @ The University of New Haven Tim LewisAssociate Director of OperationsUniversity of Vermont

Brief background • Large and small institution experience. • Program and facility implementation. Why Risk Management as a topic? • Always questioning if we are doing enough. • Passion and interest in best practices. • Continual learning opportunity. • Recent survey audit.

Learning Objectives • At the end of this presentation you will: • Be able to define Risk Management . • Be able to define Tort Law. • Be able to identify the necessary components. of a comprehensive Risk Management Plan. • See tangible examples of plans, documents, waivers, etc… • Begin to specifically prioritize what areas you need to focus on at your institution. Maybe even an Ah Ha moment or two?

Presentation Considerations • Cell Phones off or silent please. • Risk Management at the conference. • Audience participation/feedback. • Documents/PPT location. • Time, Lunch, and Questions.

We begin with the end in mind • Most of why Risk Management is important to us can be broken down into the following two outcomes. #1 – Safety of our users/participants #2 – Legal/liability protection

Introduction to Risk Management • As defined by Law • Hand Rule (Judge Learned Hand) from U.S. V. Carroll Towing where a service provider’s duty is a function of 3 variables. The probability of an accident’s occurrence, the gravity of loss if it should occur, and the burden imposed on the service provider to make adequate precautions. • Formalized as “an act is in breach of duty of care if B<PL” (B=Burden, P-probability of occurrence, and L = gravity of loss) • Problems with this definition?

The unfortunate new standard • RISK= HAZARD + OUTRAGE (Risk Communication: Evolution and Revolution, Covello and Sandman, 2004). Where Hazard is the objective factor (e.g., damaged equipment), and Outrage is the subjective emotional factor. • Where common sense once prevailed, outrage has become the standard. As outrage has become increasingly prevalent, waivers, standardization, and training have become increasingly important.

Tort Law • A tort is an act that injures someone in some way, and for which the injured person may sue the wrongdoer for damages. A tort consists of four basic components: • Duty: an obligation imposed on an individual requiring that they adhere to a reasonable standard of care while performing any acts that could cause foreseeable harm others. • Breach: when conduct has fallen short of the standard that was expected. • Causation: there must be a reasonable connection between the breach of duty and the injury. • Damages: the basis for tort law is to compensate for an injury resulting from a wrongful act; no damage = no compensation.

What is Risk Management? • “The process for measuring or assessing risk and developing strategies to manage it.” (national incident management system (nims)) • Risk management strategies may include avoiding the risk (e.g., not offering full contact flag football), reducing the negative effect of the risk (e.g., wall padding, ), or accepting some or all of the consequences of a particular risk. (e.g., inherent risk and/or waivers).

Which strategy do we choose? • Exercise common sense • Best practices • Determine level of care required. • Establish processes of documentation. • Develop and provide training. • Comprehensive/Department wide. • Interoperability and Global. • Keep things simple.

Six General Risk Areas Ian McGregor and Associates Inc • General Administration • Emergency Response Plan • Supervision • Training • Facilities and Equipment • Documentation

General Administration • Risk Management Committee. • Staff job descriptions incorporating safety responsibilities. • Rental process, contracts, certificate of insurance. • Special events procedures and training. • Waivers (vetted/crafted appropriately.) • Enforceability of your policies? • Transportation policies. • Signage(procedural/directional/informational).

Annual Best Practices Meet with general counsel/legal representative to: • Review waivers/consent forms. • Review accident/incident reports. • Discuss new programs that may affect plan(s). • Discuss current standards of practice and/or minimum certification requirements you have for your staff.

Policy Development • Collaboration with the university • Membership requirements, service eligibility, etc… • Recommending vs. Requiring • Policy vs. Guidelines • To determine policy legitimacy ask the following questions: • Is there adequate staff to always enforce it? • What is the rationale for the policy? How well can you substantiate it? • How does it relate back to the university/department mission?

Emergency Response Plan • Documented comprehensive department wide plan. • Documented, specific, program plans. • Documented emergency procedures. • Documented training requirements. • Communication protocol for serious emergencies.

Risk Management Plan Contents • Primary and secondary EC…Call Tree with all key phone #s • Industry Standards Duty to Act, Standard of Care, Negligence, Good Samaritan Law, Informed/Implied consent, Refusal of Care • First Aid Kit Locations/BBP Control • Emergency Action Plan/Procedures to include: General, Natural Disaster, Bomb Threat, Shooting/Terrorist Attack, Lockdown Procedures, Fire Emergency, Mechanical Problems

Four parts of an EAP • Establish supervised, direct routes for every area/floor • List staff responsibilities (i.e. positioning, instructions, equipment) • Directions for getting to established routes • Final destination and/or meeting place

Emergency Action Plan POWER OUTAGE 1. Safely lower any climbers on the Wall. 2. Once notified, clear area and direct to lobby. 3. Remain at Outdoor Pursuits Entrance. OUTDOOR CENTER STAFF

Supervision • Supervision of programs & facilities, especially high-risk • Supervision ratios for high risk programs • Instructor qualifications • Lesson plans and progressions for high risk instructional activities.

Training • Why is it important? • How much is enough? • Who to train and in what? • Some examples.

Training Why it is important • Legal View • Tort Law. • Standard of Care, Negligence, Duty to Act / Good Samaritan Act. • Safety View • The best EAP plan is worthless without the staff to implement it. • Seconds wasted has big impacts on life/quality of life. • Builds confidence in staff’s abilities. • Creates consistency. • Student Development as a part of the mission.

TrainingHow much training should you do? • It should be a priority (department wide). • Regular practice & mock scenario drills are important. • Mandatory In-Service (Lifeguard Staff) are necessary to keep their lifesaving skills up to date. • Audit & Testing is a good tool to ensure staff are capable. • When there are new standards (e.g., R.C. CPR), new facilities/renovations, or new programming is implemented.

TrainingWho to train and in what? • Staff Levels • Professional Staff • Supervisor, Office Assistants, Building Monitors, Lifeguards, etc… • Go through every position and make sure you know what certifications they should have and that every employee has those certifications. • What Training • Certifications (industry standards). • Certified Staff vs Trained and Certified Staff. • EAP (for the areas they work in). • All staff positions are given specific roles in the event of an emergency • Comprehensive Plan (EAP must relate to all positions – IM’s, Climbing Wall, etc…).

TrainingWho to train and in what? • Depends on the activity (i.e., risk level), is it supervised and in what facility/location is the activity occurring in. • Training in various emergency procedures (evacuation, bomb, fire, power outage, etc…). • Training in specific safety skills (First Responder, CPR, AED, Nose Bleed). • Ask yourself, “If an accident {list them all} were to happen right now in any facility would we know what to do?” • Preventive vs Reactive.

You are an Intramural Supervisor on Thursday night who is watching/supervising an Intramural basketball game in the gym. During the second half of the game you witness a player jump to get a rebound and land awkwardly on his ankle. He is in obvious pain and thinks he broke his ankle. As the Intramural Supervisor how do you respond to this incident? • Instructor Notes: • Make sure the scene is safe! • If the person is conscious make sure they ask for permission. • Put on gloves – Anything other than sweat! • Determine how sever the injury is • Life Threatening • GET HELP (Radio, Cell Phone, Another Participant, Campus Phone, Ask for Assistance - Another Supervisor, Office Assistant, Building Monitor, Professional Staff, etc… ) • Non-Life Threatening? • Stay with the person if asked and provide support • Not Sure if it is Life Threatening? • GET HELP (If in Doubt Call)! • Where is the closest first aid supplies to the accident • Supervisor Back Pack • Where is the closest phone – what other ways are there to contact help (radio/cell phone/another participant) – Campus Recreation Program Office • Care that should be given: • R.I.C.E • Rest – Do not move or straighten the injured area • Immobilize – Stabilize the injured area in the position found • Cold – Provide ice to the area for 20min put thin barrier between skin • Elevate – Above heart – DO NOT ELEVATE IF IT CAUSES MORE PAIN • If you have to call an ambulance: • Call 911 – give them the exact location within the building (through the main doors of PG) • Call Building Supervisor to come over and meet the ambulance at the front door • Make sure to fill out an accident report • If the person can’t/won’t provide information - document what they said in writing. • Get their name and phone number if possible so we can get information from them at a later time. • Fill out form completely including back of form

Facilities & Equipment Two Components to “Facilities” • Actual Physical Structure • Activity Occurring in Facility. • Why is it important. • Facility Rounds & Daily Duties. • Equipment. • Example.

Facilities & EquipmentWhy is it important? • Legal View. • Standard of care. • Negligence. • Safety View. • Patrons expect a safe and welcoming facility… if it isn’t they won’t keep coming. • Vandalism and improper use of equipment. • ACSM's Health/Fitness Facility Standards.

FacilitiesActual Physical Structure • Be aware of facility safety conditions/concerns: • Examples include: • Tripping hazards. • Multiple access points. • Padding on walls behind basketball goals. • Inaccessible emergency exits. • Membership and Access Service systems. • Central hub for communication/surveillance, lighting controls, etc…

Facilities & EquipmentActivity Occurring in the Facility • Facility Rounds. • Allows your staff to have a “presence” around the facility. • Check for unsafe or potentially dangerous situations. • Used for periodic supervision in low risk areas. • Keys to using daily duties or a checklist. • Allows you to document the facility and equipment is safe. • Allows you to make sure job specific tasks are being completed. • Divided up by days and shifts – (very specific to their shift). • Things to watch out for with checklists: • If you document something is broken and don’t fix it… • Safety essential vs general expectations. • Pitfall: “Once I am done with my check list I don’t have anything else to do”.

Facilities & EquipmentEquipment • Create an accurate listing & collect information on all equipment in your facility (not just fitness equipment). • (Scoreboard controllers, emergency radios, etc…). • Develop a preventative maintenance plan. • Organize routine safety checks and inspections on all equipment. • Work on a replacement plan to prevent costly turnover all at one time.

Documentation • Why is it important? • Waivers for high-risk activities. • Medical screening in high-risk activities. • Accident report forms. • Communicating risk information.

DocumentationWhy is it important? • Legal View • Allows you to verify ways you are mitigating risk. • Proof of providing a standard of care and a lack of being negligent. • Safety View • Allows staff to track potentially dangerous patterns. • Leads to proactive documentation.

Documentation Waivers • Waivers • Should be reviewed and vetted via Institutional Legal (or comparable staff). • Great to have and use but not enough. • “We’re covered we have a waiver” • Mindset of “the greater the potential risk, the more necessary the waiver is”. • Why limit yourself?

Risk Management; Are we covered?