OSH ISSUES IN THE HEALTHCARE SECTOR AND STAFF EMPOWERMENT

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OSH ISSUES IN THE HEALTHCARE SECTOR AND STAFF
EMPOWERMENT

• Sarah Copsey

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The Agency www.agency.osha.eu.int

• Provides information
• Networking
• Coordinates
• Information services
• Information projects
• Agency website dissemination means

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Why the health care sector?

• European concern
• Sector has been highlighted as a priority by the
  Member States
• Common risks across Europe

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

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Plenary 1 The hospital a staff empowering
workplace
Sarah Copsey
Thursday 19th May 2005
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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

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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

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Good practice examples

• 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

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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

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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

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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

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Violence to hospital staff - Ireland

• Visible management commitment
• New report form, reporting positively encouraged,
  electronic database
• Multidisciplinary working group and hs
  consultants --gt risk assessment and prioritised
  recommendations
• Comprehensive framework - Measures covering
  anticipation, prevention, intervention, support
  and evaluation

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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

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Violence to hospital staff Ireland measures (2)

• Staff feedback system

• Improvements for patients, e.g. waiting time
  information

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Stress prevention in an old peoples 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

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Stress prevention in an old peoples 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

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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

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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

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Physiotherapists 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

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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

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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

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http//europe.osha.eu.int/good_practice/sector/hea
lthcare/