Transcript No Slide Title

OSH ISSUES IN THE
HEALTHCARE SECTOR AND
STAFF EMPOWERMENT
European Agency for
Safety and Health at Work
Sarah Copsey
The Agency: www.agency.osha.eu.int
• Provides information
• Networking
• Coordinates
• Information services
• Information projects
• Agency website –
dissemination means
Why the health care sector?
• European concern
• Sector has been highlighted as a
priority by the Member States
• Common risks across Europe
Most frequently identified
sectors at risk by OSH Authorities
(Agency 2000)
Sector Description
Construction
Manufacture of
Fabricated Metal
Products, except
Machinery and
Equipment
Agriculture, Hunting
and related service
activities
Health and Social Work
Manufacture of Food
Products and Beverages
Total Number
of Times
Identified
112
63
62
57
52
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
Plenary 1: The hospital –a staff
empowering workplace
Sarah
Copsey
European
Agency for
Safety and Health at Work
Thursday 19th May 2005
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
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
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
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
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
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
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
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
Violence to hospital staff – Ireland:
measures (2)
• Improvements for
patients, e.g. waiting time
information
• Staff feedback system
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
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
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
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
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
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
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
http://europe.osha.eu.int/good_practice/sector/healthcare/