Date Published | Jun. 1, 2008

When things go wrong in the airline industry, a nuclear power plant or a mine, the result can often be catastrophic. Images of radioactive plumes, body bags and mine rescue teams racing against the clock to free trapped miners have instilled in all three industries a culture of safety that has put the health care sector to shame. Until now.
In the aftermath of the 1998 Krever Commission of Inquiry on the Blood System in Canada and the 2006 Campbell Commission on the SARS crisis, health care administrators are finally getting serious about workplace safety.

North Bay General Hospital saw the writing on the wall four years ago, said CEO Mark Hurst.

“We found that the traditional way wasn’t delivering the results we expected, so we started working with the Canadian Standards Association guidelines.”

Led by Jason Raymond, the hospital’s co-ordinator of employee safety, and director of facility Dave Smith, North Bay General began turning things around. Lost time injuries fell from 21 in 2004 to 12 the following year, 10 in 2006 and six in 2007. Not bad for a facility with 1,200 full- and part-time staff.

OSACH pilot

When the Ontario Safety Association for Community and Healthcare (OSACH) began looking for sites to pilot its new health and safety management system last year, North Bay General jumped at the opportunity.

“The downfall of the more traditional approach was that things were done in a disjointed fashion and they weren’t done effectively,” said Raymond. “It’s a cultural change and a fundamental shift from being operationally reactive to a mindset that’s proactive.”

In the past, hospitals had a silo approach to health and safety, said OSACH president and CEO Joseline Sikorski. Activities to promote worker safety, patient safety and infection control were made in isolation from each other.

“The new system is different in that it brings people together to look at risk in a holistic way. It brings senior leadership together with representatives from throughout the organization to collectively problem-solve and come up with solutions.”

One of the keys to success is senior management buy-in, said Hurst.

“Senior management must be absolutely committed to this process. If the commitment isn’t there at the top, it won’t permeate through the organization.”

Hurst literally walks the talk by conducting health and safety tours through the hospital with Raymond.

“It emphasizes to staff that senior management will step out of the so-called ivory tower. It’s all about having a culture of safety clearly enunciated at the senior levels of the organization and holding people accountable at all levels.”

A culture of safety permeates through the organization, boosts morale, improves the quality of work life and pays off in lower Workplace Safety and Insurance Board premiums.

Premiums

North Bay General’s WSIB premiums are between $400,000 and $500,000 per year. Surcharges, or penalties, are applied if it falls below the mean in its rate group, and rebates kick in if it performs above the mean.

“We’ve had some success in recent years with rebates, but we’ve experienced the other side of the coin too in years gone by,” said Hurst.

Of course, the more money a hospital spends on insurance premiums, the less it has available for patient care.

“The financial argument is compelling. There’s no question about it, but over and above that, the way people think about an organization is the way they behave in an organization,” said Hurst. “If you have a culture about feeling good about your organization, a culture of caring and a commitment to safety, that’s got a benefit you almost can’t put a dollar sign on.”

North Bay General is one of six hospitals in Ontario to pilot OSACH’s health and safety management system, but plans are currently in the works to roll it out to another 12 hospitals.

www.nbgh.on.ca
www.osach.ca

Health and safety facts and figures

The health care sector’s lost time injury rate in 2006 was 2.12 per 100 workers. The Ontario average was 1.67. The lost time injury rate recorded by the mining industry was 1.39.

The lost time injury rate in the health care sector has fallen only marginally since 1998 – from 2.24, to 2.12 in 2006. Other sectors have seen precipitous drops in lost time injury frequency. The transportation industry, for example, recorded a lost time injury rate in excess of 4.5 in 1998 and 2.99 in 2006.

Within the health care sector, group homes and nursing homes experience the highest rates of lost time injuries (3.57 and 3.52, respectively); hospitals experience a lost time injury rate of 1.86.

Musculoskeletal disorders in the health care sector account for 55 per cent of all lost time injuries; in Ontario as a whole, musculoskeletal disorders account for 44 per cent of lost time injuries.

Violence and aggression account for eight per cent of lost time injuries in the health care sector, versus three per cent for the province as a whole.