Evacuation preparedness: managing the safety of employees with disabilities.
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Persons with Disabilities↗
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Results for “Safety Management”
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[Patient safety and risk management].
Patient safety is the latest issue in the present stage of the German health care system, characterized by costs and quality both resulting in value of care. Patient safety defined as "absence of adverse events" represents an important problem, because 10% of in-house patients experience an adverse event, which in nearly 50% of the cases is due to an error (preventable adverse event). Threats and near misses are errors without a consecutive adverse event, much more common and better to integrate in the concept of risk management, which is based on thorough analysis and prevention of errors in medicine. Chart reviews show adverse events in between 3% and 11% of hospital patients, studies with direct observation result in higher estimates (17.7%). Nosocomial infections occur in 3-5%, adverse drug events in 0.17-6.5%, and adverse medical device events in up to 8% of patients. Medication errors (ordering, dosing, distribution) are present in up to 50% of all drug applications. Adverse drug events are important reasons for hospital admissions (3.2-10.8% of all admitted patients), other consequences of adverse drug events are severe disability and death. Mortality of adverse drug events is estimated between 0.04% and 0.95% of all patients. The introduction of risk management in the German health care system is one option to prevent a malpractice crisis similar to the situation in the US health care system in the 1990s. Errors are not to be considered only individual but also organizational failures. Critical incident report systems (CIRS) can help to increase the knowledge about errors, near misses and adverse events, so that prevention of errors can take place. On the organizational level, it is an issue of leaderchip to convince the members of the organization that prevention of errors has a higher priority than punishing and blaming. The medical and other professions, on the other side, have to change their self-understanding from the zero mistake philosophy to accepting errors as common events. This understanding is a prerequisite that analysis can be performed. The participation of patients should be strengthened, because public disclosure is an important issue, although the scientific evidence for real improvement in health care resulting from public disclosure is still inconclusive.
Cross Infection↗
The development of an audit technique to assess the quality of safety barrier management.
This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed.
Accidents, Occupational↗
Risk management or safety first?
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Humans↗
The safety experience of New Zealand adventure tourism operators.
BACKGROUND: This survey examined parameters of the New Zealand adventure tourism industry client injury risk. The research also sought to establish priorities for intervention to reduce adventure tourism risk, and identify client injury control measures currently in place (or absent) in the New Zealand adventure tourism industry, with a view to establishing guidelines for the development of effective adventure tourism safety management systems. This 2003 survey builds upon an exploratory study of New Zealand adventure tourism safety conducted by us during 1999. METHOD: A postal questionnaire was used to survey all identifiable New Zealand adventure tourism operators. The questionnaire asked respondents about their recorded client injury experience, perceptions of client injury risk factors, safety management practices, and barriers to safety. RESULTS: Some 27 adventure tourism activities were represented among the responding sample (n=96). The highest client injury risk was reported in the snow sports, bungee jumping and horse riding sectors, although serious underreporting of minor injuries was evident across the industry. Slips, trips and falls (STF) were the major client injury mechanisms, and a range of risk factors for client injuries were identified. Safety management measures were inconsistently applied across the industry. CONCLUSIONS: The industry should consider the implications of poor injury reporting standards and safety management practices generally. Specifically, the industry should consider risk management that focuses on minor (e.g., STF) as well as catastrophic events.
Athletic Injuries↗
Organizational safety: which management practices are most effective in reducing employee injury rates?
PROBLEM: While several management practices have been cited as important components of safety programs, how much does each incrementally contribute to injury reduction? This study examined the degree to which six management practices frequently included in safety programs (management commitment, rewards, communication and feedback, selection, training, and participation) contributed to a safe work environment for hospital employees. METHOD: Participants were solicited via telephone to participate in a research study concerning hospital risk management. Sixty-two hospitals provided data concerning management practices and employee injuries. RESULTS: Overall, the management practices reliably predicted injury rates. A factor analysis performed on the management practices scale resulted in the development of six factor scales. A multiple regression performed on these factor scales found that proactive practices reliably predicted injury rates. Remedial measures acted as a suppressor variable. DISCUSSION: While most of the participating hospitals implemented reactive practices (fixing problems once they have occurred), what differentiated the hospitals with low injury rates was that they also employed proactive measures to prevent accidents. IMPACT ON INDUSTRY: The most effective step that hospitals can take is in the front-end hiring and training of new personnel. They should also ensure that the risk management position has a management-level classification. This study also demonstrated that training in itself is not adequate.
Accidents, Occupational↗
Intranet-based safety documentation in management of major hazards and occupational health and safety.
In the European Union, Council Directive 96/82/EC requires operators producing, using, or handling significant amounts of dangerous substances to improve their safety management systems in order to better manage the major accident potentials deriving from human error. A new safety management system for the Viikinmäki wastewater treatment plant in Helsinki, Finland, was implemented in this study. The system was designed to comply with both the new safety liabilities and the requirements of OHSAS 18001 (British Standards Institute, 1999). During the implementation phase experiences were gathered from the development processes in this small organisation. The complete documentation was placed in the intranet of the plant. Hyperlinks between documents were created to ensure convenience of use. Documentation was made accessible for all workers from every workstation.
Computer Communication Networks↗
Audit and 'responsible care' in the chemical industry.
Audit is an essential element of Health and Safety Management Systems. This paper examines the Chemical Industry Association's 'Responsible Care' initiative and its role in encouraging continuous improvement in the management of safety, health and the environment, within the chemical industry. The case study from Zeneca describes how the principles of audit have been incorporated into their Safety, Health and Environmental Management practices.
Chemical Industry↗
EMS incident management: the safety sector.
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Emergency Medical Services↗
[Nurses and risk management. Transfusion safety and prevention of risks].
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Blood Transfusion↗
The evolving role and care management approaches of safety-net Medicaid managed care plans.
This article provides new empirical data about the viability and the care management activities of Medicaid managed-care plans sponsored by provider organizations that serve Medicaid and other low-income populations. Using survey and case study methods, we studied these "safety-net" health plans in 1998 and 2000. Although the number of safety-net plans declined over this period, the surviving plans were larger and enjoying greater financial success than the plans we surveyed in 1998. We also found that, based on a partnership with providers, safety-net plans are moving toward more sophisticated efforts to manage the care of their enrollees. Our study suggests that, with supportive state policies, safety-net plans are capable of remaining viable. Contracting with safety-net plans may not be an efficient mechanism for enabling Medicaid recipients to "enter the mainstream of American health care," but it may provide states with an effective way to manage and coordinate the care of Medicaid recipients, while helping to maintain the health care safety-net for the uninsured.
Accreditation↗
Workers' perceptions of workplace safety: an African perspective.
This study investigated workers' perceptions of workplace safety in an African work environment, specifically in Ghanaian work places. Workers' safety perceptions were examined with Hayes et al.'s. (1998) Work Safety Scale. Comparative analyses were done between high- and low-accident groups, and t tests were employed to test for differences of statistical significance. Relative to their colleagues in the low-accident category, workers in the high-accident category exhibited negative perceptions on safety. They had negative perceptions regarding work safety, safety programmes, supervisors, and co-workers' contributions. Besides, they expressed less job satisfaction and were less committed to safety management policies. Perceptions regarding management's attitude towards safety between the 2 groups were not of statistical significance. The analyses provided an explanation for the cause of a substantial portion of the high rate of industrial accidents in Ghana's work environment. Implications for safety management are discussed.
Adolescent↗
Self-assessment and resolution of indoor air quality problems.
Indoor air quality (IAQ) problems have their origins in many different generating sources within facilities. General categories of these sources include building systems, processes and procedures, management, employees, and outside influences. Knowing how to identify the source(s) is the only way to resolve IAQ issues. This paper discusses methods that can be used by facilities managers and safety managers in hospitals to conduct a self-assessment to address IAQ complaints so that the problems can be quickly and adequately resolved.
Air Conditioning↗
Managing the safety net: hospital provision of uncompensated care in response to managed care.
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California↗
Expanding the scope of practice for radiology managers: radiation safety duties.
In addition to financial responsibilities and patient care duties, many medical facilities also expect radiology department managers to wear "safety" hats and complete fundamental quality control/quality assurance, conduct routine safety surveillance in the department, and to meet regulatory demands in the workplace. All managers influence continuous quality improvement initiatives, from effective utilization of resource and staffing allocations, to efficacy of patient scheduling tactics. It is critically important to understand continuous quality improvement (CQI) and its relationship with the radiology manager, specifically quality assurance/quality control in routine work, as these are the fundamentals of institutional safety, including radiation safety. When an institution applies for a registration for radiation-producing devices or a license for the use of radioactive materials, the permit granting body has specific requirements, policies and procedures that must be satisfied in order to be granted a permit and to maintain it continuously. In the 32 U.S. Agreement states, which are states that have radiation safety programs equivalent to the Nuclear Regulatory Commission programs, individual facilities apply for permits through the local governing body of radiation protection. Other states are directly licensed by the Nuclear Regulatory Commission and associated regulatory entities. These regulatory agencies grant permits, set conditions for use in accordance with state and federal laws, monitor and enforce radiation safety activities, and audit facilities for compliance with their regulations. Every radiology department and associated areas of radiation use are subject to inspection and enforcement policies in order to ensure safety of equipment and personnel. In today's business practice, department managers or chief technologists may actively participate in the duties associated with institutional radiation safety, especially in smaller institutions, while other facilities may assign the duties and title of "radiation safety officer" to a radiologist or other management, per the requirements of regulatory agencies in that state. Radiation safety in a medical setting can be delineated into two main categories--equipment and personnel requirements--each having very specific guidelines. The literature fails to adequately address the blatant link between radiology department managers and radiation safety duties. The breadth and depth of this relationship is of utmost concern and warrants deeper insight as the demands of the regulatory agencies increase with the new advances in technology, procedures and treatments associated with radiation-producing devices and radioactive materials.
Hospital Administrators↗
The efficacy and safety of pain management before and after implementation of hospital-wide pain management standards: is patient safety compromised by treatment based solely on numerical pain ratings?
UNLABELLED: Inadequate analgesia in hospitalized patients prompted the Joint Commission on Accreditation of Healthcare Organizations in 2001 to introduce standards that require pain assessment and treatment. In response, many institutions implemented treatment guided by patient reports of pain intensity indexed with a numerical scale. Patient safety associated with treatment of pain guided by a numerical pain treatment algorithm (NPTA) has not been examined. We reviewed patient satisfaction with pain control and opioid-related adverse drug reactions before and after implementation of our NPTA. Patient satisfaction with pain management, measured on a 1-5 scale, significantly improved from 4.13 to 4.38 (P < 0.001) after implementation of an NPTA. The incidence of opioid over sedation adverse drug reactions per 100,000 inpatient hospital days increased from 11.0 pre-NPTA to 24.5 post-NPTA (P < 0.001). Of these patients, 94% had a documented decrease in their level of consciousness preceding the event. Although there was an improvement in patient satisfaction, we experienced a more than two-fold increase in the incidence of opioid over sedation adverse drug reactions in our hospital after the implementation of NPTA. Most adverse drug reactions were preceded by a documented decrease in the patient's level of consciousness, which emphasizes the importance of clinical assessment in managing pain. IMPLICATIONS: Although patient satisfaction with pain management has significantly improved since the adoption of pain management standards, adverse drug reactions have more than doubled. For the treatment of pain to be safe and effective, we must consider more than just a one-dimensional numerical assessment of pain.
Adult↗
Non-ionizing radiation safety program management--one corporation's approach.
Development and implementation of non-ionizing radiation safety programs differ from ionizing radiation safety programs primarily due to the absence of prescriptive state and federal regulations. Industry consensus standards and research publications provide the basis for non-ionizing radiation safety program development. This work discusses the methodology used to develop a non-ionizing radiation safety program suitable, with minimal modification, for use both in research and industrial facilities. This program includes identification of industry consensus standards, measurement of actual or potential exposure, establishment of engineering and administrative controls, training and orientation of the workforce, and tracking of changes. Implementation of the program involves cooperation between a small corporate staff and many individuals representing various environmental, safety and health as well as manufacturing and research disciplines located in the facilities that contain the actual radiation sources. Challenges in program implementation include the wide variation in types, numbers, and uses of non-ionizing sources in numerous facilities located throughout the United States. Additional opportunities include providing advice and support to facilities located outside of the United States.
Equipment Failure Analysis↗
Patient safety systems for case management.
Patient safety is an important concern of many healthcare stakeholders, including patients, providers, employers, health plans, and insurers. In 2003, URAC conducted a qualitative study to examine the role of utilization management programs as part of a systemic approach to promoting patient safety. Many of URAC's findings are applicable to case management as well. URAC found that most medical management companies address patient safety indirectly, as part of a global quality management program. Even so, the study identified a number of strengths that could be deployed by medical management organizations to more systematically promote patient safety. For example, case management organizations use decision support tools to assist frontline practitioners in conducting assessments and tracking interventions. Such systems could be programmed to flag safety concerns and guide interventions. The study also found that commonly used case management assessment protocols could be adapted to routinely assess for high priority safety concerns. URAC concluded that each stage of the medical management process offers opportunities for data collection and clinical interface to promote patient safety. Case managers have key positions interfacing between patients, providers, and the healthcare system. Development of safety indicators and training of staff are key elements needed to effectuate a safety program in medical management. Case management leaders in each organization and at the national level should make patient safety a priority, and define the processes for implementing safety systems wherever case management is practiced.
Case Management↗