Workplace Safety

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Making the Point About Needle Safety

Deck: 
A team of nurses seeks out a safety solution

Story body part 1: 

Do you doubt you can lead changes that make Kaiser Permanente a better—and safer—place to give and get care?

A small group of nurses at the San Diego Medical Center showed that leading change is, in fact, part of their job.

Brittni Demers, RN, and three of her colleagues spearheaded a successful effort to reduce needlestick injuries, and now their expertise is being tapped throughout Kaiser Permanente to bring the voice of frontline workers to safety initiatives.

Demers, a member of UNAC/UHCP, is on KP’s National Sharps Safety Committee. It is one of the many sourcing and standards teams that advises KP on everything the organization buys—and it is the only one with union representation. As such, it gives the caregivers who actually use needles, scalpels and other sharps a way to influence purchasing decisions. It also impacts workplace safety and tools workers use every day.

From July to December 2013, a huge remodeling project at the hospital shut down two medical-surgical units, leaving several nurses temporarily without anywhere to work. Demers and RNs Jessica Heffern, Leanne Vitacco and Lucas Pepin got together to tackle a problem that had been concerning them: needle and sharps injuries. By July 2014, the team’s project had led to an astounding 76 percent decrease in needlestick injuries in inpatient nursing units. There were similar improvements for all sharps injuries throughout the San Diego service area.

Here’s what the team did:

Peer-to-peer training

Only two years out of nursing school, Demers quickly saw that “real life” didn’t always comport with what she had learned in her classes. “You go to school, you learn correct techniques, then you go into a hospital and it’s different,” she says. “People like doing things their way.” The team devised a quick refresher for nurses, by nurses, that emphasized what the evidence and research said about safe needle handling. The nurses traveled from unit to unit in the hospital, and to some outlying clinics, to make their case. “When you emphasize safety—our own and the patients’—and provide the supplies, then people will do it,” she says.

“The peer-to-peer approach was effective because the team understood the nurses’ day-to-day concerns,” says Mark Trask, the director of environmental health and safety in San Diego. “There is empathy and understanding, which allows for more dialogue.” In addition, because the trainers were registered nurses, they could spell other nurses for the 10-minute refresher. More than 700 nurses, physicians and lab techs took the training.

Standardize supplies

While demonstrating safe needles to other units, the team members often would hear, “Oh, we don’t have that one.” So they got to work standardizing the needles throughout the medical center. “We went through every single medication room,” says Demers. “They became supply chain experts,” says Trask. By adjusting the types and amounts of equipment, they also reduced waste and saved money.

Share expertise

These nurses now participate in incident investigations when there is a needlestick injury, which is an important part of the region’s workplace safety program. Plans are in the works to spread the training to primary care departments in the ambulatory setting.

Identify resources

Demers’ participation on the National Sharps Safety Committee extended her reach system-wide. The committee field tests safety sharps in every KP region to identify products that most effectively prevent injuries. Based on user feedback, the committee selects the highest-rated safety sharps as KP’s national standard.

Why did the four frontline nurses step up? For Demers, the answer is easy: “You have to be focused on safety when you have a needle in your hand.”

TOOLS

Poster: If You See Something, Say Something

Format:
PDF (color and black and white)

Size:
8.5” x 11”

Intended audience:
Frontline employees, managers and physicians

Best used:
This is a good primer during your UBT meetings to encourage team members to speak up when they see hazards.

Related tools:

TOOLS

Poster: Floor Cleaning Made Greener, Cheaper

Format:
PDF (color and black and white)

Size:
8.5” x 11”

Intended audience:
Frontline employees, managers and physicians

Best used:
Share this piece on an EVS team that maximized costs, worker safety and environmental concerns with your UBT to inspire discussion of cutting costs while being green.

 

Related tools:

Safety on a Silver Platter

Deck: 
By standardizing common tasks, and having regular updates, you can help to reduce workplace injuries

Story body part 1: 

Want a safer workplace served up on a silver platter?

Then stop by the operating room at Kaiser Permanente’s West Los Angeles Medical Center in Southern California. Surgeons and the other health care workers there pass sharp instruments to one another on silver trays—rather than passing them hand to hand—which reduced injuries related to handling sharp instruments during procedures by 34 percent between September 2013 and May 2014.

“We can see the results,” says Lisa Duff, a surgical tech and workplace safety champion at the facility. This success is part of a new emphasis at the facility on task standardization—analyzing each step of an activity, identifying the potentially hazardous steps, coming up with a safer way of doing things and then ensuring everyone follows the new process the same way, every time.

How to reduce risk

“Injuries occur when there is not consistency,” says Tracy Fietz, chief administrative officer for Southern California Permanente Medical Group at West L.A.  “If you break [a task] apart on a fishbone diagram, you can identify where the risks are. It is about removing variation.”  

Standardizing practices also has helped several departments reduce—and in some cases eliminate—sharps-related injuries for up to 17 consecutive months. It’s also helped reduce injuries to EVS workers by 75 percent when they clean floors.

Another practice that is improving safety at West L.A. Medical Center is regular monthly meetings between senior leaders,  including Fietz, and the labor and management safety leaders of targeted departments. Departments that have special line-of-sight safety goals (see below) in the region’s Performance Sharing Program get special attention. The gatherings are a space to analyze processes, see what’s working—and what isn’t—and collect information to share with others.

How partnership helps

“I work with managers and the workplace safety champions, because it’s a partnership,” says Nor Jemjemian, the chief administrative officer for Kaiser Permanente Hospital/Health Plan at West L.A., who also leads those meetings. “I want the employees doing the tasks to be part of the solutions.”

Union-represented employees, for their part, appreciate the crystal-clear message top leadership is sending.

“You need management to back you up when you speak up,” says Duff, a member of SEIU-UHW. “Employees know that our managers will back them up 200 percent.”

Open communication, trust and partnership processes are the foundation of a safer workplace, says Jemjemian.

“When I was an employee, there were [hazardous] tasks I did that my manager didn’t know about,” he says. Today, in contrast, “UBTs create a venue and a forum to discuss the everyday work.”  

Talking About Safety Reduces Injuries

Deck: 
Wheatridge Medical Office spreads safety

Story body part 1: 

For at least one Colorado facility, workplace safety started with awareness. And building awareness was a team effort.

Wheatridge Medical Office, with about 140 employees, had three workplace injuries in the first half of 2013. The Wheatridge Safety team, representing departments across the facility, agreed that was unacceptable. But team members weren’t sure where to start, and the team lacked a management representative, making it hard to find time or resources to implement ideas.

That changed when Jeanne Kraft, RN, nurse manager for Internal Medicine, joined the safety team. The team adopted two ideas that had worked elsewhere. One was to host a safety fair, following a tried-and-true format: People visited several booths where they got information and answers to a quiz on basic safety practices. Everyone who completed the quiz then got a ticket for a barbecue lunch on the patio.

Northwest Team Spreads Success, Boosts Safety

Deck: 
A unified approach, and a competitive challenge, pay off

Story body part 1: 

It’s one thing to identify effective practices in an issue as important as workplace safety. It’s another to educate and engage teams in adopting a consistent set of practices across a region.

The Northwest’s Employee Health and Safety Department has done just that—and earned program-wide recognition for its approach.

In November 2012, the department’s Labor Management Partnership Workplace Safety team issued a challenge to the region’s 16 facility safety committees. The committees, established to help identify and resolve safety issues at the facility level, often differed in their approach and results. The safety challenge provided a fun way for the local committees to get to know more employees in their facilities, follow a consistent protocol and improve safety.

Challenging teams to step up

“The Safety Awareness Challenge provides safety committees an opportunity to work together with their labor, management and Permanente partners to effect real change around workplace safety,” says Chris Mozingo, RN, workplace safety labor consultant for the NW Region.

The yearlong campaign challenged each facility to:

  • submit monthly or quarterly safety meeting minutes, to help keep their work on track
  • have physicians and dentists attend at least 80 percent of their facility’s safety meetings, to ensure widespread participation and leadership (nonclinical departments were asked to send representatives to each meeting)
  • promote safety conversations (a blame-free approach for observing work practices) and ensure at least 25 percent of employees are trained to lead such conversations
  • adopt and promote safety awareness plans to help teams identify and correct at least three different workplace hazards (for instance, trips and falls or sprains and strains)
  • host a safety fair, safety barbeque or other facility event within the year

“The Safety Committee Challenge goes beyond recognizing achievement. It fosters and reinforces the relations between Regional Safety, management and frontline staff,” says Employee Health and Services Safety Specialist II Brian Cekoric.

Getting results, recognition

Nine facilities completed the safety challenge by meeting each of the five established criteria. These efforts helped the Northwest region—already a leader in some key measures of workplace safety—record a 4 percent decrease in injury rates compared with the previous year. Teams that met the challenge will receive additional funding to support safety awareness promotions in their facilities.

For its part, the Northwest Employee Health and Safety team won the 2013 National Workplace Safety Award for its work in engaging frontline teams.

“The simple focus on injury prevention and raising awareness goes a long way to changing the culture of safety,” says Rob Weiking, Employee Heath and Services program manager.

Creating an Injury-Free Workplace

Deck: 
A manager's tips for leading on safety

Story body part 1: 

Leonard Hayes, manager of Environmental Services culture and training in the Northwest, oversees workplace safety for 125 outpatient EVS workers in five service areas. This includes the East Side service area, whose EVS unit he directly supervises and which has recorded no injuries for nearly five years. In February 2014, Hayes won the National Workplace Safety Individual Award. He spoke recently with Jennifer Gladwell, LMP communications consultant, about how he engages teams to work more safely.

Q. You and your department have achieved a great turnaround in workplace safety. How did you do it?

A. You have to give people information and recognition. Workplace safety is a standing item on our UBT agendas. We talk about working safely, acknowledge how well our teams do and tell them “thank you.” I’ve been put in this job to take away the myths that injuries are inevitable, so people can go home at the end of their shift and enjoy their time outside of KP.

Q. What do you do personally to engage your staff on safety?

A. I’m in there with them physically.  I’ve been a worker and I take interest in what the teams are doing. I try to make sure people know I care for them by being available to them and making sure they have the tools to do their job. I am committed to responding to issues as quickly as possible and resolving them. I have a great labor partner and co-lead, Sherri Pang. She’s been my anchor with the campus and the (East Side) team. She helps me a lot by sending emails, creating fliers, understanding and encouraging the team.

TOOLS

3 Essential Tips for Workplace Safety

Format:
PDF (color or black and white)

Size:
8.5" x 11"

Intended audience:
Team members, managers

Best used:
Discuss these successful practices for building a safer work environment In meetings and team huddles.

Related tools:

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