OSHA’s Voluntary ProtectionProgram

and Lancaster General Hospital’sJourney

Bobbi Jo Hurst, BSN, RN, MBA, COHN-S, SGEManager Employee Health and Safety

LGHealth/Penn MedicineAOHP Community Liaison

April 3-4, 2018

What is OSHA VPPVPP is a voluntary protection program that promotes effective worksite-based safety and health.

In the VPP, management, labor, and OSHA establish cooperative relationships at workplaces that have implemented a comprehensive safety and health management system.

Approval into VPP is OSHA’s official recognition of the outstanding efforts of employers and employees who have achieved exemplary occupational safety and health

Participants from NAICS 622118 HOSPITALS

6221 Baptist Hospital Nashville, TN Star SB

62211 Fairbanks Memorial Hospital Fairbanks, AK Star SB

622110 88th Medical Group WPMC Wright Patterson, OH

Star SB

622110 AnMedical Health Medical Center

Anderson, SC Star SB

622110 Guthrie Robert Packer Hospital Sayre, PA Star SB

622110 Lancaster General Hospital Lancaster, PA Star SB

622110 New Ulm Medical Center New Ulm, MN Star SB

622110 Southern Ohio Medical Center Portsmouth, OH Star SB

How Has VPP Improved Worker Safety & Health

• Below average injury rates and days away/restrictedwork day rates

• Statistically continue to reduce rates

• Strengthen safety and health management programs

LGH (licensed) OSHA RateWork related injuries requiring medical care or related to a sharp exposure

0

2

4

6

8

10

12

14

LGH OSHA Rate

National Average

Linear (LGH OSHARate)

How Does VPP Work?Sets performance-based criteria for a managed safety and health system.

Invites sites to apply.

Assesses applicants against these criteria.

Completes a rigorous onsite evaluation by a team of OSHA safety and health experts.

Requires an annual evaluation of all of the required elements annually.

The average VPP worksite has a Days Away Restricted or Transferred (DART) case rate of 52% below the average for its industry(1).

Reductions in injuries and illnesses begin/continue when the site commits to the VPP approach to safety and health management and the challenging VPP application process.

OSHA approves qualified sites to one of three programs

Star – Designed for exemplary worksites that have implemented successful safety and health management systems and achieved injury/illness rates below their industry’s national average.

Merit – Designed for worksites with commitment and potential to achieve Star quality within 3 years.

Demonstration – Designed for worksites with Star quality safety and health protection that want to test alternatives to current Star eligibility and performance requirements.

What does OSHA VPP look for in hospitals?

Recordkeeping• Injury reports, including those that are not OSHA

recordable

• Corrections made when an injury/near miss is reported.

• OSHA logs• Annual OSHA summaries are posted at sites

and are also submitted electronically to OSHA.

• Trends

What does OSHA VPP look for in hospitals (part 2)

Methods to report safety concerns• Noted in policies • Discussed by employee knowledge• Anonymous method provided

Whistle blower protections• Policies to prevent retaliation• Employees discuss freedom to report

What does OSHA VPP look for in hospitals (part 3)

Identify Hazards• Conduct tours throughout the facility

• Look for any items/procedures that do not meet OSHA standards (90 day items)

• Recommendations. Items not required to be fixed but may assist in reducing injuries/illnesses to staff.

What does OSHA VPP look for in hospitals (part 4)Hazard Controls• Engineering controls

• safer needles• Sharps containers• Patient lifts

• Work process controls• Neutral zones• Lock out tag out

• Administrative controls• Job rotations

• PPE• Gloves, gowns,

What does OSHA VPP look for in hospitals (part 5)

Job Hazard Analysis• Looking at steps required to do job• Note where an injury may occur • What controls can be put in to place• What PPE should be used• Difficult to do for nursing• Must separate into job tasks

What does OSHA VPP look for in hospitals (part 6)

Training• Review training records• Make sure Bloodborne pathogen, respiratory

protection and other training is annual• Ensure staff are knowledgeable of what the training is

about.• Fit testing, ensure annual fit testing and/or training

and availability of paprs• Make sure staff are aware of any chemicals they may

encounter and hazard communication and SDS• Ensure all persons are trained on hazards they may

encounter.

Lancaster General Hospitals JourneyBegan in 2006

A senior VP suggested we consider OSHA VPP since our rates had improved and we were doing well.

OSHA VPP Regional Office was contacted to learn more.

Had several persons from LG meet with VPP official as well as an employee from another VPP site.

Obtained executive managements support of proposal to participate in VPP process.

Developed a multidisciplinary team to work on the program.

Assessment of current program by team members

The first part was to asses current program with standards of the OSHA VPP program.

Noted strengths and opportunities for improvement.

Reviewed compliance with OSHA standards.

Reviewed requirements as noted in the VPP application.

Reviewed OSHA VPP worksheet and started completing how we met objectives

Preparing for OSHA VPPMaintain OSHA rates under National AverageApplication preparationCorrected deficiencies identified through self assessment and OSHA’s pre-survey partnership.Developed a communication plan

– Bulletin boards– Handouts( i.e. blazing the trail to safety – trail mix)– Contests prior to arrival and bulletin board contests while OSHA guests

here– Department and management meetings with power point presentations– Net learning power point for all employees– System wide emails to employees

This process took approximately 1 year.

Survey expectationsAt end of each day, reviewers met and compared notes.

Met with team members and asked questions, discussed concerns and complimented areas of best practice.

End of survey, report completed with recommendations and 90 day items..

Power point review completed.

Meeting held with executives, team members and employees to discuss findings and recommendation.

OSHA’s VisitProvided transportation to off sites.

Provided morning time for surveyors to talk and afternoon time to meet.

Lunch time provided presentations from various departments in the facility (best practices).

Documentation review of policies, education, health and safety records.

It is time to WOW the surveyors!

ObstaclesSize of organization

Culture

Constant awareness

Sustainability

So many regulatory agencies demanding time

Successes

Already familiar with regulatory surveys and requirements.

Tour plan and timeline pre-developed for survey team efficiency.

Similar regulatory requirements already in place which made achievement easier.

Document review of required material readied and flagged for required review, and placed in order for review for surveyor ease.

Safety and Health Management System

OSHA wants all institutions/companies to develop a Safety and Health Management System

VPP is a way to solidify the requirements of a system and reduce the OSHA recordable rates and injuries associated with that.

Resources are availablewww.OSHA.gov. Provides lots of resources to assist in this Journey.

VPP Regional Directors help guide through process.

VPPA , provides resources.

VPP site can share sample applications, schedules and other information.

We are here to help.

And So The Journey Never Ends

Lancaster General Hospital continues on with our next recertification less than 3 years out.