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SAFETY AND SECURITY GUIDELINES FOR REMOTE
AND ISOLATED HEALTH
ii
INTRODUCTION 02
HOW TO USE THE GUIDELINES 04
GUIDELINES SUMMARY 05
GUIDELINES AIMS AND ACTIVITIES 06
1AlwaysBeingAccompanied(NotAlone) 06
2BeingPreparedforRemoteHealthPractice 07
3EnsuringStaffResilienceandManagingFatigue 08
4CreatingaStableWorkforce 09
5TheEssentialNatureofCommunication 10andConnectivity
6TheAbilitytoPreventandDe-escalate 11
7IdentifyingHazardsandManagingRisks 12
STAKEHOLDER ROLES AND CONTRIBUTION 13
CONTENT
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 1
CRANAplusacknowledgestheAboriginalandTorresStraitIslanderpeoplesasthetraditionalcustodiansofAustralia,manyofwhomliveinremoteareas,andwepayourrespecttotheirEldersbothpastandpresent.CRANApluscontributessignificantlytoimprovingthehealthofAboriginalandTorresStraitIslanderpeoplesbybuildingthestrengthoftheremoteandisolatedhealthworkforce.
CRANAplusSafetyandSecurityGuidelinesforRemoteandIsolatedHealth,2017,©CRANAplus,CairnsQLD.
Copyrightprotectsthispublication.ExceptforpurposespermittedbytheCopyrightAct1968,reproduction,adaptation,electronicstorage,andcommunicationtothepublicisprohibitedwithoutpriorwrittenpermission.EnquiresshouldbeaddressedtoCRANAplusPOBox7410,Cairns,[email protected]
TheprojecttodevelopthispublicationwasfundedbytheAustralianGovernmentDepartmentofHealth.
www.crana.org.au
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 2
INTRODUCTION
Workplace violence in remote health is an ongoing and escalating concern that presents unique challenges not faced in urban areas.
ThedrivetoimprovethesafetyandsecurityoftheremotehealthworkforcebecameanindustrywidepriorityfollowingthetragicmurderofremoteareanurseGayleWoodfordin2016.Thiscausedtheremotehealthindustrytocriticallyreflectonlongheldpracticesandchallengeitsacceptanceoftherisksthatwereroutinelyconsidered‘justpartofthejob’.
Inthe2016–2017financialyear,CRANAplusreceivedfundingbytheCommonwealthDepartmentofHealthtoundertakearemotehealthworkforcesafetyandsecurityproject.
Adiverserepresentativeexpertadvisorygroupinformedtheentireproject.Themembersofthisgroupincluded:
Christopher CliffeCEOCRANAplus,VIC;(Chairperson)
Geri MaloneDirectorProfessionalServices,(DeputyChairperson)CRANAplus,SA
Marie Baxter ExecutiveDirectorNursingandMidwifery,CountryHealthService,WA
Julianne Bryce SeniorFederalProfessionalOfficerANMF
Michelle GarnerExecutiveDirectorNursingandMidwifery,MountIsaQLD
Heather KeighleyActingChiefNursingandMidwiferyOfficer,NT
Assoc. Prof Sue LenthallCentreforRemoteHealth,NT
Dr. Jennifer MayDepartmentofRuralHealth,TamworthNSW
Rod MenereProfessionalOfficer,CRANAplus,NSW(ProjectOfficer)
Johanna NevilleRemoteAreaNurse/MidwifeApunipimaCapeYork,QLD
Lesley PearsonDirectorofClinicalOperations,SilverChainWA
Bobbi SawyerSocialWorker,TeamManager,CAMHS,SA
Rob StarlingChiefInformationOfficer,NACCHO,ACT
Tony VaughanChiefOperatingOfficer,RFDS,SA
ThecompletionofphaseoneoftheprojectsawthereleaseoftheNationalRemoteHealthWorkforceSafetyandSecurityReport:LiteratureReview,Consultation,andSurveyResults,inJanuary2017.ThereportincludedaliteraturereviewbuildingontheworkoftheWorkingSafeinRuralandRemoteAustraliaProject.Additionally,utilisingworkshops,surveysandsocialmedia,CRANAplusundertooka‘nationalconversation’withremotehealthstakeholders.
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 3
Thisprovidedanopportunitytoseektheviewsoftheworkforce,employers,andotherstakeholders,andtestexistingassumptionsontherealandperceivedissuesaroundsafetyandsecurity.
Thereportidentifiedseveralsignificantissues:
• Theneedforemployersandstafftoconducthazardidentificationandriskassessment,eventreporting,andworkplacereviewofsignificanteventsandnear-misses;
• Theneedforstafftobeaccompaniedon-call,andatothertimeswhenrisksareidentified;
• Theneedformorecomprehensiveandtimelyorientationofnewstaff;
• Theneedtopromoteindividualresilienceandmanagetheriskoffatigue;
• Theneedtoaddresshighworkforceturnoverandissuesrelatingtobullyingandharassment;
• Theneedforreliable,accessibletransportandemergencyafterhourscommunicationsystems,includingmonitoring,supportedbystafftraininginequipmentuse;
• Theneedtoprovideaccesstopatientinformationanddatainstaffaccommodation;
• Theneedforstafftrainingandpracticeincommunicationandde-escalationtechniques,tomitigatetheriskofconflictleadingtoviolence.
ThefullreportcanbeaccessedontheCRANApluswebsitewww.crana.org.au.
Recognisingthatthesafetyofstaffandservicesareessentialfortheeffectiveprovisionofhealthservices,theguidelinescontributetosupportingtwosignificantgovernmentinitiatives:TheCommonwealthWorkHealthandSafetyAct;andtheNationalSafetyandQualityHealthServiceStandards(StandardOne:GovernanceforSafetyandQualityinHealthServiceOrganisations).
Thegoaloftheseguidelinesistoprovidebroadstatementswithexamplesofactivities,whichcanbeimplementedbyemployers,serviceproviders,communities,clinicians,andotherstakeholderstoestablishandmaintainsafeandeffectiveoperatingsystemsinremotehealthservices.
Theguidelinesidentifysevensafetyandsecuritypriorityareas,eachofwhichistobeconsideredthroughthelenseoftheindividual,theteam,theemployer,theinfrastructure,theenvironmentandthecultureandcommunity.
Theseguidelinesprovideastructuredpathwaytoidentifyriskandprioritiseareasforimprovement.Ultimately,itwillbehighlyvaluabletodevelopagreednationalstandardsforremotehealthworkforcesafetyandsecurity.Standardswillprovideclear,measurableexpectationsonsafetyandsecurityissues,providinggreaterimpetustodrivereform.
Althoughdevelopedprimarilyforsmallremotetownsandcommunities,theseguidelinescanbecontextualisedtoanyareaorindustrythatrequireshealthserviceprovisioninanisolatedsetting.
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 4
1. Theinfographicprovidesasummaryoverviewoftheguidelinesandlenses.
2. Thesummarytableassiststoidentifythecomplexityofissues,rolesandresponsibilitiescontributingtoremotehealthworkforcesafetyandsecurity.
3. Moredetailedinformation,isprovidedundertheheadingofGuidelines,AimsandActivities.Thisinformationisprovidedasaguideonly.Activitiesshouldbedevelopedaccordingtothecontextofindividualservicesandcommunities,andwiththecontributionoflocalstakeholders.
4. Thefinalcomponentofthisdocumentprovidesactivitiesonhowdifferentremotehealthstakeholderscancontributetosafetyandsecurityissues.
Improved Safety and
Security
Safe
ty an
d Security
Guidelines for Remote and Isolated HealthIndividual
Environment
Team
Infrastructure
Employer
Culture &Community
Workforce Stability Communication & Connectivity Prevention & De-escalation
Hazard Iden
ti�ca
tion &
Risk
Man
agem
ent
Alw
ays A
ccom
panie
d (Not A
lone) Preparation for Remote Practice Sta� Resilience & Fatigue Management
HOW TO USE THE GUIDELINES
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 5
GUIDELINESLENSES
Individual Team Employer Infrastructure Environment Culture and community
Always accompanied (not alone)
Adheretoworkplacesafetyguidelines.
Clinicpracticespreventexcessiveon-call.
On-callguidelinesreflect‘alwaysaccompanied’fullcomplementofskilledstaff.
Transportandcommunication.Reliablecommun-icationwithon-callsupportworker.
Zerotoleranceofviolence
Communitypartnershipsandsupport.Afterhoursserviceforemergencyonly.
Preparation for remote practice
Bepreparedfortheworkplace,undertakeorientation.
Providelocalorientation.Earlyhazardidentificationandprevention.
Comprehensiveorientationtobeprovided.Embedacultureofsafetyandreporting.
Securebuildings,adequatelighting,andpreventivemainte-nance.Monitoringandreviewofsystems.
Hazardandriskassessmenttraining.Workhealthandsafetyhierarchyofresponses.Industrycultureofsafety.
Orientation.Culturalsafetyeducation.Communityemergencyplan.
Staff resilience and fatigue management
Engageinclinicalsupervision,mentoringandself-carepractices.
Equitabledistributionofworkload.Proactiveresponsetocriticalevents.
Managementtraining.Supportivestaffsupervision.Proactiveresponsetofatigueandwellbeingissues.Servicefullystaffed.
Fitforpurposeandwellmaintainedequipmentandinfrastructure.
Serviceresponsetomanageclimateandmajorevents.Limitedworkandtravelhours.Manageteamtensions.
Improvecommunities’healthliteracyandcapacitytoreduceburdenonafterhoursservices.
Workforce stability
Careergoalsandplans.Communityparticipation.
Supportiveworkplaceculture.Shareworkloadandclinicalinterests.
Professionaldevelopment.Remotestaffrecreation.Exitinterviews,supportandcounselling.Leaveentitlements.
Safe,secure,adequatelyequippedandmaintainedaccommodation.Goodinternetaccess.Vehicleuseforrecreationalactivities.
Supportiveorganisationalculture.Proactiveresponsetobullying.
Communityeducationandprocessestoattractstaffandlimitattrition.Exitinterviewfeedback.
Communication and connectivity
Logallon-callworkandlocation.Establishandmaintainowncommunicationnetworks.
Teamdevelopmentandsupport.On-callstaffmovementsmonitoredbyobjectiveprovider.
Businesshoursandafterhourscommunicationsystems.Proactiveresponsetopossiblehazards.
Voice,datacommunicationwithinandoutsidecommunity.Powerbackupsystem.Clinicandmobile/emergencycommuni-cationandtransport.
Emergencycommunicationandtransportplan.
Healthserviceandcommunitymeetings.Problemresolutionprocess.
Prevention and de-escalation
Communicationandde-escalationskillsandexperience.
In-servicetraining.Alertsystemforhighriskpatients.Monitoringandreviewevents.Peersupport.
Maintainsafetypriorities.Supportcommunicationandde-escalationforstaff.
Abilitytocontrolclinicaccess.Goodaccessandegress.Saferoom.Noserviceprovisionatstaffaccommodation.
Culturalsafetyeducation.Positivecommunityandstaffrelations.
Localemployedstaff.Communityandhealthservicepartnerships.Communitytoalertstafftohazards.
Hazard identification and risk management
Orientation.Safetyprioritised.WorkplaceSafetyGuidelines.Auditandriskassessmenttools.
Ongoinghazardidentificationandresponse.Teamresponsetosafetyandsecurityissues.
Workhealthandsafetyrequirements.Workplacesafetyguidelinesdeveloped,resourced,monitoredandreviewed.
Programmedmaintenance.Infrastructureandequipmentaudit.Prioritisedresponseprocessforacutehazards.
Reduceimpactofisolation.Emergencyresponseplans.
Localculturalsafetyeducation.Communityalertstaffabouthazardsandparticipateinresponse.
GUIDELINES SUMMARY
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 6
1. Always Being Accompanied (Not Alone)
AIM
Cliniciansarenottobealonewhenattendingcall-outsafterhours,orduringbusinesshoursiftheyareattendinganunknowneventorhaveconcernsfortheirsafety.
ACTIVITIES
Individual• WorkwithintherequirementsandexpectationsofWorkplaceHealthandSafety
ActsandRegulations.
• SupportandadheretoWorkplaceSafetyGuidelines.
• Nottoworkunaccompaniedorinisolationuntilsafetyconcernshavebeenresolved.
Team• On-callrostersareapprovedandreleasedinadvance.
• On-callallocatedequitably,withnewstafforientedbeforebeingrosteredon-call.
• Thecareofacutelyill/returningpatientsisclinicallyconsideredtoreduceanyafterhoursburden.
Employer• UpholdWorkplaceHealthandSafetylegislativeobligations.
• Resourcingrequirementstomeetremotehealthservicesafetyguidelinesrecognisedinfunding.
• Develop,resource,implement,monitorandevaluatesafetyprocessesinallhealthcentres.
• Recruitandmaintainafullcomplementofadequatelyskilledstaff.
• Staffarenotrequiredtoworkunaccompaniedifsafetyconcernsareidentified.
Infrastructure• Fitforpurposetransportandcommunicationresourceswillalwaysbeavailable.
• Clinicianswillhaveaccesstoreliablecommunicationwithon-callsupportworkers.
Environment• Conflictresolutionprocessdevelopedtoresolveanyproblemsorcomplaints.
• Services,clinicians,patientsandcommunitiessupportzerotolerancetoviolence.
Culture and Community
• Communityandhealthservicespartnershipsdevelop,manage,andresourceafterhours(alwaysaccompanied)guidelines.
• Afterhourshealthserviceattendancelimitedtoemergenciesandcriticaleventsonly.
• Acultureofsafetyintheworkplaceispromotedandencouraged.
GUIDELINES, AIMS AND ACTIVITIES
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 7
2. Being Prepared for Remote Health Practice
AIM
Thehealthworkforcewillhaveundertakenthenecessaryeducationtobebothprofessionallyandpersonallypreparedfortheirroleinremoteandisolatedpractice.
ACTIVITIES
Individual• Prospectivestaffwillresearchremotehealthsafetyandsecurityissues,includingpathwaystoremote
practice,priortoseekingremotehealthemployment.
• Staffwillcompletepersonalpreparations(educational,financial,nutrition,emotional,andsocial)priortocommencingworkinremoteorisolatedsettings.
• Staffwillparticipateinworkplace/communityorientationpriortoplacementandonarrival,engageinmentoringpartnerships.
Team• Localorientationofnewstaff.
• Hazardanticipation,riskassessmentandpreventionundertakenroutinelyintheworkplace.
• Teammeetingsrespondtosignificanteventsandnearmisses.
Employer• Recruitmentagenciesandemployersshouldsupplypre-employmentinformation/preparationfor
applicantswhoaregoingtonewareasorcommunities.
• Initialemployerorientationshouldbecompletedpriortocommencingwork,withlocalorientationandcommunityculturaleducationoccurringonarrivalattheworkplaceandpriortocommencementofservicedelivery.
• Healthservicesshouldresourceandmonitorworkplacesafetystrategies.
Infrastructure• Securebuildings,vehicleparking,adequatelighting,maintenance,monitoringand
evaluationofsystems.
Environment• Hazardandriskassessmentincorporatedintomanagementschedules,withclinicstaffassessingand
respondingtoemergenthazardsandrisks.
• Workplacehealthandsafetyhierarchyofresponsesusedtoguideinterventions.
Culture and Community• Communitiesshouldcontributetoworkplaceorientationandculturalsafetyeducationpromotinga
communitypartnershipapproach.
• Communities,healthservicesandclinicstaffdevelopandpracticeemergencyresponses.
GUIDELINES, AIMS AND ACTIVITIES
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 8
3. Ensuring Staff Resilience and Managing Fatigue
AIM
Staffarepersonallyandprofessionallyabletorespondtothechallengesofremotepractice.Theriskoffatigueisminimisedthroughworkloadmanagement,supportivesupervision,timelyuseofleaveopportunities,andprioritisingofself-care.
ACTIVITIES
Individual• Accessclinicalsupervisionandmentoring.
• Monitorandprioritiseself-care,healthandwellbeing.
Team• Shareclinicroles/clinicalinterestsandon-callresponsibilitiesandparticipateinpeersupport.
• De-briefaftercriticaleventsandnear-misses.
• Pro-activeresponsewhensignificantissuesaffectingteammembersareidentified.
• Educatethecommunityontheroleofafterhoursservicesandthatcliniciansworkinglonghourson-callimpactonthefunctionoftheservicethenextday.
Employer• Ensureremotehealthmanagershaveinterpersonalandmanagementskillsand
trainingopportunities.
• Allocateprogrammeandon-callworkloadsequitably.
• Workwithcliniciansandcommunitiestolimitafterhoursserviceexpectations.
• Supportivesupervisionofclinicstaffwiththeopportunityfor‘timeout’followingcriticalincidents.
• Schedulestaffleave,limitingcapacitytodeferorclusterleaveentitlements.
• Monitor,identifyandrespondtoissuescreatingstafffatigueandchallengingwellbeing.
• Planandrecruittoensureafullcomplementofappropriatelyskilledstaff.
Infrastructure• Accommodationandclinicbuildings:designedandbuiltfitforpurpose;cycloneratedinnorthern
Australia;adequatelyequippedandmaintained.
Environment• Flexibilityofworkhourstoaccommodateclimateextremesorsportingandculturalactivities.
• Identifyworkrelatedtravelaspartoftheworkingday.
• CliniciansandManagersproactivelyrespondtotensionswithinteams.
Culture and Community• Buildcommunityhealthliteracytoself-manageminorailmentsafterhours.
• Limitafterhourshealthserviceexpectationstocriticalcareandemergencies.
GUIDELINES, AIMS AND ACTIVITIES
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 9
4. Creating a Stable Workforce
AIM
Maintainaregularandreliableworkforce,alongwithareduction/managementofstaffturnoverandchurntopromotesafe,qualityandreliableremoteserviceprovision.
ACTIVITIES
Individual• Developamedium-termcareerplan.
• Engagewithcommunityresidentsandothers–participateinsocialactivities.
• Identifypersonalneedsandhowyoucanachievethesewhileworkinginremotehealth.
Team• Shareworkloadandclinicalinterests.Adjustrolestoincludetheinterestsofincomingstaff.
• Worktogethertocreateandsustainasupportiveteamenvironment.
Employer• Structuredrecruitmentandorientationprocessestopreparestaffforplacement.
• Supportivestaffsupervisiontoensuremanagersintervenebeforestaffburnout,andtoreducethepotentialforbullyingwithinteams.
• Plancliniciancoversostaffcanscheduleleaveentitlements.
• Managersareeducatedandpreparedfortheirroles,includingstaffwellbeingandcreationofworkforcebenchmarkstomonitorsuccess.
• Structuredexitinterviewwithresultsconsideredindividuallyandcollatedforreviewbymanagementandcommunities.
• Respondtorecognisedstafffrustrationsincluding:accommodationsafety;excessiveon-calldemands;andlackoflocaltransportforstaff.
Infrastructure• Safe,secure,adequatelyequipped,cleanandwellmaintainedaccommodation.
• Internet/datalinkandphoneconnectioninstaffaccommodationwithcostsco-shared.
• Healthservices,communitiesandcliniciansconsiderinnovativewaystomakeafterhourstransportaccessavailableforstaffwhohavenolocaltransport.
Environment• Supportiveclinicalandhumanresourcemanagementculture.
• Pro-activemanagementresponsetobullyingandotherissuesaffectingstaffwellbeing.
Culture and Community• Communityeducationaboutlimitingstaffattrition,includingexitinterviewfeedback.
GUIDELINES, AIMS AND ACTIVITIES
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 10
5. The Essential Nature of Communication and Connectivity
AIM
Ensurethatreliableandeffectivecommunicationandtransportsystemsareavailabletomitigateriskstotheremotehealthworkforce.
ACTIVITIES
Individual• Developandmaintainsocialcontactswithinandoutsidethecommunity.Utilisingsocialmedia,
participationinprofessionalorganisationsandpersonalsocialmediacontacts.
• Trainingforsafeandeffectiveuseofhealthservicetransportandcommunicationequipment.
Team• Orientincomingstafftosafe,effectiveuseoftransportandcommunicationequipment.
• Scheduledauditandtestoftransportandcommunicationequipment,includingmaintenance,repair,safetyandsurvivalequipment.
• Scheduledteammeetingstoidentifyissues,reviewsignificanteventsandnearmisses.
Employer• Developandimplementanon-callcommunicationsystemthatmonitorsandrecordslocationofstaff
anddurationofcallout,includingrealtimemonitoring24/7.
• Ensurethatremotehealthserviceshavereliable,effectivephoneanddatacommunication,includinginallvehiclesandaccommodation.
• ArobustmaintenanceschedulewithauditedcomplianceagainstKPIsforrespondingtofaults.
• Ensurethatstaffaretrainedandexperiencedinusingallequipment,includingtrouble-shootingproblemswithsatellitephonereception.
• Fitforpurpose,adequatelymaintainedvehiclessuppliedtoremotehealthfacilities,withstafftrainedintheiruse.
• Trainingandexperienceindistancetravelonbushroadsinvaryingconditionsdayandnight.
Infrastructure• Reliable,effectivevoiceanddatacommunicationwithinandoutsidethecommunity.
• Emergencypowerback-upsystemforcommunicationsequipment.
• Mobilecommunications,monitoringand/oremergencyassistequipmentavailable.
Environment• Emergencytransportandcommunicationsplantomanageseasonalextremesand
environmentalrisks.
Culture and Community• Regularmeetingswithhealthservicestaff,managersandcommunityrepresentatives,including
policeandeducation.
GUIDELINES, AIMS AND ACTIVITIES
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 11
GUIDELINES, AIMS AND ACTIVITIES
6. The Ability to Prevent and De-Escalate
AIM
Theremotehealthworkforceisequippedwitheffectiveinter-personalcommunication,preventionandde-escalationskillstomanagebullyingandharassment,andreducetheincidenceofeventsescalatingtoviolence.
ACTIVITIES
Individual• Includecommunication,de-escalationandsafetyinprofessionaldevelopmentpriorities.
• Practiceandreflectoncommunicationandde-escalationstrategies,includingself-awarenessandyourroleinescalatingorsettlingpotentialconflict.
• Researchyourrightsandresponsibilitiesinrelationtobullyingandharassment.
• Processexperiencesandeventsthroughclinicalsupervision,mentoring,communityengagementand/orcontactwithBushSupportServices.
Team• Ongoinghazardidentificationandresponse,includinghi-riskclientregister/alertsystem.
• Promotesupportiveteamculturetomanage/reviewsignificanteventsandnearmisses.
Employer• Workplacehealthandsafetyrequirementsfulfilled
• Allafterhourscaretobeprovidedintheclinic,notatstaffaccommodation.
• Monitorandreviewepisodesofworkplaceviolence,respondingtohazardsandrisks.
• Educationandtrainingoncommunication,de-escalationandemergencyresponsestrategiestodevelopstaffcapacitytodefuseescalatingsituationsandprioritisetheirownsafety.
• Supportivestaffsupervision,engagingandrespondingearlytoemergingevidenceofdeterioratingstaffwellbeingorindicationsofbullyingandharassment.
• Supportive,rapidresponseforstaffwhohaveexperiencedtraumaticevents.
Infrastructure• Saferoominclinicwithdualaccessandinternalcommunicationlink(phone/radio).
• Clearviewofclinicentrances,withaccessabletoberestricted/controlled.
• Clinicandaccommodationalarmsystemswithinternal(community)alarmsandexternalmonitoring.
Culture and Community• Localcommunityprovidesculturalsafetyeducation.
• Communityalertstaffaboutemerginghazardsandcooperateindevelopingandimplementingasaferesponse.
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 12
7. Identifying Hazards and Managing Risks
AIM
Aproactivescheduleofmonitoring,evaluationandworkplaceauditstoidentifyandrespondtohazardsandrisks.
ACTIVITIES
Individual• Developskillsusingworkplacesafetyguidelinesandriskassessmenttools.
Team• Hazardidentificationandriskmanagementanagendaiteminteammeetings.
• Reviewandrespondtoallnear-missesandsignificantevents.
Employer• WorkHealthandSafetyobligationsfulfilled.
• Workplacesafetyguidelinesresourced,implemented,monitoredandreviewed.
• EmployerWorkHealthandSafetyreviewsscheduled.
• Reviewandrespondtoallsignificanteventsandnearmisses.
• Eventsandnear-missesreported,datacollatedandusedinqualityimprovementactivities.
• On-callandbusinesshourssafetyplanimplemented.
• Orientationincludesuseofworkplacesafetyguidelinesandriskassessmenttools.
Infrastructure• Safe,secure,well-litclinic,accommodationandvehiclestorage.
• Bi-annualinfrastructureandequipmentauditcompleted.
• Alertsystemsinplaceforrespondingtoimmediatehazardsthroughanemergencymaintenancesystem.
• Aplanforstaffsafetyifinfrastructureistemporarilyinsecure.
Environment• WorkplaceHealthandSafetyGuidelinesreduceimpactofisolationandenvironmenton
staffandservices.
• Emergencyresponseplansdeveloped,resourced,andpracticed.
Culture and Community• Culturalsafetyeducationdevelopedandprovidedbylocalcommunity.
• Communityalerthealthstaffabouttransienthazards,andparticipateinresponse.
GUIDELINES, AIMS AND ACTIVITIES
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 13
STAKEHOLDER ROLES AND CONTRIBUTION
Employers
Role Contribution
Developandimplementtheadministrativeandclinicalservicesrequiredtoprovideasafeandsecureworkenvironmentfortheremotehealthworkforce.
Ensuresafeworkplace,accommodation,communicationandtransportfacilitiesandequipmenttoachieveNationalmodelOHSrequirementsandenableclinicianstoimplementsafetyprotocols.
FulfillegislatedOHSrequirementsie:workplacesafetycommitteeandworkplacesafetyrepresentatives.
Conductfacetofacemeetingswithcommunitymanagementandcouncilrepresentativestoensurecommunitiesareawareandsupportiveofsafetyprotocols.
Providetrainingandsupporttoensurecommunitiesareabletocontributeasrequiredtoimplementeffectivesafetyprotocols.
Informcommunityifspecificservicessuchason-callarebeingsuspended,orstaffarebeingevacuatedatanytimeduetocriticaleventsorsafetyguidelinesnotbeingabletobeimplemented.
Develop,resourceandimplementstandardoperatingprocedures/safetyguidelinestopromoteandfacilitatecliniciansafetyatwork,inemployerprovidedaccommodation,andwhileoncall.
Providetimelyorientationfornewstaffthatidentifiesworkplacesafetyandsecurityguidelines,andpracticalexperienceinuseoffacilitiesandequipment.
Incorporateinformationandtrainingaboutculturalsafetytraining,safety,security,andriskassessmentintostafforientation.
Ensurearapidandsupportiveresponsetostaffwhohaveexperiencedsafetyandsecurityproblems.
Thefollowingisalistofsignificantstakeholderswhocontributetothesafetyandsecurityoftheremotehealthworkforce.Farfrombeinganoverwhelmingandseeminglyintractableissue,therearemanyinterventionsabletobeimplementedthatwillcontributetoimprovingworkforcesafetyandsecurity.
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 14
STAKEHOLDER ROLES AND CONTRIBUTION
Workforce Agencies
Role Contribution
Promotethesafetyandsecurityofclinicians/employeesrecruitedtoremoteareahealthservicesthroughendorsementandimplementationoftheNationalGuidelines.
Agenciesseekwrittenworkplacesafetyguidelinesandconfirmationofimplementationfromemployersseekingtorecruitstaff.
Agenciesinformprospectiveapplicantsofbasicsafetyandsecurityguidelines,andacuteeventsplacingstaffatincreasedrisk.
Suspendrecruitmenttospecificserviceproviderpendingissueresolutionifstaffcontractedthroughyouragencyhaveidentifiedthatprotocolsarenotdocumentedorimplemented.
Collectivelydevelopsafetyandsecuritystandardsforthenurseagencyindustry.
New and Incoming Remote Area Staff
Prepareyourselfprofessionally,clinicallyandpersonallyforyourremoteareaworkforceexperience.
Beinformedabouttheprospectivejob,locationandprofessionaltransition.
Initialinternetandsocialmediasearchandfollowupidentifiedorganisationsandtopics.
ReadNationalSafetyandSecurityGuidelinesandenquirewithemployer/agencyregardingactiveuseofworkplacesafetyguidelines.
Askforacopyofworkplacesafetyguidelines,includingon-callprotocols
Applytoworkwithemployersandrecruitmentagenciesthatsupportidentificationanduseofsafetyandsecurityguidelines.
Considerseekingfeedbackfromotherstaffwhohaveworkedinthelocationyouareconsidering.Keepinmindthatexperiencescanvary.
Seekinformationandadvicefrompeakprofessionalorganisations.
The Existing Remote Workforce
Engagewithallrelevantstakeholderstopromoteimplementationandasrequired,developmentoforrefinementtoworkplacesafetyguidelinesbasedonan‘alwaysaccompanied’approach.
Contributeto,andworkaccordingtoworkplacesafetyguidelines.
Informandsupportincoming/newstafftoworkaccordingtosafetyguidelines.
Donotofferclinicalserviceorotherwiseplaceyourselfatriskuntilsafetyguidelinesaremet.
Ensureinformationaboutsafetyguidelinesisavailableinthehealthcentreandelsewhere.Opportunisticallydiscussguidelineswithotherstaffandcommunitymembers.
Promotecommunitycooperationin‘alwaysaccompanied’strategies.
Informemployerandcommunityrepresentatives,withasmuchnoticeaspossible,ifspecificservicessuchason-callavailabilityarebeingrestrictedduetoriskissues.
ContacttheBushSupportServices,CRANAplusoryourunionifsupportisneeded.
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 15
STAKEHOLDER ROLES AND CONTRIBUTION
Communities
Role Contribution
SupportlocalcliniciansintheprovisionofviableandeffectiveremoteareaPrimaryHealthCareServices.
Discussrequirementsofsafetyprotocolsandidentifyhowcommunitycontributioncanbeachieved.
Participateindiscussionsandnegotiationswithhealthservicemanagementaboutsafetyandsecurityissues.
Contributetoeffectiveimplementationofsafetyandsecurityguidelines.
Promoteresidentadherencetosafetyguidelines.
Agreeonandimplementbackupoptionsasneededtoensuresafetyprotocolsareabletobeimplemented.
CRANAplus – the professional body for remote and isolated health
Industryadvocacy,professionalsupport,andeducation.
Lead(andchampion)ImplementationofNationalremoteareasafetyandsecurityproject.
Industryinformationaccessthroughwebsite,magazineandprintresources.
Trainingthroughexistingandproposedcoursespromotingsafetyandsecurityaspartof,andinadditiontoclinicalroles.
Developmentofprofession(notworkplace)orientationforincomingclinicians.
Continuingadvocacyonsafetyandsecurityissues.
Participateinresearchinitiativesanddevelopmentofpublicationscontributingtobodyofworkonsafetyandsecurityinremoteandisolatedhealthsettings.
CRANAplus Bush Support Services
24-hourprovisionofpersonalsupport,counselling,andreferraloptionsfortheremoteareaworkforceandfamilymembers.
CounsellingService
PrintandOnlineResources
BullyingApp
ResearchandAdvocacy
Police
Protectionoflifeandproperty. Negotiateandliaisewithhealthservicesregardingco-operativesafetyandsecurity,planningandresponse.
Staffinremotesitesparticipateinacollaborativeresponsetoandmanagingsafetyandsecurityissues.
Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 16
STAKEHOLDER ROLES AND CONTRIBUTION
Researchers and Educators
Role Contribution
Educationandtrainingofprospectiveandexistingclinicians.
Prioritisingandconductingresearch,supervisingpostgraduateresearch.
InclusionofworkforcesafetyandsecurityinformationandNationalguidelinesincoreunitsofallprogramsacrossthesectorsinvolvedineducationprogramsfocusingonremoteandisolatedhealthincludingtransitionprograms.
Clinicaleducationincludesassessmentofstaffsafetyandsecurityinrelevantunits.
Newresearchproposalstoconsiderexistingandemergentsafetyandsecuritypriorities.
Industrial Organisations
Professionaladvocacy,industrialinformationandadviceformembers.
Documentinformationaboutsafetyandsecurityrisksandinterventionsonwebsiteandjournaltoempowerclinicianstopromotetheirownwellbeingandprovidesafe,effectivehealthservicesinremotecommunities.
Respondtospecificindustrialeventsorrequestsforassistancefrommembers.
Professional and Peak Bodies
Varyingrolesrepresentingandadvocatingformembershipissues,orspecificinterestgroupswithinmembership.
Advocacygroupssupportingdevelopmentofsafetyandsecurity,policyandbestpracticebymembership.
Sectoraladvocacy,policyandresearchsupport.
Worksafe Australia
Policy(Nationally)implementationandmonitoringoflegislated/regulatedworkplacesafetyandsecurityguidelines(StateandTerritory).
Remoteworkforcesafetyandsecurityissuesinformationandadvice,respondingtoproblemandpriorityimprovementnotices.
Provideadvicetoorganisationsandindividualsaboutrightsandresponses.
AllocateaPriorityImprovementNotice(PIN)toalocationorserviceproviderifsignificantsafetyrisksareidentified.
‘
Regulatory Authorities
Role Contribution
ClinicianRegulationandprotectionofthepublic.
ImplementPractitionerComplaintsSystem
Acknowledgecontextandseekexpertcontributioninmanagementandassessmentofcliniciannotification.
Governments
Legislationandpolicydevelopmentandreview.
ReviewofWorksafeguidelines(COAG)toconsiderhowWHSregulationscanbeimplementedandrespondedtoinatimelymannerinveryremoteareas.
Developmentofmandatedstandardsandincludeintherequirementsforfindingserviceproviders.
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 17
www.crana.org.au
CRANAplus DIRECTORYCAIRNS HEAD OFFICEADDRESSSuite2WallamurraTowers189–191AbbottStreetCairns,QLD4870
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POSTALPOBox7410Cairns,QLD4870
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