Fall Risk Assessment Risk Reduction May 12, 2016 Clint Parram, MPH, CEAS, WACH Deidre Harris, CEAS Insurance Solutions Workers Compensation Laurie Knoke, APN/CNP, MHA Nurse Practitioner Employee Health Services, KishHealth System Fall Risk Assessment Risk Reduction 2014 Incident Rate for Slips and Falls 30.4 26.8 22.8 21.3 11.4 Bureau of Labor Statistics Injures and Illnesses per 10,000 fulltime workers 1
Illinois Compensation Trust 2013 to 2015 Slips and Falls Total Incurred $3,139,114 $3,733,325 $2,194,409 $2,235,229 $1,910,669 Slip and Falls $1,363,298 Patient Handling 2013 2014 2015 Valued as of March 31, 2016 Fall Risk Assessment Risk Reduction The Centers for Medicare and Medicaid Services (CMS), The Joint Commission (TJC), the National Database for Nursing Quality Indicators (NDNHQI) and now the Occupational Safety and Health Administration (OSHA) all have an expectation for fall reduction for either patients or employees or both. 2
Fall Risk Assessment Risk Reduction 1) Data Analysis. 2) Regulatory and Standard requirements and recommendations. 3) Utilizing best practices from related organizations. Palmetto Hospital Trust 3
Fall Risk Assessment Risk Reduction Purpose <Hospital NAME> Fall Risk Reduction The purpose of the <Hospital Name>Fall Prevention (FRRP) is to identify and reduce hazards in all walking/working surfaces in an effort to eliminate the number and severity of slip and fall injuries to employees as well as non-employees who may come onto the premises. Our proactive slip and fall prevention approach focuses on correcting walking/working surface hazards that have been identified, a systematic approach to identify and correct new hazards as they arise, as well as employee behavior that may contribute to slip and fall accidents. All employees are required to follow the procedures outlined in this. Any deviations from this must be immediately brought to the attention of your supervisor or the Safety Committee. 4
Fall Risk Assessment Risk Reduction Purpose <Hospital NAME> Fall Risk Reduction The purpose of the <Hospital Name>Fall Prevention (FRRP) is to identify and reduce hazards in all walking/working surfaces in an effort to eliminate the number and severity of slip and fall injuries to employees as well as non-employees who may come onto the premises. Our proactive slip and fall prevention approach focuses on correcting walking/working surface hazards that have been identified, a systematic approach to identify and correct new hazards as they arise, as well as employee behavior that may contribute to slip and fall accidents. All employees are required to follow the procedures outlined in this. Any deviations from this must be immediately brought to the attention of your supervisor or the Safety Committee. Fall Risk Assessment Risk Reduction 5
Fall Risk Assessment Risk Reduction 6
Fall Risk Assessment Risk Reduction KishHealth System s Experience with a Serious Slip/Trip/Fall Employee Injury Presented by Laurie Knoke, APN/CNP, MHA Nurse Practitioner KishHealth System Employee Health DeKalb, IL 60115 7
Choose one answer: Do 40 respirator mask fittings in a day. Undergo a root canal. Conduct an OSHA investigation. Which Would You LeastLike To Do? Choose one answer: Perform 40 respirator mask fit tests in one day. Undergo a root canal. Conduct an OSHA investigation. 8
An employee fall, a broken hip, a hospitalization, a call to ICT, but there was more to come OSHA Rapid Response Investigation (RRI) 9
1. Notify OSHA of inpatient hospitalization within 24 hours 2. Phone call from OSHA 3. Letter of instruction from OSHA - RRI 4. OSHA letter posted where readily viewable by employees 5. Administrator signature on Certificate of Posting/return to OSHA 6. Conduct investigation a. Interviews b. Site inspection c. Education d. Photo documentation 7. Root cause analysis 8. Corrective actions What Does an OSHA Investigation Entail? 9. Submit RRI report to OSHA WITHIN 5 DAYS (or be subject to immediate on-site investigation by OSHA) 10. OSHA response satisfactory/investigation closed vs. other? In Our Case, Root Cause Analysis Revealed Human Factor as Primary Cause of Fall No Environmental Cause for Fall 10
Hospitals All Injuries by Age 2014* U.S. Hospitals Illinois Hospitals 12280 14990 1920 280 3110 11310 12140 16 to 19 20 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 & over 510 690 20 80 150 550 480 16 to 19 20 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 and over * Occupational Injuries/Illnesses and Fatal Injury Profiles, Bureau of Labor Statistics. Hospitals All Injuries by Length of Service 2014* U.S. Hospitals Illinois Hospitals 1690 50 6610 300 < 3 months < 3 months 3 to 11 months 3 to 11 months 30200 17610 1 to 5 years > 5 years 1370 830 1 to 5 years > 5 years * Occupational Injuries/Illnesses and Fatal Injury Profiles, Bureau of Labor Statistics. 11
Hospitals Slips, Trips, and Falls 2014* U.S. Hospitals Illinois Hospitals 870 70 Falls slips trips Falls slips trips 11090 13930 Slips trips without fall Fall on same level 500 680 Slips trips without fall Fall on same level Fall to lower level Fall to lower level 1900 90 * Occupational Injuries/Illnesses and Fatal Injury Profiles,Bureau of Labor Statistics. Slips, Trips, & Falls - Illinois 2014 STF by Age STF by Length of Service 2500 2000 1500 1000 500 0 130 16 to 19 490 20 to 24 1490 25 to 34 1920 35 to 44 2130 2160 45 to 54 55 to 64 650 65 5000 4000 3000 2000 1000 0 740 1940 < 3 months 3 to 11 months 2880 4280 1 to 5 years > 5 years 2000 1800 1600 1400 1200 1000 800 600 400 200 0 STF by Industry 2014 1170 1160 Manufacturing Transportation and warehousing 30 Utilities 1830 Health care and social assistance 7000 6000 5000 4000 3000 2000 1000 0 1530 Person injured or ill worker STF Source of Injuries 6440 Floors walkways ground surfaces 530 730 Ladders Vehicles * Occupational Injuries/Illnesses and Fatal Injury Profiles, Bureau of Labor Statistics. 12
Normal aging process Loss of balance Loss of strength Loss of flexibility Vision loss Stress What? Why? Takes longer to re-establish balance More difficult to compensate for slight unbalancing Harder to see and adjust to surface changes Narrows vision and attention (Source: Occupational Health & Safety, March 2015 and October 1, 2015) KHS Response Develop Fit for Duty Assessment Process Manager Has Concerns HR & Manager Discuss Option HR Requests Fit for Duty Exam via EH EH Arranges Exam w/physician and/or Physical Capacities Testing with PT EH Relays Synopsis of Results to HR HR & Manager Make Final Employment Decision w/employee 13
Conclusions STFs are a major cause of employee injuries, lost work time, cost to health system.and may result in an OSHA investigation. STFs may be due to environmental conditions but the human factor plays a big part, especially as employees age and length of service w/organization increases. Conclusions A multi-department, proactive approach to addressing STF risk and fitness for duty may be beneficial in reducing employee injuries, lost work time, and workers compensation costs. 14
QUESTIONS? COMMENTS? FINAL THOUGHT Let s Be Careful Out There! 15