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Caregiver Safety

Environmental Health and Safety

Within Cleveland Clinic’s Enterprise Quality, we have a formal Environmental Health and Safety (EHS) team charged with the implementation and monitoring of EHS management activities at Cleveland Clinic main campus and our family health centers. In addition, each community hospital maintains written management plans that address the “Environment of Care” based on management structure and individual needs.

Enterprise safety leadership members regularly review regulations and assess the need for changes to general safety policies, equipment, procedures, training and other activities. Ultimately, the responsibility for environmental health and safety at Cleveland Clinic extends through the entire supervisory force to every caregiver. Only through a cooperative effort by supervisors and caregivers can an effective accident prevention program be established and preserved.

Cleveland Clinic also protects our caregivers and patients through risk control efforts related to serious diseases. For example, Occupational Health promotes the health and safety of our caregivers through new hire pre-placement assessments, urine drug screenings, annual compliance, Tuberculosis testing, audiograms, as well as required immunization and flu vaccinations. In addition, we established a work restriction policy for caregivers with communicable diseases, a safety event reporting system and post-exposure guidelines and support for those exposed to blood-borne pathogens. Employees are encouraged to report all exposures and near-misses, and aggressive post-exposure follow-up procedures are followed.

EHS Data

Cleveland Clinic’s recording and reporting of accident statistics is in accordance with the requirements of the Occupational Safety and Health Administration (OSHA) and the Bureau of Labor Statistics (BLS). An injury or illness is considered to be work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing condition. Our injury data presented below represents the majority of caregivers, reflecting our Ohio facilities. Injury rates are listed as the number of injuries per 100 full-time employees.  2016 includes caregiver data for the newly-acquired Akron General Health System (AGHS).

Caregiver Injury Rates

In 2016, Cleveland Clinic experienced a year similar to 2015. Our OSHA-recordable injury rate of 3.46 and a lost-time injury rate of 0.56, are well below the U.S. hospital average for 2015. The Bureau of Labor Statistics* indicated the average hospital had an OSHA-recordable injury rate of 6.0 and a lost-time injury rate of 1.40.

Caregiver Gender
Caregiver Injuries By Gender

There were no work-related fatalities in 2016. Injuries by gender relate closely to our overall male/female employment ratios.

Absenteeism

Cleveland Clinic absenteeism, as measured by unscheduled paid time off (UPTO), dropped from 1.0 percent in 2010 to 0.67 percent in 2015, but then increased slightly in 2016 when AGHS data was included. Absenteeism can be used to indicate caregiver health and wellness, engagement, job satisfaction and work-place effectiveness.

Bloodborne Pathogens

Bloodborne Pathogens

Bloodborne Pathogen Exposures are the most frequent injury type our caregivers experience.

In 2015, Cleveland Clinic adopted a strategic initiative to minimize or eliminate occupational exposures to human blood, blood products, and other potentially infectious materials.  The initiative continued in 2016.  Reduction activities include creating 30 hospital and institute Bloodborne Pathogen Exposure teams; developing an implementation guide; producing an exposure prevention video; evaluating new products; distributing personal protective equipment, especially eye protection; sharing best practices; formalizing incident investigations; developing a data dashboard; and chartering a Bloodborne Pathogens Steering Committee.

With emphasis on reporting, bloodborne pathogen exposure event reports have increased approximately 36% since 2015 to approximately 1500 per year (Ohio locations).  We expect event reports to plateau and begin to decline. In 2017, work will focus on central reporting of bloodborne pathogens exposure events; robust use of data; incident investigations; best practice sharing; and policies and procedures.

OSHA Recordable Injuries

Cleveland Clinic also works to reduce the two most expensive injury types that caregivers experience on the job: Ergonomic injuries, and Slip, Trip, and Fall injuries. Ergonomic injuries in healthcare are most likely associated with patient handling and movement. In addition to these, we monitor and evaluate injuries associated with moving objects, and those associated with person/machine interfaces, such as keyboard activities.

In 2016, Cleveland Clinic published its Mobility with Safe Patient Handling (MSPH) Care Path. This care path is intended to provide evidence-based patient care to reduce or eliminate the adverse effects of immobility, while providing caregivers with the tools and techniques to provide care safely. All of our medical/surgical RNs take a MSPH class as part of their ongoing education.

This process, and the results it can achieve are highlighted in this video

Watch Now
Ergonomic OSHA Recordable Injuries

As you can see from the above graph, OSHA-recordable ergonomic injuries dropped significantly throughout the year. The program was also highlighted in our June 2016 Connection.

Starting in 2015, and continuing through 2016 and beyond, walking and working surfaces are being evaluated to reduce the potential for caregiver, patient, and visitor falls. Northeast Ohio can be treacherous in the winter months, and fall data is somewhat seasonal. We see an increase in outdoor falls between November and March each year. However, our trend for the year was a nice downward line as indicated in the graph below.
Slip/Trip/Fall OSHA Recordable Injuries

Our Main Campus, which includes our regional operations facilities such as our Family Health Centers and Ambulatory Surgery Centers, is a Magnet Hospital, indicating it has achieved excellence in nursing practice. As part of our sustained commitment to our RNs, continuous improvement efforts work to improve caregiver and patient safety.

When we look at just RN data for ergonomic and slip/trip/fall injuries, we see reductions in each of the four quarters of 2016, as the graph below indicates. Fewer injuries means less harm to our caregivers, and less interruption of care to our patients.

RN OSHA Recordable Injuries

A.L.I.C.E.

With the sudden rise in active shooter incidents in the United States, providing our caregivers with training to survive such an incident is a top priority at Cleveland Clinic. The Protective Services Department adopted the A.L.I.C.E. Active Shooter Response model that was developed by the A.L.I.C.E. Training Institute. Thirty-five caregivers from various disciplines across the Cleveland Clinic Health System received A.L.I.C.E. Instructor training to help facilitate enterprise wide training.

The Emergency Management Department, in conjunction with the Cleveland Clinic Police Department, developed a healthcare-oriented A.L.I.C.E. training module that is used by all of our certified Instructors to provide consistency in the delivery of the material. The training is delivered through various media: as a module that is embedded in the annual mandatory online Emergency Management training; as “lunch-and-learn” live training sessions; during monthly department meetings; and as whole-house in-service training.

The A.L.I.C.E. Active-Shooter Response training has been a huge success with Cleveland Clinic caregivers. Every new caregiver and contracted vendor participates in training, and over 51,000 caregivers receive an annual refresher course.

A.L.I.C.E

Victim Advocate Program

NO More

In 2014, Cleveland Clinic’s Police Department secured Victims of Crime Act grant funding for our Victim Assistance Program. This program is dedicated to providing Cleveland Clinic patients, visitors and employees with support, education, and resources to cope in the aftermath of a criminal offense. The Victim Assistance Program continued to offer these services in 2016 to victims or survivors of any crime, such as domestic violence, sexual assault, workplace violence, harassment, assault or human trafficking. The services are available free of charge at Cleveland Clinic main campus, regional hospitals and family health centers.

Emergency Management

Protective Services

Cleveland Clinic’s Emergency Management Department maintains standardized programs in line with all local hospitals, city, state and federal government agencies to assure interoperability during disaster or emergency conditions.

Infection Prevention

Infection Prevention

Cleveland Clinic’s hand washing campaign addresses traditional and waterless hand washing as a means of infection prevention for our caregivers, patients and visitors.

“We value the critical role our caregivers play in creating the culture of safety that protects our patients. The goal is zero preventable harm. We must speak up and stop the line when something is not right. And the same is true when we or fellow caregivers have the potential to be harmed.”

—Stuart Kline, CIH, CSP, CSM, CHMM, CHEM, Director, Environmental Health and Safety