Excela worker safety efforts paying off but unfinished

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Hospital workers care for accident victims every day. It is David H. Byers' job as manager of health, safety and workers compensation at Excela Health in Westmoreland County to make sure those workers don't become accident victims themselves.

Keeping workers safe is not always easy in the chaos and contagion of a 24/7 hospital operation, but over the last five years Mr. Byers and his staff have redoubled their efforts to prevent staff injuries -- with remarkable results.

In 2008, Excela had 233 OSHA recordable injuries, defined as injuries that require medical treatment beyond first aid. Since then, Westmoreland County's major health system has steadily improved and last fiscal year had only 68 injuries among its 4,700 staff members at the three Excela hospitals and 70 outlying physician offices and laboratories.

It's an injury rate that's less than half the industry average, but that's still too many for Mr. Byers and John Caverno, Excela senior vice president for human resources. "We can't stop until that number is absolute zero," Mr. Caverno said.

The safety initiatives at Excela's Westmoreland Hospital start before a patient or employee enters the building.

Mr. Byers has had ice alert signs posted at major entrances and parking garages that turn blue when the temperature nears freezing, so people are aware that footing may be icy. He even rigged a flashing blue light on the signs so they will be noticed.

Entering the hospital, everyone walks across a good 25 feet of carpet that soaks most of the moisture from the bottom of their shoes. Immediately inside, there are plastic covers for wet umbrellas and, just around the corner, there's a wall container of absorbent mats to quickly clean up a spilled drink.

While a bad fall can result in weeks, if not months, of lost work time, by far the most common worker injury is blood or body fluid exposure, usually due to inadvertent needle sticks. Addressing that has involved purchasing safer syringes, ones with which a nurse can deploy a cover that goes over the sharp point as soon as the injection is administered.

"We have a number of products that we no longer use," because something safer has been found, Mr. Caverno said.

Some of what Excela has done is intuitive, using practices and procedures found at every hospital. Staff members are trained, and must undergo mandatory refresher courses every two years, to properly lift and transfer patients between a gurney and a bed to reduce strain on their backs, necks and wrists. The health system also has invested in materials and equipment, from slide sheets to smooth bed transfers to heavy-duty patient lift equipment for patients who cannot support themselves.

But not every health system has a full-time ergonomics coordinator like Excela's Sandra Truschel, who may be teaching patient escorts how to safely move patients one day, then helping clerical staff the next day to prevent repetitive motion injuries or back pain as they sit at their work station.

Even the best preventive programs do not guarantee an injury-free workplace, particularly when the primary focus is patient care. When there is an incident, a needle stick or a strained back, Mr. Byers investigates that day how the injury occurred and how to prevent future injuries.

Elizabeth Maschak, a registered medical assistant at Westmoreland Hospital, said 25 of the 30 patients on her unit may need help sitting up, standing up or walking during a shift. She admitted feeling sore when she first started -- "I'm more worried about the patients" -- but that's gotten better more recently.

It's gotten better systemwide, too, and not just in the declining number of injuries.

Fewer injuries has meant Excela has been paying fewer workers compensation claims, with payments declining from $859,515 in 2008 to $286,533 in fiscal 2012. While the savings is welcome, "Our primary focus is on the employee," Mr. Caverno said. "The driving force is the safety of our people."

The training and the reminders -- they even have reminders to people to put a lid on their hot coffee -- all make for safer work habits, but Mr. Byers said they also have to constantly think of new and unique ways to grab people's attention, such as the flashing blue ice alert lights.

He already has plan for a winter marketing campaign called "What's on your feet?" to get staff to consider what shoes they should wear in inclement weather. The plan calls for raising awareness of slip hazards using posters and safety bulletin boards, among other initiatives, as well as suggesting that staff wear anti-slip footwear.

"It's going to be staring them in the face," he said, "so they can't do anything but absorb it."

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Steve Twedt: stwedt@post-gazette.com or 412-263-1963.


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