Tuesday, September 10, 2013

What can we do to make GBMC safer for our people?

Our fourth or “quadruple” aim is more joy for those providing the care. All of us in our healthcare system should derive joy from serving those in need. But how can work be joyful if it is not safe? Safety on the job is surely relative. There are many jobs that have higher risk of injury than working in healthcare. Nonetheless, it is unethical to not be working toward zero injuries among our people.

The run chart below shows the monthly number of injuries reported to employee health. 

In fiscal year 2013, which ended on June 30th, we had 327 injuries. That number is an improvement of 12% from fiscal 2012’s 370 injuries. We have set a goal of no more than 294 injuries in fiscal 14, a further 10% reduction. Our Senior Executive Team receives a daily report of the number of employee injuries in the preceding 24 hours and measures this on our Lean Daily Management board. We are driving toward a goal of zero injuries.

The injuries can be grouped into a number of large categories. The most dangerous of the injury groups is the needle stick/body fluid splash category. Being injected with hepatitis C or HIV contaminated blood can lead to a lifetime of therapy and/or long term morbidity. These injuries can be prevented by using the appropriate safety devices like needle-less systems, needles with protective sheaths and protective eyewear. A respiratory therapist was recently exposed when the therapist did not use protective eyewear when inducing cough in a patient.

System design is also important. Standard work in the passing of sharps in the operating room is critical to reducing needle stick injuries. Recently, a resident physician stuck himself with a contaminated needle because he used his fingers rather than pickups to reposition a needle on a needle driver.

Another category of injury among workers at GBMC is sprains and strains, usually from lifting. With the national epidemic of obesity, it is very important that we use the appropriate lifting devices to avoid musculoskeletal injuries. Slips and falls is a category of injury that usually occurs from spills that go unnoticed or from workplace clutter. An employee recently fell after tripping on an exposed electrical wire. Our IT Team has recently been doing environmental rounds to make sure that computer and printer electrical cords are not creating tripping hazards on our units.

Our last major category of injuries is those due to workplace violence. We have made some progress in this area by implementing training for employees in high risk areas like the Emergency Department and also by stationing a security guard on Unit 36. There are other injuries that don’t fit into common categories like the employee who was recently harmed when a swinging door came off its hinge.

So what can we do to drive towards zero workplace injuries? First, we can make sure that we are following safe practices and using protective devices when appropriate. Secondly, we can report all injuries and participate in the learning from injuries to make our systems even safer. Thanks very much for sharing your ideas on how we can reduce employee injuries in the GBMC HealthCare system.

A Day of Remembrance

Finally, tomorrow is a somber day for our nation as we remember those we lost on September 11, 2001. It’s hard to believe it has been 12 years since that tragic day in our country’s history. We should all take some time out of our daily lives to reflect on the sacrifices made by our first responders and every day citizens. Instead of focusing on the inhumanity and the horror of the day, let us focus on the many stories of hope and humanity that we witnessed as people came together to help others in any way possible. It’s the examples of humanity that keep us strong and we hope that by remembering incidences of the past, we can grow and change to create a better future. My thoughts are with everyone touched by this tragedy as we remember and hope for a more peaceful tomorrow.


  1. Thank you for your hard work to make GBMC safer! One suggestion I have is that it feels very unsafe for anyone walking from Bluebell Parking Lot in the crosswalk to walk up Farm House Hill. On numerous occasions drivers do not stop for people walking across on the crosswalk and it can be very scary. Is there any discussion in the works on how to make it safer for when people cross?

    Thank you!

    1. Thank you for pointing out your safety concern when walking from Bluebell Park up to Farm House Hill. I have asked our facilities team to take a closer look at this area and they have come up with a plan I believe will improve the safety of this crosswalk. According to our team, a pole mounted, diamond-shaped and double facing pedestrian crosswalk sign is expected to be installed in this area in mid October. This sign will be equipped with a yellow strobe light at the top of the sign so that it will be very apparent as drivers approach this area. It's our hope that the new sign will make this crosswalk safer for our employees, patients and visitors. Thank you for bringing this safety concern to our attention.

    2. Thank you so much, it is great to know someone is listening!

  2. A huge issue is that patient belongings are not being thoroughly checked upon admission to the ED. The patients are coming up to the units with knives, lighters, alcohol bottles, and all sorts of things to the units. This is not safe practice at all. These things should be confiscated and taken to security from the beginning.

    1. Thanks, Anonymous. I agree that the items you named have no business being carried to our units by patients. I am not aware of any injuries from these items. I hope that our staff is taking direct action when these items are found. Our patients have the responsibility to not put our staff at risk of violent injury. We do not search patients or belongings for these items.


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