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Safety: A Key Ingredient in the Recipe for Success

February 1, 2003
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A facility-wide program succeeds at The Forest at Duke By James J. Thompson, MHA
Safety: A Key Ingredient in the Recipe for Success
From CNAs to administrators, everyone at The Forest at Duke makes safety a priority

BY JAMES J. THOMPSON, MHA As all good managers understand, the key to any successful enterprise is a well-trained and dedicated workforce. It doesn't occur by accident. As employers, we need to demonstrate our sincere concern for all our employees. Perhaps one of the most dramatic demonstrations of such caring is in the area of safety, which (as has been said) is everyone's business-from the CEO to the newest CNA. The significance of a sound safety program is far-reaching. With such a program in place, employees will not only feel that their employers care about their well-being, but they also will recognize that each of them has an important role in the overall mission of the facility. If, for example, one team member is absent because of a safety-related accident, it will directly affect the workload of all remaining employees.

An effective safety program can reap additional benefits. By reducing the number of work-related injuries and subsequent lost workdays, a facility can dramatically reduce its workers' compensation insurance premiums. Staff productivity can increase markedly, along with morale.

At our CCRC, The Forest at Duke in Durham, N.C., our safety program also helps us to hire good staff. Current employees spread the word that it's a safe place to work, and we let prospective employees know about our commitment to safety, both when interviewing them and in our want ads. We also tell them about our distinction as one of the first healthcare facilities in the United States to participate in OSHA's Voluntary Protection Program (see sidebar).

A safe work environment also enhances marketing to prospective residents. On tours, staff members mention our safety program, and it's highlighted in our marketing materials, as well. As a matter of fact, both our employee handbook and our marketing brochure include the following line on their front covers: "An OSHA Star Facility." Of course, new residents are often referred by current residents, many of whom are involved in the safety program.

Whether considering a SNF or a CCRC, prospective residents and their families will take added comfort in knowing that a facility is concerned for its employees' safety, because that same concern can be translated into resident care.

Safety awareness at The Forest begins with our executive director setting the standard. Believing that there is no such thing as bad luck, he feels injuries can usually be prevented by careful attention and by avoiding careless actions. Line supervisors are particularly important to a good safety program. Employees are encouraged to bring safety concerns to the attention of these immediate supervisors, who then actively address them.

Department heads constantly reinforce the need for safe practices-by employees and residents alike. For example, they conduct frequent in-services on topics such as electrical safety, tripping hazards, ladder safety, prevention of musculoskeletal injury caused by lifting, construction safety, and more. (Instruction in construction safety is necessary because parts of our facility are still being built, so staff are exposed to the hazards of a construction site.)

We also enhance safety with positive reinforcement, which we feel is more effective than disciplinary action. One ongoing incentive program rewards all employees with a luncheon (ice cream buffet, taco bar, etc.) for every 50 days without a lost-time accident. In addition, we reward safety ideas, which staff and residents are invited to submit to our safety review committee. Also, if we see an employee doing something that promotes safety, we give him or her an "Attaboy" card, which is displayed in the employee lounge.

The success of our safety program also relies on positive peer pressure, or what I'd call "peer encouragement." All staff members working in our facility, regardless of position, are considered peers when it comes to safety promotion. For example, we had a frontline housekeeper working in our health center who observed one of our RNs standing on a chair to change a light bulb. The housekeeper told her, "You might want to use a ladder for that." Instead of bristling at the reminder, the RN responded, "You're right. Thank you for reminding me." This illustrates the culture we strive for. Our safety consciousness goes up and down the chain of command and between departments. We don't want anyone to be intimidated about reminding anyone else about a safety issue. Even if someone saw the executive director driving too fast on our campus, we'd expect that person to tell him so.

Another aspect of the makeup of our staff that enhances our safety program is that many of our employees have had prior safety experience. We have former firemen, police officers, military personnel, and paramedics on board, as well as former construction workers who can help with that aspect of safety. And we are fortunate to have literally hundreds of years of resident experience at our disposal-including, for example, one resident who was the safety manager for a major chemical company. We have built excellent relationships with our local fire marshal, emergency management team, and fire and police departments. These officials regularly tour our buildings and provide safety recommendations and training to our staff and residents.