© Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. Elements of a Slip & Fall Prevention Program

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 2 Why a Slip and Fall Prevention Program?  Legislative requirements  Occupational Health and Safety Act  Employer responsibility to develop H&S policy and a program to implement the policy  Employer responsibility to provide a safe workplace  Health Care and Residential Facilities Regulation  Employer must develop written measures and procedures for the health and safety of workers  Slip and Fall prevention program is part of that health and safety program.

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 3 Type of Lost Time Accidents in the Health Care and Community Services Sector in 2004 Data Source: WSIB Firm Experience Snapshot Period: September 2005

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 4 Type of Slips and Falls Data Source: WSIB Injury Analysis Snapshot Period: October 2005

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 5 Slip & Fall Statistics  ~1250 injuries in health care facilities annually  17% of all injuries second after MSI- client handling  62% of the sources were floors and 12% parking lots/driveways  May result in cuts, bruises, muscle sprains and strains, broken bones and back injuries  Social workers (15%)  Childcare and PSW/HCA (27%),  Nurses (11%).

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 6 The Costs of Slip and Fall Accidents DIRECT COSTS  ~$4000/claim  ~4 weeks of lost time  Replacement worker  Replacement or repair of damaged property  Work accommodation for injured worker  MOL charges/fines INDIRECT COSTS  Interruption or loss of service to client  Reduction in client care  Reduction in employee morale  Time spent in accident investigation, MOL orders

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 7 Occupational Health and Safety Act - Sharing the Responsibility Employer  equipment, information, instruction & supervision to protect worker  do everything reasonable in the circumstances to protect worker Supervisors  ensure workers uses/wears equipment/PPE properly  do everything reasonable in the circumstances to protect workers Workplace: any land, premises, location or thing at, upon, in or near which a worker works. Workers use equipment, report hazards and work safely

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 8 Steps to Managing Slip & Fall Program Safety Group Elements 1. Set the standard 2. Communicate the standard 3. Train to the standard 4. Evaluate and modify 5. Make Improvement and celebrate success Slip & Fall Prevention Program Elements  Conduct a risk Assessment  Assess slip and fall hazards  Develop a policy on slips and falls  Put program elements together  Provide training  Evaluate the program

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 9 Risk Assessment Conduct a Risk Assessment  Look at injury statistics  Determine the potential for slips and falls  Identify programs/departments with high potential for slips and falls, e.g. homecare  Assess the likelihood and consequence of injury  Consider direct and in-direct causes

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 10 Sources of Information  Observations and reported worker concerns  Workplace inspections  Accident investigations  Examining WSIB/HCHSA records  Review incident and injury data  Laws/Standards/guidelines  Manufacturer’s recommendations  Company policies & procedures

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 11 Step 1: Set the Standard  Develop policies and procedures to deal with prevention of slips and falls  Goal, roles and responsibilities, accountability, review  Reporting of unsafe conditions  Reporting of accidents/incidents and near-miss

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 12 Develop Procedures  Walking and working surfaces  Lighting  Cleaning and maintenance  Ladder safety  Footwear policy  Flooring material  Office/administrative  Shower/bathroom  Dietary and laundry  Entrance/hallways  Parking/outdoor  Community Include:

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law Communicate the Standard  To staff, visitors, etc.  Clear understanding of expectations  Procedures for  preventing slips and falls  reporting unsafe conditions  reporting accidents, incidents, near miss

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 14 Potential Hazards to Consider  Changing and hazardous driving conditions  Improper footwear – outdoor, client’s home, shower, other work area  Spills, clutter, loose rugs, electrical cords, etc.  Use of ladders  Working with incontinent clients/patients/residents  Icy surfaces, walkways/steps to the home/parking lot or entrance areas

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 15 Step 3: Train  Hands-on, one on one, group discussion  Planned sessions to new and transferred workers  Annual and refresher training  Written records  Relevant and applicable Provide training to everyone in the workplace to increase awareness and engage their support

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 16 Suggestions for Implementation  Use the proper equipment & ensure it is in good working order  Ensure lighting is bright enough without shadows and glare  Keep floors clear of litter e.g. paper, spills, food, toys  Clean up any solutions or other liquids that may drop to the floor.  Avoid cluttering walkways with bags or boxes.  Eliminate or mark changes in elevation

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 17 Suggestions for Implementation  Use an automatic dispensing system for measuring detergents/liquids  Ensure mops and mop buckets are free of dirt and grease  Use appropriate signs to warn the floor is wet & remove when floor is dry  Arrange for alternate by-pass route  Use mats at building entrance/exit

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 18 Suggestions for Implementation  Ensure management and supervisors are conducting unplanned inspections on a regular basis  Review policy on footwear, cleaning of spills, maintenance of walkways and parking areas  Review preventive maintenance program

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 19 Suggestions for Implementation  Monitor parking areas, walkways  Eliminate causes of blocked or restricted vision  Follow manufacturers and chemical suppliers recommendation for cleaning floors  Add spot cleaning and mopping of spills to scheduled housekeeping  Install flooring or treatments that can increase slip resistance

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 20 Step 4. Evaluate Your Program  Check that the program has been implemented as planned, is current and up to date  Verify if there has been a reduction in slip and falls  Review policies and procedures to identify opportunities for improvement  Obtain JHSC support

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 21 Step 5. Make Improvements and Celebrate Success  Review the policy/procedures to ensure they are effective/meeting goals  Advertise reduction/increase in slips and falls  Review the process for reporting hazards  Ask staff about hazards they are aware of and encourage staff to give suggestions  Develop recognition awards  Use discipline where necessary  Catch people doing things the right way and say “thanks”

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 22 Slip and Falls Prevention A good Slip and Fall Prevention program prevents accidents by :  Identifying problem areas  Taking decisions and acting on them  Checking that the actions taken have been effective

Health Care Health & Safety Association © Copyright 2005 HCHSA. All rights reserved/ tous droits réservés. Reproduction in whole or in part by any means without express written consent of HCHSA is prohibited by law. 23 Slips and Falls can be Prevented! Resources:  Sample checklist  Sample policy  Ladder safety fact sheet  Sample footwear policy Hillarie Klass Consultant Toronto Southwest