1. OSACH Safety Group Meeting March 26, 2007 Musculoskeletal Disorders Prevention Introduction & Guide to Step 1

2. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 2 Intro Injuries & disorders of the MS system Cause or aggravated by hazards in the workplace *42% of LTIs *42% of all costs *50% of all days lost from work (* from MOL Provincial Ergonomist )

3. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 3 High Priority Rate Group 857 Nursing Services (LT MSD) 851 LTC (# Reported injuries)

4. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 4 MOL Initiatives Launched Pains & Strains Jan 06 Web site http://www.labour.gov.on.ca/english/hs/pains March 06 High Risk Inspectors receive training April 06 Inspectors ask questions during visits to HC workplaces

5. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 5 MOL Pains & Strains Initiative - MOL Visits Goal of MSD questions: Raise awareness of MSD ID hazards that contribute to MSD Motivate workplaces to RACE hazards

6. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 6 MOL Pains & Strains Initiative - MOL Visits *Examples of Questions: Have you seen MOL Advisory? How many MSD claims have you had in lat 1-2 years (LTI/MA/FA)? What job/task is most responsible for MSD? Do you have a modified/RTW program?

7. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 7 MOL Pains & Strains Initiative - MOL Visits *Examples of Questions: Do you provide training on manual materials handling, risk factors, signs & symptoms, how to report MS discomfort? Do you have a formal process for ID & controlling MSD hazards? Do you conduct an investigation to ID MSD hazards? Are MSD hazards identified during Part 2 Certification?

8. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 8 *Types of Hazards MOL may Look For Lifting/lowering Pushing/pulling Awkward postures (neck, shoulder, back, knees)

9. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 9 MOL Pains & Strains – High Risk Initiative July 04, MOL announced plan to reduce injuries by 20% 20,000 fewer injuries by 2008 Targeted enforcement by MOL from WSIB data March 04, launched “Last Chance” Offer assistance & support to ID workplaces to voluntarily improve their H&S performance

10. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 10 MOL Pains & Strains – High Risk Initiative Use a risk assessment screen that sorts firms by their risk profile - based on # injuries/worker - cost of injuries (LT & NLT) - based on 3 years of data - 2007 (2006, 2005, 2004) - firms are compared to others within the same sector (e.g. Health & Community care)

11. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 11 MOL Pains & Strains – High Risk Initiative Top 2% identified as “high risk” MOL inspectors visit firms up to 4x/year Firm can be dropped off list if compliant with OHSA & IRS Remaining 8% forms “priority” by MOL or “last chance” by HSA

12. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 12 Step 1- Set the Standard What is acceptable for Step 1? Policies Standard Procedures (including SOP’s, terms of reference, job/task, duties, specifications) Rules Responsibilities NOT: Guidelines or Options

13. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 13 What is a policy? Mandate (influence people) Directive from the top of the organization for the entire organization Management provides principles under which business operates Does not vary in message or enforcement

14. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 14 What is a standard? Written document to guide and direct performance in relation to a specific circumstance or combination of circumstances Not mandated Promote uniform actions that lead to predictable results More dynamic vs policy (rarely changed)

15. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 15 What is a procedure? Process specific Detail steps to be taken to achieve an objective/complete a procedure or process Aimed at a specific group of people Example – Procedure for reporting and investigation of MSD hazards/incidents

16. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 16 Policy vs Standard Policy Example - The organization is committed to providing a safe & healthy environment….. to ensure all staff understand and are aware of risk factors associated with MSD, assess risk factors, identify priorities and where possible provide appropriate ergonomic equipment or other controls

17. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 17 Policy vs Standard Standard Example: - To recognize, assess and apply appropriate controls for MSD risks associated with the repositioning of consumer/clients in bed/wheelchair..

18. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 18 Step 1- Create a General MSD Policy Tips for writing a standard/policy Identify the issue(s) Refer to legislation Define terms Address the who, what, when, where, why, how questions Date, review evaluate

19. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 19 Step 1- Create a General MSD Policy First Do some research – why do you need the policy, what do you intend to accomplish? What are the objectives/goals/purpose? - increase awareness? - increase reporting of hazards? - reduce LTI’s? - define role of JHSC during monthly inspections

20. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 20 Step 1- Create a General MSD Policy First con’t Determine Objectives Ensure measurable Add value for the organization/ensure senior management support Get employee buy-in/support

21. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 21 Step 1- Create a General MSD Policy Second - Refer to Legislation/Resources CSA (Z412-00) Guideline Office Ergonomics NIOSH (an agency established to help assure safe and healthful working conditions for working men and women by providing research information, education, and training in the field of occupational safety and health). http://www.cdc.gov/niosh/about.html HSAs

22. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 22 Step 1- Create a General MSD Policy Second - Refer to Legislation/Resources con’t OHSCO (Occ.Health & Safety Council of Ontario) Part 1 – MSD Prevention Guideline for Ontario Part 2 – Resource Manual for MSD Prevention Guideline Part 3 – MSD Prevention Toolbox OHSA

23. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 23 Step 1- Create a General MSD Policy Third - Write the policy Clear simple language Define terms Provide all info an employee needs to perform the task Involve employee feedback or ask staff to review for clarity, concerns or additional info

24. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 24 Step 1- Create a General MSD Policy Fourth - Include all workplace parties Will all staff be affected? Define accountabilities (individual or department) Include in performance standards Refer to other policies/procedures as needed (e.g. lift and transfers, etc.)

25. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 25 Step 1- Create a General MSD Policy Fifth - Address Who, What, Where, When, How, Why? Why is it needed? What needs to be done (procedure, records, inspections, training, training, investigations)? Who is responsible?

26. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 26 Step 1- Create a General MSD Policy Sixth – Date and sign policy Signature by senior management & committee who assisted.. Include review date & responsible person(s) Who will be responsible?

27. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 27 Step 1- Create a General MSD Policy Seventh – Review Ask for feedback Verify if content is understood/followed/completed

28. © Copyright 2006 Ontario Safety Association for Community & Healthcare. All rights reserved/tous droits réservés. Reproduction in whole or in part by any means without express written consent of Ontario Safety Association for Community & Healthcare is prohibited by law. 28 GROUP EXERCISE Goal: to design a MSD policy for community care sector that can be used as a template for future reference/and your own needs Within table groups, review the policy sample and make changes, additions, deletions. Be prepared to share findings.