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Commitment and involvement are essential in any safety and health program. Management provides the organizational resources and motivating forces necessary to deal effectively with safety and security hazards. Employees can be involved, both individually and collectively, through participation in the work site assessment, assisting in developing clear effective procedures and identifying existing and potential hazards. Employee knowledge and experience should be incorporated into any written plan to abate and prevent safety and security hazards.
1. Commitment by top management. The implementation of an effective safety and security program requires the public commitment of hospital, clinic, and agency administrators. Such a commitment provides a context for decisions and planning. An effective program should include the following:
a. Demonstration of management’s concern for employees’ safety and health by placing a high priority on eliminating safety and security hazards.
b. A policy which places employee safety and security on the same level of importance as patient/client safety. The responsible implementation of this policy requires management to integrate issues of employee safety and security with restorative and therapeutic services to assure that this protection is part of the daily hospital/clinic or agency activity.
c. Employer commitment to assign and communicate the responsibility for various aspects of safety and security to managers, supervisors, physicians, social workers, nursing staff, human resources, and other employees involved so that they know what is expected of them; also, commitment to ensure that appropriate records are kept and used.
d. Employer refusal to tolerate violence in the institution and the assurance that every effort will be made to prevent violent incidents.
e. Employer commitment to provide adequate authority and budgetary resources to responsible parties so that identified goals and assigned responsibilities can be met.
f. Employer commitment to ensure that each manager, supervisor, professional, and employee responsible for the security and safety program in the workplace is accountable for carrying out his or her responsibilities.
g. A program of medical care for employees who are assaulted.
h. A process of employee participation which includes receiving input from all levels of workers and managers, and evaluates all reports and records of assaults, incidents of aggression, and employee complaints related to violence. A suitable means of follow-up should be implemented to ensure that all measures taken are implemented properly and their effectiveness evaluated.
2. Employee involvement. An effective program includes a commitment by the employer to provide for and encourage employee involvement in the safety and security program and in the decisions that affect worker safety and health as well as the well-being of the client. Some methods of obtaining involvement are:
a. An employee suggestion/complaint procedure that allows workers to bring their concerns to management and receive feedback without fear of reprisal.
b. A procedure that requires prompt and accurate reporting of incidents with or without injury.
c. Employee participation in whatever process or system is devised to receive information and reports on security problems, make facility inspections, analyze reports and data, and make recommendations for corrections.
d. Employee participation in case conference meetings to present patient information and to identify problems that may help to identify potentially violent patients and to plan safe methods of managing difficult clients.
e. Employee participation in security emergency teams that are trained in required professional assault response skills.
f. Employee participation in training and refresher courses in professional assault response training, management of assaultive behavior, or disaster-plan response. Such training should include recognition of escalating agitation, diverting or controlling undesirable behavior, and any other methods of handling assaults and of protecting the individual, clients, and other staff members. Programs provided by police departments on "personal safety," or other commonly provided classes on "handling the hostile customer," often can be arranged for employees to participate in on site.
B. Written program
In large organizations in particular, effective implementation requires a written program for job safety, health, and security that is endorsed and advocated by the highest level of management, including professional practitioners or the medical board. In small establishments, the program may not need to be written or heavily documented.
The program should establish the employer’s goals and objectives.
The written program should be suitable for the anticipated hazards, and for the size, type, and complexity of the facility and its operations. These guidelines should be applied to the specific hazardous situation of each health care unit or operation. A large institution should have different plans and programs for high-risk and low-risk facilities.
The written program should be communicated to all personnel. The program should establish clear goals and objectives that are communicated to and understood by all members of the organization, including housekeeping, dietary, and clerical.
Source: National Security Institute, Albuquerque. NM.