Scarborough Hospital dramatically turns around frequency rates, high injury costs with ambitious safety improvement project that engages employees
Back in November 2006, Scarborough Hospital received an unsettling call from Ontario’s Workplace Safety and Insurance Board (WSIB) — there would be an audit if the Toronto-based institution did not improve its considerable injury costs and frequency rates.
That could have meant a $500,000 fine and an increase in premiums, adding up to about $2 million in total liability, says Steve Marchi, safety manager at the Toronto-based hospital, which has two campuses — Scarborough General and Scarborough Grace.
But a year and a half later, the institute was eager to get a call from the WSIB — it had vastly improved its safety rating by getting all staff engaged in the cause and setting up the necessary frameworks for sustainable improvements. The number of lost-time incidents dropped 70 per cent — from 159 in 2005-2006 to 96 in 2006-2007 and 48 in 2007-2008.
While the threat of an audit was a strong incentive for the launch of the Safety Investment Project — an internal audit based on WSIB parameters revealed a score of 27 per cent when the minimum required is 75 per cent — there were other reasons for making such a commitment to health and safety, says Marchi, such as legislative compliance and employee morale.
“The objective was to basically put structure in place, develop a system-wide approach that was based on continuous quality improvement principles to try and make safety a corporate priority, implement it through internal responsibility systems,” he says. “The ability to have employees engage was missing. There were no mechanisms for them to voice their opinion, no ways for them to engage. We went from taking a really reactive approach to taking a more proactive approach based on prevention.”
Various levels involved
To launch the program, the hospital formed a senior-level steering committee, to endorse what needed to be done and act as champions. A task force was also created, with representation from all levels of workers, and a project team was put together to implement everything.
The budget was $160,000, including consulting services from RTS Consulting because the hospital’s people services department was understaffed. (In the end, the consultant’s involvement validated the need for new hires in health and safety at the hospital, with a dedicated safety specialist at each site.)
The institution looked at four key areas: training and education, policies and procedures, senior management engagement and hazard identification and control. The team decided to take a strong project management approach, by being structured, organized and looking for deliverables, says Marchi, and bi-weekly meetings were held with senior management throughout the project.
The hospital developed 36 corporate policies that applied to everybody and 108 policies around job-hazard analysis.
“There had never been a corporate-wide risk assessment, not even at a job level. And we hadn’t done job hazard assessments, so we had to conduct all of those,” he says.
The 3,700 employees were divided into job-type groups, such as technical maintenance or clerical, which were drilled down to baseline hazard assessments. The risks were then ranked and standard operating procedures were put in place at the unit level.
“If they weren’t covered by corporate policy, chances are we had to develop something at the unit level,” says Marchi. “So that took a lot of engagement through front-line supervisors and employees, because only the employees themselves know best how to do their jobs.”
A lot of structure was also put into management roles and accountabilities, he says, and the hospital had to design first-aid programs, which had never existed before. The project also included the building of mechanisms for employees, for example, such as safety concern reporting forms with built-in accountability. If not rectified in a number of days, the concern would escalate all the way up to the joint health and safety committee and then the CEO.
Extensive training
In all, 48 training programs were developed and rolled out to the 3,700 employees. The hospital took a modular approach to the full-day courses, says Marchi, and all new employees now receive the training, which rotates back yearly through the organization.
The training was available online but most of it was done face-to-face with 90 people in a class. Topics included legislation, personal protection equipment, ergonomics and emergency codes.
Along the way, the hospital conducted mock audits to see how it was progressing, going through every line on the standards to make sure its numbers were coming up, says Marchi.
The whole initiative was well-received by the joint health and safety committee, which previously had “floundered around a bit” and lacked structure or objectives, he says.
“Once we started to put a lot of this in place, they could visually see upfront what it is we were trying to do and we are committed to change things. So we engaged them fairly significantly,” says Marchi.
To roll out the new procedures and policies, HR had managers do monthly safety talks on certain topics, which were prepackaged by HR so they were easy to deliver. The campaign also included a Faces of Safety campaign with safety champions who picked a key topic and came up with a theme or activity to promote the cause. Food services, for example, had a “Spot the Slip” initiative where employees could win a trip to Niagara Falls. Another part of the campaign involved personalized testimonials about the impact of workplace injuries, with posters and prizes.
Safety now part of performance appraisal
The hospital also made safety performance part of an employee’s performance appraisal, he says.
“The main thing in looking at this was not only trying to be proactive but we were trying to put something in that was sustainable, to have this culture, because you didn’t want to go through this project and have it fall off the radar and everything falls apart again,” says Marchi.
There are also continuous quality improvement mechanisms in place to gauge where the hospital is at with its health and safety, in terms of benchmarks.
“We’re always looking at the figures,” he says.
Scarborough Hospital knew the whole process was working when safety concerns actually went up while the number of incidents went down, says Marchi. Awareness had obviously grown and people were more inclined to report, but the safety record had improved.
It was one of many lessons learned, he says.
“Make sure you’ve got a good framework in place. Make sure you engage all the clinical services early in the game, all your stakeholders. Rather than try to put stuff together and roll it out to them, we found out pretty fast that’s not the way to do it — you’ve got to engage them early in the game so they’ve got a voice and they’re more receptive to doing anything.”
