This result is most obvious in medicine where the use of surgical checklists has saved thousands of lives and untold suffering. The importance of checklists in medicine was highlighted in a 2007 article in the New Yorker Magazine, The Checklist. The most dramatic of these incentives is the international adoption of a one-page Surgical Safety Checklist developed, promoted and disseminated by the World Health Organization.

Click here to download a copy of this checklist. 

There are numerous uses of checklists in OH&S management systems.  In fact, checklists are one of the most effective way of creating management system procedures and work instructions to meet the OHSAS 18001 requirements. 

Some of the OH&S uses of checklists include –

1. Inspection checklists – for forklift trucks, fire extinguishers and other safety-critical devices, equipment and supplies.
2. Plans and permits – for confined space entry, hot work and equipment lockout where the sequence of tasks and adequacy of precautions are critical.
3. Emergency preparedness – for making sure equipment, materials and personnel will be ready and available when an incident occurs.
4. Risk assessments – for evaluating the hazards and risks associated with materials, equipment and tasks.
5. Internal audit protocols – for making sure that OHSMS audits are complete, inclusive and cost-effective.

As regulations, activities and organizations become more complex, checklists become increasingly important for ensuring that nothing is missed.  This is why pilot checklists were developed in aviation in the 1930s.  This is why surgical checklists are being aggressively promoted in medicine today.  This is why most OH&S management systems would benefit from the use of appropriately-designed checklists. 

In my next blog, I will cover the 5 steps you should follow in order to develop good OHSMS checklists.

In the meantime, click here to request a copy of my EHSMS Implementation Checklist.

© ENLAR® Compliance Services, Inc. (2011)

I am saddened by the end of shuttle program and the associated loss of jobs.  Some of those impacted are fellow safety and health professionals. They are friends of mine who have participated in my training programs and helped me by providing references when I have asked.

As I watched the launch, I was struck by the discipline imposed by the formalized processes NASA uses to ensure safety.  The launch was momentarily paused – with only 31 seconds to go – to double check that the GOX Vent Arm had properly retracted and latched.  This was confirmed visually using a closed circuit camera while those watching the launch waited in suspense. 

This is what an occupational health and safety management system is all about.  It is putting processes in place, and using them, to ensure safety.  Many organizations write procedures and checklists.  World-class organizations use them – even when the whole world is watching.

Want help in launching your own management system?  Click here to go the webpage where you can request your copy of ENLAR’s EHSMS Implementation Checklist. 

As a special tribute to the NASA Shuttle Program, I am making it available for FREE for the next month. 

© ENLAR® Compliance Services, Inc. (2011)

I have been working for several years with the Tampa Bay Regional Planning Council to help local businesses prepare for disasters.  In our area, the Florida west coast, the disaster we fear is a major hurricane.  As part of these efforts, we developed and presented a series of interactive workshops covering emergency planning, risk assessment and disaster preparedness. 

If you want to be prepared, the following points are key -

• Prioritization of Efforts – It is impossible to address every need at the same time.  Before a disaster strikes, you need to define your risks and establish what your recovery priorities are going to be and then, when disaster strikes, act accordingly.
• Clearly Defined Roles and Responsibilities – To repurpose an adage from cooking (i.e. “Too many cooks spoil the pudding.”) – too many bosses creates chaos.  Someone must be in charge and that has to be clear to everyone.
• Communication is Key – Without clear communication, you are likely to have incomplete response actions, wasted duplication of efforts and run the risk of festering anger, outrage and violence in those who are impacted by the disaster event.
• Protecting Your Responders - Heroics look good for TV but should be discouraged. Having responders taking unnecessary risks adds to the ultimate “body count” of those impacted by the disaster.

If you haven’t reviewed your emergency preparedness plans yet this year, pull them out and review them now.  While you are at it, update those emergency contact lists, chances are they are out of date.

© ENLAR® Compliance Services, Inc. (2009)

One of the challenges associated with all of these alarms – “What are you supposed to do when the alarm goes off?”

Since my husband is at the top of the call list when an alarm goes off at his facility, I am only too familiar with this question – particularly since the “alarm alert” often occurs in the wee hours of the morning  (as it did this morning).  I can tell you attempting to answer the “now what?” question at 4 am is no fun.

One of the important tasks associated with implementing an OH&S management system is making sure there are thought out, agreed upon, documented and acceptable answers to all the “now what” questions.  In determining the “acceptability” of the answers agreed upon, it is important to consider of the views and needs of multiple stakeholders –

• The views and needs of the individual(s) who are required to answer the calls in the middle of the night (as well as the other members of their households whose sleep is disrupted).
• The views and needs of the individual(s) who are required to physically respond to alarms – including the need for specialized training and PPE.
• The views and needs of those who will have to deal with the public relations issues if an alarm triggers a “911” call for emergency services.
• The views and requirements of insurers if alarms are ignored because of frequent false alarms.
• The views and needs of individuals who are relying on alarms to protect their safety or property.
• The views and needs of the individuals who have the responsibility of keeping the alarms working right.

Putting in alarms is fine…just make sure there are plans in place for when they go off.

© ENLAR® Compliance Services, Inc. (2009)

At this meeting I gave a presentation – Challenges & Opportunities in Developing OHSMS Standards – that outlined five common barriers to implementing Occupational Health and Safety Management Systems.  Also giving presentations on this topic were Mike Seymour from OSHA and Barbara Braun from The Joint Commission.  Mike Seymour discussed the OHSMS guidance document that OSHA is currently in the process of developing and Barbara Braun discussed how the Joint Commission standards also include worker safety requirements.  As several of the attendees pointed out, there is a clear and obvious link between patient safety and worker safety.

The purpose of these presentations was to assist the HCSA Sector Council in developing implementation plans for the new National Occupational Research Agenda for this sector (currently out for public comment until the end of October 2009).  A key strategic goal in this agenda is promoting the use of OH&S management systems and improving safety culture in healthcare organizations.

The scary part of the meeting…

The critical issues that need to be addressed to protect health care workers – particularly as it relates to the H1N1 pandemic.  There was a great deal of discussion concerning the precautions that need to be taken related to providing proper respiratory protection - NOT JUST SURGICAL MASKS – and the current lack of hospital preparedness.  The importance of this topic was emphasized by the advisory issued by the Institute of Medicine yesterday that urges health care workers to use N95 respirators instead of surgical masks for protection.

© ENLAR® Compliance Services, Inc. (2009) 

Disney Fireworks

Unfortunately, early Sunday morning tragedy struck Disney’s transit system when two monorail trains collided – killing one of the train operators.  According to news reports, the Occupational Safety and Health Administration (OSHA) is currently conducting an investigation into this accident. 

I was contemplating this accident – and the resulting negative publicity for Disney – as I reviewed the latest draft of ISO 31000 – ISO’s newly developed Risk Management standard.

One of the weaknesses of many risk management programs is failing to fully evaluate the risks associated with events that are rare (low likelihood) but with the potential for severe (highly negative) consequences.  In Section 5.5.2, ISO 31000 suggests that such events may warrant risk treatment even when it appears that action may not be justifiable on strictly economic grounds.  The typical assumption being that the event will never happen; therefore, the time and money expended to evaluate and address the risk will be wasted.

This monorail accident appears to be this type of an event. 

It was clearly rare.  According to Disney, this is the first fatal crash in the 38-year history of the monorail’s operation.   

Yet, the consequences of this accident are likely to be severe –

• death of an employee
• reduced confidence in – and utilization of – the transit system by guests
• the costs incurred associated with an OSHA fatality investigation – even if no fines are imposed
• negative publicity for a company that is very concerned about maintaining a positive public image

Take ISO 31000’s advice to heart in your own risk management programs – including the risk assessments conducted to meet the requirements of OHSAS 18001.  Be sure that your low likelihood risks are evaluated - including those associated with abnormal or unusual activities.  As the accident at Disney proved, just because an event hasn’t happened yet, that doesn’t mean it may not happen tomorrow.

© ENLAR^® Compliance Services, Inc. (2009)

So what does that have to do with an occupational safety and health management system?

A great deal, as it turns out.

As I mentioned in my last post, I attended the annual AIHce two weeks ago.  The keynote speaker on Wednesday morning was Dr. Robin Herbert.  She is the director of the World Trade Center Medical Monitoring Program Data and Coordination Center with the Mount Sinai Medical Center in New York, New York.

Her presentation covered, in sometimes graphic detail, the on-going health impacts to those who responded to the World Trade Center (WTC) attack on 9/11.  This includes both physical and psychological health effects – including respiratory disease, stomach problems and post-traumatic stress disorder (PTSD).  Some of these effects are the result of the fact that individuals worked long hours, ate their meals and slept outdoors at the site – in effect having 24/7 exposure to a toxic environment.

Dr. Herbert ended her presentation with a list of recommendations that every organization should consider in their annual review of their emergency plan to prevent future impacts to the health of their emergency workers and first responders:

• Ensure that each person has, and is trained to use, appropriate personal protective equipment

• Include the steps (and supplies) necessary to define a “boundary” around areas that are not safe and limit access to those areas

• Limit the time individuals spend in emergency response and in areas with unsafe exposures

• Record the name of each individual who participates in the emergency response in case future follow-up is needed

• Take action to prevent and address psychological as well as physical trauma

Just as we have learned for confined space entry, we need to be aware that emergency response to disaster events can kill or maim responders.  We need to have plans in place to prevent this from happening – before the disaster occurs.  In other works – we need to include emergency response as part of an OH&S management system.

© ENLAR^® Compliance Services, Inc. (2008)

There were no plane crashes – no one died. Why?

A report on ABC Evening News last night highlighted two key reasons – pre-planning and the availability of an alternate means of communication.

The FAA has a contingency plan in place to address the loss of air traffic control at a particular location by diverting control to other centers – pre-planning.  Individual air traffic controllers used their personal cell phones to contact other air traffic control locations – an alternate means of communication.

Within one hour, planes were diverted around the Memphis air space creating what one commentator described as “a black hole in the sky.”

In a previous blog, I discussed the importance of emergency preparedness in an occupational safety and health management system.  Having procedures in place so you are prepared when things go wrong (including telecommunication and computer failures) is a key requirement of OHSAS 18001.  More importantly, it saves lives.

For the last year and a half, I have been working with the local emergency planning committee (LEPC) conducting workshops for local businesses and emergency responders to assist them with business continuity planning in regional disasters.  We have focused our outreach to organizations that handle significant quantities of hazardous materials.

During these workshops, two critical needs keep coming up.

Know what they are?

Adequate pre-planning (being prepared) and a functioning communication system.

As one attendee in our workshops put it, “As long as you have a plan and can talk, you can figure the rest out.”

© ENLAR^® Compliance Services, Inc. (2007)

What is an emergency?

According to the dictionary – it is an unexpected occurence requiring immediate action.

One of the critical parts of being prepared for emergencies is the anticipation of the unexpected.  One way of accomplishing this “anticipation” is to include it as an explicit part of your hazard identification and risk assessment processes.  As you are identifying hazards, ask – “What if ….”  The answer may surprise you.

According to reports in The New York Times and Forbes, two firefighters were killed in a fire and two were injured in a separate construction accident last week at the Deutsche Bank building near Ground Zero.  This building has been empty, and undergoing demolition, since it was damaged during the 9/11 terrorist attack six years ago.

These incidents highlight the importance of having a functioning OH&S management system – even for construction and demolition projects.

What were the obvious management system failures?

• Lack of appropriate risk assessment / inspection processes.  Apparently, the fire department was not inspecting the building because of concerns about exposure to toxic materials.
• Lack of emergency preparedness procedures.  No plans were in place for fighting a fire in the building.
• Failure to take effective corrective and preventive actions.  This demolition project had apparently been plagued by accidents and the primary contractor has been cited for dozens of safety violations.

According to The New York Times article, Scott Stinger, the Manhattan Borough president, summed up the situation as follows:

“[W]e sent 100 firefighters in with little water, not enough oxygen and no plan….They have got to shut this down pending a safety review.  I don’t understand why that is so difficult.”

It’s too bad a “safety review” wasn’t done before more people died.  Even better – make sure an effective OH&S management system is put in place.

© ENLAR^® Compliance Services, Inc. (2007)