A Participatory Approach to Health &

Safety

Employees Participating

in Change (EPIC)

Agenda

• Scope of the Problem

• Background

• EPIC Program Introduction

• Case Study

The West Park Hospital Experience

• What did we learn?

• What’s next?

Scope of the Problem – Ontario Health Care LTIs (2011)

3

MSD Other (21,686) 38%

MSD Client Handling

(1,718) 3%

Falls (11,843) 21%

Contact with/Struck by (10,851) 19%

Exposures (3,280) 6%

Workplace Violence

(2,107) 4%

Machinery (1,923) 3%

Uncoded (1,644) 3%

MVI (1,170) 2%

Transportation (891) 1% Fires and

Explosions (238) 0%

Total MSDs (23,404)

41%

MSD Other (1,763) 26%

MSD Client Handling

(1,330) 19% Falls (1,216) 18%

Exposures (864) 13%

Workplace Violence

(658) 10%

Contact with/ Struck by (639) 9%

Uncoded (166) 2%

MVI (121) 2%

Machinery (56) 1%

Transportation (12) 0%

Fires and Explosions

(2) 0%

Total MSDs (3,093)

45%

Ontario Health Care & Community Services

Data Source: WSIB1

Background

• Collaborative effort between Ontario Neurotrauma Foundation (ONF) and PSHSA.

• ONF identified a leading practice - WellAware at BJC Healthcare (St. Louis, MO).

Reduce workers compensation claims.

Ergonomic, Infection Control, Claims component.

Ergonomics component (slips, trips, falls)

Involves management and employee participation.

Background

• PSHSA created Employees

Participating in Change (EPIC), an

adaptation of the WellAware program.

• EPIC is based on a participatory

approach to health and safety.

Applies the principles of Participatory

Ergonomics.

Involving front line workers in the recognition,

assessment and control of workplace hazards.

Background

• Why a participatory approach?

Employee and knowledge and experience

in relation to health and safety.

Training alone will not impact a lost time

injury reduction 4,5

Offers a means to shift safety culture 8

Supports the Internal Responsibility

System (IRS)

• What is EPIC?

A solution to addressing health and safety

hazards in the workplace.

Utilizes a team based approach at the

unit/department level

Teams (majority front line workers) who

participate in the identification, assessment and

control of workplace hazards.

EPIC Program Introduction

EPIC Program Introduction

• EPIC is based on three principles:

Engagement of front line workers

Knowledge transfer (education/mentoring)

Ensuring a hazard specific focus

Recognize, Assess, Control and Evaluate

(RACE)

• Purpose of EPIC is to foster a culture of

safety by creating an internal

participatory framework.

• How to implement EPIC?

Identification of a hazard specific focus.

Musculoskeletal Disorders

Slips, Trips and Falls (STF)

A implementation structure is created.

Multidisciplinary Steering Committee

Change Team (s)

PSHSA consultant assists and supports

the intervention.

EPIC Program Introduction

Implementation Structure

Multidisciplinary Steering

Committee

Change Team

Change Team

• Oversee

implementation

• Establish goals and

objectives

• Front line problem

solving

• Apply RACE principle

• Education Component

All participants received the following

training:

Participatory Approach to Health & Safety (1

Day)

o What is Participatory Ergonomics?

o Applying a participatory approach

o Effective team engagements

Hazard Specific Topic - MSD or STF (1 day)

o Application of RACE Principle

Implementation Structure

• Sample activities completed by the Multidisciplinary Steering Committee

Marketing & communication plan (e.g. intranet, pay stub messages, staff newsletters, management forums, etc.)

Create list of indicators to track as a means to evaluate intervention success.

Celebrate initiative – acknowledge and communicate success (e.g. certificates, staff newsletter, etc.).

Implementation Structure

• Sample activities completed by the Change Team

Identify and prioritize hazards to be addressed.

Implement the use of various tools (e.g. discomfort surveys, culture surveys, etc.).

Assist with marketing and communication (e.g. educational display during health and safety week, STF scavenger hunt, winter weather campaigns, etc.).

Assist with the creation of standardized work practices.

Implementation Structure

Role of the Consultant

• Act as a facilitator and content expert.

• Train participants involved.

• Role is expected to evolve over time.

Facilitator to supporting role.

• Important the consultant does not

weaken the IRS.

Promote self-reliance.

EPIC Pilot Project?

• Piloted in 6 healthcare facilities across

Ontario during a 12 month period.

• Process evaluation was

completed by McMaster

University, Nursing Health

Sciences Research Unit

and led by Dr. Andrea

Baumann.

• Senior management commitment is

essential.

• Consider logistical challenges (e.g.

scheduling, replacing staff, time

requirements, etc.) prior to onset.

• Maintain momentum in order to

maintain interest.

What did we learn?

• Must consider organizational readiness

prior to implementation.

• The participatory approach is not

always a quick and simple process.

• Participants considered supporting the

change team as the most important.

• Engagements at least once a month

required to make progress.

What did we learn?

• “… learned processes to assess risk”.

• “… developed more awareness of safety and hazards”.

• “… saved a lot of steps and learned how to do things with less wear and tear on our bodies”.

• “… EPIC improved our way of working and understanding of our work – we work smarter and safer”.

• “… now everyone is taking responsibility to reduce risk”.

What did we learn?

Barriers to Success

• Resistance to change.

• Need for adequate

resources and funding.

• Cost of replacing staff.

• Time required to

participate in education

and implementation

program.

• Inability to manage and

measure outcomes.

• Competing priorities

or initiatives.

• Not advancing a blame-

free culture.

• No plan for

sustainability of the

program and its

principles.

Facilitators of Success

• Dedicated

organizational leaders.

• Stable workforce –

surge capacity

• Time to attend

meetings/education.

• Timely follow-up on

suggested control

measures.

• Clear accountability for

safety.

• Encouraging staff

involvement.

• Multiple communication

tools.

• Visibility and use of

incident reporting

systems.

What's Next?

• EPIC has been customized to fit other

sectors.

• Current research study underway with

Institute for Work and Health (IWH).

Long Term Care sector

• Further refine the program following

release of IWH research findings.

www.pshsa.ca

www.healthandsafetyontario.ca

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