The safety of our caregivers is of the upmost importance. Cleveland Clinic has an extensive safety program managed by a team of teams who provide training and resources to prevent safety events, respond when events occur and review our safety performance for continuous improvement. Our Environmental Health and Safety (EHS) team monitors and implements safety practices at our main campus and family health centers. Due to variances in the structure and needs of our regional hospitals, each hospital maintains written management plans to address their unique environments of care.
The enterprise safety leadership team revises safety policies, equipment, procedures and training as appropriate based on regulatory changes and ongoing reviews of our performance. Occupational Health promotes the health and safety of our caregivers through new hire pre-placement assessments, urine drug screenings, annual compliance, Tuberculosis testing, audiograms and mandatory immunizations and flu vaccinations.
Our Protective Services Department is responsible for the safety and protection of patients, visitors, caregivers and property throughout the Cleveland Clinic Health System. The department is comprised of teams focused on personal safety, confidentiality, security, transportation and parking services and emergency readiness. This includes our Cleveland Clinic Police Department, who work 24 hours a day, seven days a week to make the Cleveland Clinic main campus one of the safest areas in the city to work or visit. The Cleveland Clinic Police Department is comprised of more than 150 sworn police, security, communications and traffic control officers, and is nationally accredited by Commission on Accreditation for Law Enforcement Agencies (CALEA). One of the many services they provide is the Safety Escort program, which is a free service available to all caregivers, patients and visitors who need safe transportation to locations on main campus.
Safety is one of our core values, and as such, all caregivers contribute to maintaining a safe work environment for patients, visitors and one another. For example, we encourage every caregiver to report all events, exposures and near-misses through our safety reporting system. Following a caregiver safety report, we conduct thorough follow-up procedures to address the needs of our caregivers and identify opportunities for improvement to prevent subsequent events.
Environmental Health and Safety (EHS) Data
Cleveland Clinic records and reports accident statistics in accordance with Occupational Safety and Health Administration (OSHA) and Bureau of Labor Statistics (BLS) requirements. An injury or illness is work-related if an event or exposure in the work environment either caused or contributed to the resulting condition, or significantly aggravated a pre-existing condition. In 2019, all of our Ohio hospitals had total recordable injury rates less than the 2018 hospital industry average of 5.6 injuries per 100 full time equivalent (FTE) employees. There were no OSHA-recordable occupational illness nor work-related fatalities in 2019.
In 2019, caregivers in our ambulatory health and surgery centers experienced a slightly higher total recordable injury and medical treatment frequencies than the 2018 ambulatory healthcare industry average, but significantly lower severity rates as measured by restricted duty or lost time cases.
Cleveland Clinic has a comprehensive Bloodborne Pathogen Exposure (BBPE) program and a BBPE Operations Committee, which is comprised of multiple BBPE Committees representing hospitals across the Enterprise. The committee meets regularly to share metrics, best practices and ideas for improving our program and performance. To reduce BBPE in the workplace, Cleveland Clinic:
- requires all new hires to complete BBPE training during onboarding
- maintains a 24/7 BBPE hotline for caregivers to report events
- has dedicated Occupational Health caregivers to document exposures, schedule lab work and follow up with exposed caregivers following a report
- provides all caregivers access to BBPE procedures and our BBPE Toolkit via our intranet, which includes training materials, educational graphics and videos, best practices and other assets to help prevent and reduce BBPE
- offers a train-the-trainer program facilitated by the Simulation Center, which is designed to replicate scenarios in which BBPE occur frequently
OSHA Recordable Injuries, Other Emphasis Programs
Ergonomic principals support our caregivers in working as safely, comfortably, efficiently and effectively as possible. Ergonomic injuries in healthcare most commonly occur when individuals are handling patients, but also occur when individuals move objects and use equipment. Through our intranet, we provide caregivers with guidance and recommended products to help them correctly set up workstations, perform daily tasks and request help to accommodate a disability. Resources include:
- A list of ergonomically approved office products and workstations compiled by Environmental Health & Safety
- Step-by-step instructions for adjusting chairs, computers and workstations
- Laboratory set-ups and practices
- Disability accommodation examples and request forms
- Guidance documents on safely moving patients and lifting, pushing and pulling items
- Work area design recommendations
- Best practices documents on clinical ergonomics, office workstations and work at home computer set ups
To ensure the safety of our patients, visitors and caregivers, our Environmental Health & Safety team provides resources to help reduce slips, trips and falls. Materials available to caregivers on our intranet include:
- Safety and Environmental Health & Safety hotlines to report slip, trip and fall hazards
- FIX-IT: Facilities Maintenance and Repair form to report safety issues for correction
- Severe weather alerts
- Guides for identifying and preventing common slip, trip and fall hazards
- Winter walking tips
Additionally, we continue to evaluate walking and working surfaces to proactively eliminate slip, trip and fall risks. We experience a greater number of recordable injuries in the winter months of Northeast Ohio from slips, trip and falls compared to other months of the year due to snow and ice accumulation.
Workplace Violence Prevention
According to the Occupational Safety and Health Administration, healthcare workers’ risk of injury due to workplace violence is four times greater than that of workers in other industries. This important topic was the subject of a keynote session led by K. Kelly Hancock, DNP, RN, NE-BC, Executive Chief Nursing Officer at Cleveland Clinic at our May 2019 Patient Experience: Empathy + Innovation Summit. The session included panelists Christy Sandborg, MD, Chief Experience Officer at Stanford University School of Medicine; Janet Schuster, DNP, MBA, RN, Chief Nursing Officer at Cleveland Clinic Lutheran Hospital and Co-Chair of Cleveland Clinic’s Workplace Violence Committee; and Gordon Snow, Chief Security Officer at Cleveland Clinic, who shared how their organizations have been affected by acts or threats of workplace violence, as well as best practices for curtailing these incidents and improving the resiliency of caregivers.
Our efforts to prevent workplace violence include:
- Non-Abusive Psychological and Physical Intervention (NAPPI) training, during which caregivers learn how to identify and de-escalate threatening situations
- An enterprise-wide Workplace Violence Committee, policy, and procedure
- Round-the-clock police coverage at our emergency departments
- An internal website and downloadable toolkit dedicated to workplace violence prevention
- An online system through which caregivers can report alarming incidents
- The Speak-Up Award, for caregivers who go above and beyond in reporting workplace concerns
- Support resources for caregivers affected by workplace violence
Cleveland Clinic is committed to providing a safe environment for our patients, visitors and caregivers. We have pledged to speak out against workplace violence and create a culture in which those who report incidents are supported. We discuss all cases of workplace violence at our tiered daily huddles and address them immediately.
To help caregivers protect themselves, other caregivers, patients and visitors in an active shooter situation, Cleveland Clinic provides ALICE Program training. ALICE stands for: Alert. Lockdown. Inform. Counter. Evacuate. Due to the unique vulnerabilities of healthcare settings, the Emergency Management Department and Cleveland Clinic Police Department developed a healthcare-oriented ALICE training module for use by all of our certified Instructors.
Caregivers learn each step of the program so they can deploy it dynamically based on each unique situation and environment. Caregivers receive training through a module within our annual mandatory online Emergency Management training, live “lunch-and-learn” training sessions and department meetings. Additionally, caregivers can request an ALICE training for their team or location at any time, which includes a walkthrough component with a certified instructor so caregivers know how to best respond in their specific workspace. All new caregivers and contracted vendors complete ALICE training, and all caregivers receive refresher courses annually.
Victim Advocate Program
The Cleveland Clinic Police Department offers a Victim Assistance Program to all patients, visitors and caregivers. Through the program, we provide victims affiliated with Cleveland Clinic individualized, efficient and effective support, and resources to cope with the aftermath of a criminal offense, such as domestic violence, sexual assault, workplace violence, harassment, homicide survivors, assault, child or elder abuse, human trafficking and/or robbery. Advocates offer victims information about the different options available to them and support their decision-making related to medical, legal or emotional interventions. Services advocates offer include:
- Providing information regarding victimization and the criminal and/or civil justice system
- Informing individuals of their rights as a victim of crime according to the Ohio Revised Code
- Providing local resources and referrals, such as counseling, shelter, transportation, etc.
- Assisting with safety planning and protection orders
- Helping apply for Ohio Crime Victim’s Compensation and/or registering for victim notification programs
- Accompanying individuals to file a police report, meet with detectives and/or prosecutors and participate in court proceedings
Advocacy services are free of charge and are available at Cleveland Clinic main campus, regional hospitals, family health centers and administrative offices.