Overview
Cleveland Clinic has an extensive safety program to inform and protect our caregivers. Our safety teams are responsible for providing training and resources to prevent safety events, responding when events occur and reviewing safety performance for continuous improvement. Our Environmental Health and Safety (EHS) team provides guidance across the enterprise. Each Cleveland Clinic hospital maintains safety plans specific to their unique environments of care. Healthcare can be a dangerous place to work, and therefore we place special emphasis on the Occupational Safety and Health Administration (OSHA) “Focus Four” injury types: slips, trips and falls; ergonomics; bloodborne pathogen exposures; and workplace violence.
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, which 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.
New for our 2022 report, we are reporting data for all US locations. Previously, our reports included only Ohio data. Florida injury information has since been integrated into the enterprise Workers Compensation system.
In 2022, our hospital average occupational illness and injury rates were lower than the 2021 hospital industry averages for each category (see graph below). There were no work-related fatalities in 2022.
Note: 2021 is the most current year for comparison data provided by BLS
In 2022, caregivers in our ambulatory health and surgery centers experienced a slightly higher total recordable injury rate than the 2021 ambulatory healthcare industry average. The rates for restricted duty and lost time cases, as well as occupational illnesses, were significantly lower than the national healthcare averages.
Bloodborne Pathogens
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 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.
The 2022 data below includes all U.S. Cleveland Clinic locations:
Cleveland Clinic developed an online BBP Exposure Prevention Champion training module for caregivers in 2021. BBP Exposure Prevention Champions ensure that all caregivers in their area have completed BBP training at least once per year, identify potential BBP risks in their area, provide instruction on exposure prevention, assist with investigations and interventions and support caregivers post exposure.
OSHA Recordable Injuries, Other Emphasis Programs
Slips, trips and falls
The Cleveland Clinic Environmental Health & Safety Department performs annual and periodic evaluations of the physical environment to identify and address slip, trip and fall hazards to keep our patients, caregivers and visitors safe. The evaluations focus on both exterior and interior areas, and recognized hazards are reported and addressed accordingly.
We also engage caregivers in reducing slip, trip and fall hazards and incidents, and provide the following resources on our intranet to keep caregivers informed:
- Safety and Environmental Health & Safety hotlines to report slip, trip and fall hazards.
- Severe weather alerts.
- Guides for identifying and preventing common slip, trip and fall hazards.
- Winter walking tips.
Ergonomics
Ergonomic principles support our caregivers in working as safely, comfortably, efficiently and effectively as possible. Ergonomic injuries in healthcare most commonly occur when caregivers are interacting with patients (ambulation, repositioning, wound care, bathing, etc.). To provide caregivers with ergonomic resources and support programs, Cleveland Clinic has multiple cross-functional committees and teams, including:
- Ergonomics Committee: meets twice per month and focuses on keeping caregivers healthy, improving physical well-being and preventing injuries that occur while working.
- Mobility Consult Team: performs assessments of inpatient and outpatient areas by request, provides tailored education with hands-on practice and follows up to review outcomes.
- Enterprise Mobility with Safe Patient Handling (MSPH) Committee: meets monthly and works with both inpatient and outpatient locations to reduce the potential for patient and caregiver injuries by evaluating risks and implementing measures, including overhead and portable lifts, friction-reducing devices, mobility assist devices and most importantly, thorough patient screening and assessment.
- Bariatric Committee: a newly formed team that focuses on supporting bariatric infrastructure, patient care and beds and equipment.
Strains and sprains and overuse injuries also occur when individuals move objects and use equipment. Through our intranet, we provide caregivers with a suite of ergonomic resources, including approved office products and workstations, instructions for adjusting workstations, best practice documents on workstations and clinical ergonomics, disability accommodation request forms and more.
Workplace Violence Prevention
Workplace Violence is an important safety and health issue in today's healthcare workplace. Our organizational leaders are actively engaged in communicating with our caregivers about workplace violence prevention. We have pledged to speak out against workplace violence and foster a culture that supports caregivers who report workplace violence incidents.
To promote workplace safety, Cleveland Clinic has a Workplace Violence Committee, policy and procedure. Cleveland Clinic leadership created a central Workplace Violence Committee to provide guidance, direction and priorities for the planning and execution of workplace violence prevention measures. The committee is comprised of a cross-functional team of caregivers, with several local teams — including one at each of our regional hospitals — providing additional caregiver support.
We are committed to equipping our caregivers with the knowledge and skills to recognize, prevent and react to workplace violence. Some of our workplace violence prevention measures include:
- Providing ongoing education (including customized programs from the Workplace Violence Committee by request) and conducting drills.
- Requiring Welle training for all emergency department caregivers, which provides them with techniques to foster healthy behaviors, recognize signs of agitation and de-escalate threatening situations.
- Expanding police officer presence and visibility, including a commitment to 24/7 coverage at our emergency departments.
- Using metal detectors/magnetometers to prevent weapons from entering our facilities.
- An internal website dedicated to workplace violence prevention with a downloadable toolkit.
- An online incident reporting system and initiatives to encourage reporting.
- Support resources for caregivers affected by workplace violence.
RUN. HIDE. FIGHT.
Hospitals represent a vulnerable environment. By definition, they contain a population unable to counter or evacuate due to illness and injury. Additionally, visiting loved ones may not be prepared to leave the bedside of a friend or family member. It is crucial for caregivers to possess the knowledge necessary to respond readily during an active threat situation because patients and visitors are more likely to follow caregivers.
To help caregivers protect themselves, other caregivers, patients and visitors, Cleveland Clinic uses RUN. HIDE. FIGHT. for active threat response. RUN. HIDE. FIGHT. is a quick and easy way to remember what to do in an active threat. During an active threat situation, it is recommended that caregivers escape (RUN) if they can, hide if they cannot escape and, only as a last resort, fight to protect themselves and others around them.
Caregivers receive training on RUN. HIDE. FIGHT. through a module within our annual mandatory online Emergency Management training. Additionally, caregiver teams can request virtual or in-person training with the Cleveland Clinic Police Department and Emergency Management team.
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.
