As a safety professional working with the healthcare industry, much of your time is spent trying to lead organizations out of a vicious cycle of injuries, turnover, and lack of resources. It has become even more challenging to address safety issues considering the other factors impacting the industry. These factors include, but are not limited to, nursing staff shortages, medical reimbursement, employee turnover, lawsuits, and increased compliance requirements. Safety becomes a lower priority because it is not considered a basic element necessary to achieve the ultimate goal of a healthcare facility. However, there is something to be gained by incorporating safety into all facets of healthcare operations. By getting back to basics and utilizing the following three keys, you can help your organization achieve its goal.

The Problem

As an industry we have gained tremendous knowledge, but the negative trends continue. Even with increased technology, improved research, experience gained from past losses, and more highly skilled staff, injury rates for healthcare workers continue to be one of the highest in the United States.1 Throughout this article we'll mention the following example of an unsafe resident transfer procedure. The use of gait belts is encouraged to reduce employee and patient injuries while transferring patients who need some form of assistance when ambulating. It is still a commonly accepted practice for staff to use what I refer to as the "Wedgie Grab" when walking with a resident who needs minimal support while ambulating. The staff member is supporting the resident with a good strong grip on the waistband of the resident's pants. This practice is unacceptable for several reasons. First, it is a violation of the resident's dignity and, in the event of an injury, could be considered abuse. Second, it could cause injuries to the resident and staff member if they were to fall. Finally, it demonstrates a lack of administrative controls. The staff member may not have been trained on the proper transfer techniques. Leadership personnel may not be enforcing the resident transfer policies. This lack of enforcement may be implied as condoning the unsafe practice. It could also send a conflicting message to staff who take the time to perform the transfer properly.

Acceptance of Lower Standards

Someone once said that mediocrity has become the standard of excellence. A great way to look at this is as a "normalization of deviance".2 A substandard practice is done due to pressures of performing a task. The lower standard of performance is accepted and potentially rewarded, either by lack of punishment or by praise for a job well done. This lower standard of performance becomes the newly accepted practice.

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