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The Occupational Safety and Health Administration (OSHA) has vowed to take a hard look at complaints and referrals related to employee safety during the COVID-19 pandemic. Healthcare employers should prepare to answer concerns about employee safety.
The Occupational Safety and Health Administration (OSHA) stated it will prioritize investigations of complaints, referrals, fatalities, and hospitalizations related to the COVID-19 pandemic. That means risk managers should prepare to respond effectively to employee complaints or OSHA queries.
Allegations of workplace safety hazards, such as a lack of personal protective equipment (PPE), could prompt a full OSHA inspection, says Joseph W. Dorr, CIH, CSP, CHSP, assistant vice president with The Graham Company in Philadelphia.
Although the agency does not use a standard specific to infectious disease, compliance officers could cite several other requirements, such as bloodborne pathogens, PPE, respiratory protection, or the general duty clause, Dorr says. OSHA also has emphasized that employers cannot retaliate against employees who allege unsafe work conditions related to COVID-19, he notes.
“Any employer-reported fatality, inpatient hospitalization, or any complaints alleging high exposure risk without adequate PPE may warrant an on-site inspection or Rapid Response Investigation [RRI],” Dorr says. “While practicing social distancing as advised by the Centers for Disease Control and Prevention, OSHA compliance officers may conduct inspections using video conferences, phone interviews, and video recordings from the workplace. Conversely, complaints asserting medium- to low-risk tasks — from those in roles that do not have high potential for exposure — likely will be addressed through an informal process not involving on-site inspections.”
OSHA also has issued a directive to compliance officers, instructing them to consider employers’ good-faith efforts to comply with standards regarding annual training, auditing, inspections, and more, Dorr says. Because the agency realizes many employers are operating under unique and challenging conditions, this directive allows them some leeway with routine items, as long as the employer has made its best effort to comply and use alternative methods to ensure employee safety, he says.
OSHA is constantly updating its enforcement criteria and efforts as more is learned about the disease and its transmission, Dorr says.
“Healthcare facilities should be looking out for complaints from staff who feel they do not have access to proper PPE during this crisis, as it is imperative that employers provide proper PPE to protect against exposures to the virus,” Dorr says.
Employers are required to make a work-related determination of employee reports of COVID-19 illness, he says. This includes reporting fatalities and hospitalizations if determined to be work-related because of the coronavirus. OSHA had previously stated employers not in healthcare, corrections, or emergency response would not be required to record employee reports of COVID-19 infection because of its community spread unless they are aware of a workplace exposure, Dorr explains. But OSHA changed its enforcement guidance in May to require this reporting.
“Most importantly, if an organization receives Notice of an Alleged Safety or Health Hazard from OSHA, risk managers should carefully consider their response and immediately engage resources from their insurance broker to assist with answering the complaint,” he says. “A complete and detailed response can help satisfy a compliance officer’s request and prevent the need for an on-site audit of the facility and program.”
Some compliance risks may be strictly COVID-19-related, but they are unlikely to disappear soon. Even if the pandemic subsided, some COVID-19 hazards will persist.
“The unfortunate reality of the situation is that COVID-19 is not going away any time soon. The healthcare industry and society in general will experience lasting effects, such as the continued us of face masks, increased handwashing, social distancing, and more, for the foreseeable future,” Dorr says. “While the path of the virus may subside, the risk associated will not. It is critical to learn from these experiences.”
The pandemic has served as a wake-up call for many organizations in all different industries, Dorr notes.
Many pandemic risk management programs were established for a hypothetical situation, proving difficult to follow in reality. Now, risk managers have to develop and implement them on the spot, then later refine and streamline, he says.
“Risk managers should take note of what challenges their organizations are currently experiencing so they can identify solutions to be better equipped in the future, should another pandemic or similar emergency situation arise,” he says. “Learning valuable lessons from this situation will ensure programs are well-documented and ready for rapid deployment in the future.”
One of the first challenges with the pandemic was the scarcity of necessary supplies, including PPE and cleaning chemicals. While most facilities had pandemic policies in place, many were based on general infection control. As a result, the facilities did not have the supplies on hand to actually execute their emergency plans, Dorr notes.
“For risk managers preparing for similar situations or future pandemics, slowly building a reserve of necessary equipment and supplies will be key to prevent the fear and price gouging that arose in the face of limited supply following the COVID-19 outbreak,” he says. “In addition, all healthcare facilities should maintain a rotating stock of emergency supplies so as not to run into issues with expiration dates of supplies.”
Risk managers also should revisit the policies and procedures they currently have in place related to the COVID-19 pandemic to evaluate their effectiveness, Dorr suggests. This includes policies related to cleaning procedures, proper disinfection methods, employee personal hygiene practices, communication protocols with stakeholders, procedures for contact tracing, and screening of visitors.
“It’s important to also remember that this does not only apply to internal policies. Risk managers must also ensure any third-party contractors and service providers, such as equipment suppliers, janitorial services, and food manufacturers, are properly equipped to handle the facilities’ respective needs,” he says. “It is not just whether they have the appropriate supplies, but also whether they have the right protection and policies on their end to safely serve providers, residents, patients, and staff.”
Financial Disclosure: Author Greg Freeman, Editor Jill Drachenberg, Editor Jonathan Springston, Editorial Group Manager Leslie Coplin, Accreditations Director Amy Johnson, MSN, RN, CPN, and Nurse Planner Maureen Archambault report no consultant, stockholder, speaker’s bureau, research, or other financial relationships with companies having ties to this field of study. Consulting Editor Arnold Mackles, MD, MBA, LHRM, discloses that he is an author and advisory board member for The Sullivan Group and that he is owner, stockholder, presenter, author, and consultant for Innovative Healthcare Compliance Group.