OSHA warning letters double for hospitals

Injury rates are too high, agency says

More hospitals than ever have received warning letters from the U.S. Occupational Safety and Health Administration (OSHA) because they have lost-time injury and illness rates that are twice the national average for all industry.

When OSHA lowered its threshold this year to six lost-time injuries per 100 full-time-equivalent (FTE) employees, 156 hospitals received letters alerting them to their high rates, or about 9% of the 1,600 hospitals surveyed. Last year, 73 hospitals received the letters.

While the letters point out specific issues for individual hospitals, they also highlight the relatively high rate of injuries in the hospital sector. Hospitals overall have a lost-time rate of 4 injuries per 100 FTEs, compared to a rate of 3.1 injuries per 100 FTEs among private-sector employers as a whole.

The high injury rates reflect, in part, the stressful environment of health care, says Bradley Evanoff, MD, associate professor of medicine at the Washington University School of Medicine and medical director of the BJC ergonomics program at BJC Health Care in St. Louis. Barnes-Jewish West County Hospital in St. Louis was one of the hospitals on the list.

"Patient acuity has gone up, and length of stay has gone down. This means that patients are turning over much more quickly," he says. "The nursing workload goes up significantly when you have patients staying for a shorter period of time.

"I think hospitals everywhere are short-staffed. Nurses and nursing aides are working longer hours," he says. "You crank up the production rate, you decrease the number of people working — that will lead to an increase in injury rates unless you make some fundamental changes in the way people do their jobs."

BJC Health Care has a number of programs designed to reduce injury rates, including one targeting slips and falls.

Overall last year, OSHA cited hospitals most frequently for violations of the bloodborne pathogen standard — product selection, product use, and staff training related to safer needle devices. The most common lost-time injury in hospitals is back injury.

New Britain (CT) General Hospital, which also received a letter, had already begun reviewing its ergonomic interventions, says Angelina Jacobs, MD, medical director of employee health. "I’m looking at how [the lifts] are actually being utilized," she says. "You can have them in place, but if the staff doesn’t spend the time to use them, they’re not going to do any good."

Still, New Britain is taking the OSHA notice to heart. "We’re planning to have a consultant come in also and see what we can do and where we can improve further," she says.