Safety at the Practice Takes on a New Meaning

The liability and cost of poor patient safety is a leading cause of death in the United States, according to the Institute of Medicine.  It has been well documented and has become the leading focus for many healthcare institutions.  What is not as evident is the elevated incidence of work-related injury and illness among healthcare workers.. The impact of these injuries and illnesses on the workers, their families, healthcare institutions, and ultimately on patient safety has not gone unnoticed by The Occupational Safety and Health Administration (OSHA), which has stepped up its game by offering additional funding for training programs and harsher penalties for non-compliance.  

At the same time, there has been an increase in the number of healthcare organizations implementing OSHA online training programs as part of their operational practices.  In particular, there has been an uptick in workplace safety courses that are geared for physicians and allied health professionals to review various occupational hazards and methods of protection.  The compliance and safety training typically should encompass such areas as bloodborne pathogens; pre-exposure/post-exposure treatments; infection control; hazardous chemicals and drug exposures; fire safety; and lastly how to prevent or contend with workplace violence.

Penalties for Infractions

On the other side of the spectrum, OSHA is increasing the maximum penalty for serious violations from $7,000 to $12,471. The penalty for willful or repeat violations would increase from $70,000 per infraction to $124,709.  The impact of these increases will be significant since OSHA typically cites a business with more than one violation.  As penalties increase in magnitude, it will become increasingly important for business owners to find experienced experts that can first and foremost help them to safeguard their operations and healthcare practices. 

Under the General Duty Clause of the Occupational Safety and Health Act, OSHA has begun issuing more and more citations. These types of violations require a higher level of proof for OSHA.  In particular, the organization must prove that there is a recognized hazard by either the employer or industry and a feasible abatement method.  Many times there are very good arguments against OSHA being able to prove one or both of these elements of its case.  Healthcare organizations should always carefully evaluate these types of citations with an OSHA expert before accepting them.  Experienced OSHA experts understand the detailed regulations and OSHA'’s practices and can often negotiate lower penalties and much better abatement terms for the employer.

OSHA Catch-Up Adjustment

Section 701 of the Bipartisan Budget Act of 2015 contains the Federal Civil Penalties Inflation Adjustment Improvements Act of 2015, which requires OSHA and most other federal agencies to implement inflation-adjusted civil penalty increases. The Inflation Adjustment Act also allows OSHA a one time "catch-up adjustment" to adjust for inflation since 1990 (the last time penalties were adjusted) along with annual adjustments for inflation based on the Consumer Price Index.

There will be increase of 78 percent implemented in the latter half of 2016.  Now more than ever, it is imperative for medical offices to be proactive to ensure their compliance.

If an OSHA inspector conducts an inspection and unsafe or unhealthy working conditions are found, a list of citations and proposed penalties will be sent to the employer by certified mail. A posted copy of the citation must be placed at or near the place the violation occurred for three days or until the violation is abated, whichever is longer.

To provide guidance to field staff on the implementation of the new penalties, OSHA issued revisions to its Field Operations Manual. To address the impact of these penalty increases on smaller businesses, it will continue to provide penalty reductions based on the size of the employer and other factors.  States that operate their own Occupational Safety and Health Plans are required to adopt maximum penalty levels that are at least as effective as Federal OSHA's.

The Outcome Remains

For many healthcare organizations, the small OSHA fines of the past were simply a cost of doing business in comparison to other costs and risks.  Companies apparently did not see the penalties as financial deterrents, which may be why OSHA has instilled new harsher penalties.  What this means is that these fee increases could have a significant impact on smaller businesses or businesses who have previously found it unimportant to implement a safety program. Safety experts hope that businesses will make worker safety and OSHA enforcement a priority. Others believe that the penalties are already high enough and that increases will not add any extra deterrence to safety violations.  However you weigh these new penalties and increased training program grants, the outcome is clear.  Healthcare organizations now have the added incentive to review their safety programs, update worker training and implement procedure updates to ensure standard enforcement.

"Dave Hurton is Key Account Director for MedSafe (www.medsafe.com) He for has spent almost 25 years in the compliance, safety, and risk management industries.  Dave has specialized in designing and managing business development and marketing programs geared toward the healthcare industry, with a strong focus on physician practices.  In addition to his current position overseeing MedSafe’s strategic growth initiatives, Dave’s previous roles have included managing operations, account management, and safety departments."