Safe & Secure

In 2002, Diebold Inc.'s commitment to occupational health and safety became second to none.

AS Diebold, Inc.'s corporate office completes the successful rollout of its comprehensive workplace safety program, its manager of corporate safety sets his sights on company-wide implementation--and "won't rest" until Diebold's commitment to employee safety is fulfilled.

Diebold, a global services and manufacturing company located in North Canton, Ohio, seeks to be an industry leader and employer of choice not only by providing excellent traditional benefits, but also by offering a program that is much more than just another valuable benefit or morale booster; it may, in fact, be a lifesaver.

A global leader in providing integrated self-service delivery systems and services, Diebold employs more than 13,000 associates in approximately 88 countries worldwide. The company's products include banking ATMs, vaults, electronic voting systems, campus card solutions, software, and services. In 2003 it reported revenue of more than $2.11 billion. Diebold is guided by its corporate vision: "We won't rest." This principle ensures the company won't rest until it measurably improves the extent to which its customers' customers are delighted with its self-service and security solutions, and until it improves the effectiveness and profitability of its customers' business.

"We won't rest" also could apply to Diebold's determination to ensure the health, safety, and well-being of its employees. "The well-being of our associates is paramount to the company's success," says Robert J. Warren, vice president and treasurer of Diebold. "By watching out for each other, we're helping contribute to a healthier, happier work environment. Because if we don't care for one another, who will?"

In 2002, the company's commitment to occupational health and safety became second to none.

Changing Partners
Diebold began investigating the implementation of an automated external defibrillator (AED) program when a personal friend of its CEO suffered a cardiac arrest. AEDs quickly measure and detect an abnormal heart rhythm, allowing the user of the device to activate one or more electrical shocks that can stop the abnormal rhythm and allow the heart to resume a normal beat.

Most often, the abnormal rhythm that causes cardiac arrest is ventricular fibrillation (VF), which causes the heart to quiver uncontrollably and fail to pump blood through the body. The odds of surviving sudden cardiac arrest drop 7 percent to 10 percent for every minute that passes prior to CPR and defibrillation. By reducing the amount of time until defibrillation, on-site AED programs can greatly increase survival rates for VF cardiac arrest. Research has shown that in places where AED programs provide immediate CPR and deliver the first shock within three to five minutes after collapse, survival rates from VF cardiac arrest are as high as 74 percent. Currently, only about 5 percent of all sudden cardiac arrest victims survive.

With these statistics in mind, and with the full backing of its CEO, Diebold originally worked with a company that provided "soup to nuts" management of corporate AED programs. Although the program proved successful and enabled Diebold to provide adequate response times during a number of occurrences, the company continued to strive to do it better.

Diebold took the first step toward a better program by naming Tim E. Kerstetter manager of corporate safety, responsible for directing the development, implementation, and administration of corporate safety policies, programs and procedures. Kerstetter actively works to create a safer environment for Diebold associates. This includes the expansion of Diebold's new Emergency Medical Response Team (EMRT) program, which was created specifically to assist associates with medical emergencies in the workplace.

In addition to 24 years of engineering experience, Kerstetter brought a unique set of qualifications from his background in fire safety, rescue, and EMS. He also is an experienced Fire Prevention Bureau officer and is certified as a fire safety inspector and arson investigator. "I have a unique perspective on safety planning based upon years of experience and education in the engineering, fire safety, and EMS fields," says Kerstetter.

After an extensive review of Diebold's current program, he took over management of a new, corporate AED program. An extensive review of available AED training programs resulted in the selection of an authorized training provider to guide Diebold in its new, corporate AED program needs. "I had been trained and certified in another program before accepting the manager of corporate safety position, so there may have been a natural inclination to keep things the same," Kerstetter says, but the chosen provider's offerings "were simply superior."

Stepping Up to the Challenge
Because Diebold has more than 100 facilities nationwide, implementing an extensive AED program posed significant challenges. However, in its continuing quest to be a leader, Diebold closely followed the American Heart Association's AED program implementation guidelines to ensure a successful rollout. Kerstetter said the company thus ensured its AED program would be based on best practices. Diebold registered its AED devices, implemented a plan for AED maintenance, and contracted with a company that could provide physician oversight for the AED program to ensure that medical supervision was consistent at each Diebold location.

Key Steps in AED Implementation

The company decided it would be best to implement the AED program first in its North Canton headquarters facility. After determining the initial rollout location and date--November 2002--the concept of the EMRT was developed. Working in a controlled setting, the new EMRT and AED program could be tested and proven. It also would demonstrate corporate commitment to and the importance of the program as Diebold launched the programs to additional facilities.

To help recruit volunteers for the EMRT, e-mail correspondence was sent to all area associates providing general information about the success of AED programs with AED and CPR trained personnel. Letting associates know Diebold was committed to their health and well-being created an initial sense of pride and an eagerness to participate in the new program. "Our associates knew that everybody could benefit from this program, thus the response was tremendous," Kerstetter says. "This eagerness to participate has only increased with time, as we are continually receiving new requests to join the EMRT."

It quickly became obvious the EMRT program was providing a valued service with minor medical situations, as well as positively impacting morale. The program was so appealing to employees that more than 200 of Diebold's 1,300 North Canton associates responded to initial inquiries for volunteers. It attracted a number of vice presidents, including Robert Warren, the company's vice president and treasurer, and Sheila Rutt, vice president of human resources. EMRT members ultimately were selected based upon past experience and location throughout the facility.

Kerstetter, who has completed four levels of AHA training, is Diebold's AED program administrator and lead instructor. Training for new EMRT members includes a unique training course that provides a complete health and safety training solution: It combines basic first aid and medical and injury emergency training, and teaches responders how to give CPR and use an AED. EMRT members are also trained in the course's optional environmental module, which covers topics such as extreme heat and cold, stings, and bites. Additionally, supplemental training is provided in emergency oxygen use, bloodborne pathogens, and HIPAA laws.

Diebold's training program also includes a review of team procedures and protocols for functioning as an organized team, as well as interacting with the company security guards and fire department paramedics.

The EMRT program has received the praise of senior Diebold executives. "By implementing corporate safety programs we ensure a safe, healthy, and accident-free work environment for Diebold associates," said Charles B. Scheurer, vice president, corporate human resources. "The EMRT program is a good example of our commitment to the personal safety of associates."

"Corporations can limit injuries, health care costs, and exposure to liability by utilizing comprehensive safety management plans," says Warren W. Dettinger, Diebold's vice president and general counsel. "Safety programs such as the EMRT provide a positive impact on the health and welfare or our associates, as well as the corporation."

After a successful launch at headquarters, Diebold implemented four additional EMRT and AED programs at other northeast Ohio facilities. Plans now are being developed for implementation in other locations. Locations with the largest concentration of associates or having the highest likelihood for accidents (such as manufacturing or assembly plants) are being evaluated first. "As budget cycles permit, we will continue on a steady course of implementing new EMRT and AED programs," Kerstetter says.

Getting the Word Out to Employees
Diebold's commitment to excellence did not end with the technical aspects of its corporate safety and AED programs. It extended to how the company communicated program details to associates and how the EMRT communicates among team members.

After the EMRT members are selected and trained, a notification sign is placed over each of their work locations. The signs feature the blue star of life symbol and are hung so they are easily visible on each floor. "Associates know that, in an emergency, these signs point to the people they need," says Kerstetter. "The signs serve as a continual reminder that our company seeks to provide the best in employee safety."

Diebold also created a "2-2-2-2" emergency hotline number that links directly into the security office. Associates are instructed to use this hotline if a medical emergency arises or to seek help if an EMRT member is nearby. As with any large, multi-entrance facility, Diebold's corporate headquarters could present a problem for arriving paramedics. This potential problem is avoided by having associates dial 2-2-2-2. Security personnel activate the EMRT and place the call to 9-1-1. They then coordinate the arrival of EMS with the EMRT, so an EMRT member is standing by to escort paramedics into the facility. Additionally, "Dial 2-2-2-2" is featured on the star of life overhead signage, and each associate's workspace includes a sticker with the 2-2-2-2 logo next to the phone.

To provide employees with information about the program, Diebold set up an EMRT Web page on the company's intranet with links to each facility, a list of EMRT members, maps, health and safety tips, and frequently asked questions. "The Web page offers each of our associates another means to access information about the program, pick up health and safety tips and hopefully, become proactive about safety in their own work areas and daily lives," says Kerstetter.

Finally, to ensure EMRT members can be contacted immediately in the event of an emergency (even if they are away from their work areas), four EMRT members at the headquarters facility are designated as primary responders and are on call each day. Each of the four primary responders carries a two-way radio while in the office. All EMRT members have the option of being placed on a rotating schedule to be on call.

Raising Industry Safety Standards
Diebold's disciplined approach in establishing its corporate safety and AED program holds many lessons for other corporations. First, although he obtained AHA Heartsaver Instructor status in order to lead the corporate training effort, Kerstetter recognized the need for training support. To help conduct training and maintain consistency across each newly implemented facility, AHA tailored a national training solution for Diebold. "It simply isn't cost effective for me to do all of the training, especially where we would like to move fast on implementation or where long distances and travel would add to the expense," he says, "and with the quick availability of all required materials, we are able to rollout a new program in less than 30 days."

In addition, centralized control of the program ensures that all training, AED devices, medical equipment, and required physician oversight approvals meet national guidelines. "Because each facility is implementing the same program, we can easily pinpoint site-specific issues and make adjustments as necessary," Kerstetter adds.

A guided, disciplined approach also facilitates funding of the necessary equipment and training. For example, Diebold realized AEDs are a critical component of its safety program. A single-source vendor is used to provide quick delivery of all AEDs and emergency medical equipment for the EMRT programs nationwide. Based on its size and number of associates, Diebold has three AED units (strategically placed) at corporate headquarters. The four northeast Ohio facilities have one each. Diebold anticipates doubling the number of new EMRT programs and AED units by year end.

Finally, Kerstetter believes that by following the leading, national guidelines, the company has achieved its most important objective: no serious injuries or deaths. It created a scenario for a rapid, prepared response including AED shock within three to five minutes, if necessary. "Though we have yet to use an AED since program implementation, our response time to less serious emergencies has been close to one minute, and we have had the equipment ready if needed," Kerstetter says. "This has really been a morale booster and created goodwill among our associates. We hope our AED training and equipment will never be anything more than an insurance policy, but we are confident that when a life-threatening emergency arises, we will be ready!"


Key Steps in AED Implementation

The American Heart Association recommends four key steps for implementing a successful AED program:

1. Securing physician oversight to help ensure quality control. AEDs require a physician's prescription and are sold as medical devices in most states. The American Heart Association recommends having a physician or other medical professional provide medical oversight for your program and help you select an AED.

2. Integrating your program with local EMS. Before implementing your AED program, check with EMS to determine local requirements. Some states require that you fill out an application and file a response plan. Local EMS also will want to know the brand and model of your AEDs, how many are on site, and where the AEDs are placed in your facilities.

3. Using and maintaining AEDs according to the manufacturer's specifications. It is important for users to be trained to use the specific AED at your site. AEDs require little upkeep, but regular "readiness for use" checks will ensure batteries and pads have not expired.

4. Training designated rescuers in CPR and the use of AEDs. When selecting responders, consider people who typically are on the premises and respond to emergencies as part of their jobs. The American Heart Association recommends a regular review of CPR and AED skills every six months for all potential AED users.

This article originally appeared in the October 2004 issue of Occupational Health & Safety.

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