Nashville Hospital's VPP Journey Recounted

A presentation by officials from Saint Thomas Health, TOSHA, and federal OSHA traced the Midtown Hospital's four-year effort to become the first health care VPP site in the state last year.

NASHVILLE -- Achieving VPP certification is especially challenging for health care organizations, illustrated by the fact that there are only 14 hospitals, seven ambulatory health care services, and 11 nursing and residential care facilities among more than 2,000 OSHA VPP sites. But a Nashville acute care hospital in June 2012 became the first health care facility in the state to receive the Volunteer STAR Award from the Tennessee Occupational Safety & Health (TOSHA) division of the Tennessee Department of Labor and Workforce Development. A presentation at this week's 29th Annual National VPPPA Conference explained how the Saint Thomas Health Midtown Hospital, then known as Baptist Hospital, achieved it.

Amy Williamson, OSHA/VPP project/patient handling coordinator, explained that it took four years of work, steadily reducing the facility's injury rate so that its three-year average would be low enough to be eligible. She listed the teams that were formed to focus preventive efforts in specific areas, such as workplace violence and needlesticks.

Employees were designated as safety coaches to train, coach, and encourage safe behaviors, and the hospital increased employees' awareness and usage of patient handling equipment, such as ceiling lifts.

OSHA recordkeeping was a challenge, she said, because they realized as they were pursuing VPP certification that some events were being incorrectly included on their 300 summary logs. These included a patient's exposing about 70 employees to pertussis, none of whom became ill, and needlesticks with sterile sharps, she said.

Ultimately, the facility's personnel and leaders managed to reduce the overall injury rate by 50 percent from FY2008 to FY2011. Patient handling injuries declined by 74 percent during the same period, with only 10 recorded during FY2011; employee needlesticks fell by 47 percent (to 24 in FY2011) and employee falls by 32 percent, Williamson said. She said the hospital's TRIR rate in FY2011 was 12 percent below the national average for health care, and its DART rate was 24 percent lower.

Jim Flanagan, who manages the TOSHA VPP program and was a member of the on-site team that evaluated the hospital, said the evaluation "was very educational to us" because it was the state's first VPP evaluation to involve remote sites, and it involved unique hazards and preventive measures. Almost all of the sites previously admitted to the state's VPP program were manufacturing facilities, he explained. "I guess the biggest education for us was the hazards they were dealing with," with patient handling, bloodborne pathogens, and needlesticks being the hospital's top hazards.

"We really want to serve as a model for other hospitals in Tennessee and across the country by integrating associate safety into everything we do," Renee Kessler, chief operating officer of then-Baptist Hospital, said in June 2012. "We want to keep our own employees safe first so they're then able to take care of the patients we serve. We took this monumental step in focusing on this because we believe in taking care of our people. It's the right thing to do."

Carla Slaughter, OSHA VPP supervisor, participated in the presentation. She and Flanagan said additional health care employers are seeing the advantages of VPP and have expressed interest in qualifying for the program in Tennessee, Flanagan said, or in the OSHA Challenge program.

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