Internal Management of Work Place Injuries

1. Internal Management of Work Place Injuries

2. Internal Injury Reporting and Routing WHEN AN WORK INJURY OCCURS AT BGH • Report work injury or accident to your manager / supervisor: • Supervisor and employee will determine whether medical care is indicated. • Fill out the BGH Employee Incident Form with the details of the incident and send to the completed form to Occupational Health. (File path: Public\BGH Forms, Information & Phone Lists\Occupational & Employee Health Forms) • If immediate medical care is needed, the employee needs to report to the BGH Emergency Department. • If immediate medical care is not indicated: Fill out the BGH Employee Incident Form with the details of the event, indicate if it is a report only, have it reviewed and signed by your supervisor and submit to Occupational Health. • If the injury needs to be medically evaluated but it is not urgent, complete the form as instructed above and call Occupational Health x1284 to be seen by the Occupational Health Provider. • Injury Evaluation Process: • A Work Release / Work Status Report Form will be generated for the injured employee after each medical evaluation and will include: Injury Diagnosis, Work Restrictions & Modified Work Duty and Information regarding follow up medical appointments. • A copy of the work restrictions will be scanned post appointment and sent to the department manager and human resources. The original signed copy will be provided to the injured employee. • The First Report of Injury (FROI) and all subsequent medical evaluation reports are generated after each appointment and shared with the organization’s surety case managers and or adjusters. The information provided in the report includes: • Mechanism of injury • Diagnosis • Work restrictions • Medications • Physical therapy • Plan for follow-up appointments • Referral to specialist • Bonner General Hospital Preferred Medical Providers: • Bonner General Hospital ED, BGIC for initial acute injury evaluation • Jim Lanthrop, FNP Occupational Health • Bonner General Orthopedics • Performance Physical Therapy • Under Idaho Worker’s Compensation system, the employer may assign a preferred medical provider for treatment of the injured worker. (Idaho Workers’ Compensation Law 72-432 (1)) • If a BGH employee wants to seek medical care outside of the designated BGH preferred providers, they can contact Payne West Insurance and request an outside referral through their case manager.

3. Internal Employee Incident Report Employee Incident Report Instructions: Complete this form for reporting all employee injuries, exposures, and work place illnesses. Please ensure a copy is provided to the employees manager, and the original is routed to Occupational Health Director. This is a report of an Employee: Injury Illness BBP Exposure Date of Incident: ______________________ Time Incident Occurred:____________________________________ This report is made by: Employee Supervisor Manager Other ____________________________ Name: _________________________________________________ Age: _________ Sex: Male Female Department: _________________________________ Job title at time of incident: ____________________________ Employee evaluated: Emergency Department Physician BGIC N/A – report only Step 1: Nature of Incident: Abrasion, scrapes Crushing Injury Fall/slip Amputation Cut, laceration Needle Stick Broken bone Hermia Exposure DPIM Bruise Illness Struck by / against Burn (heat) Sprain, strain Caught on / in between Chemical Exposure Damage to a body system Aggravation of previous injury Concussion (to the head) Allergic reaction Other ____________________ Step 2: General Location of Incident: Admitting Health Information Nursery Business Office Home Health OB Cafeteria Hospice Outpatient Infusion Central Supply HR/Marketing/Education PACU Clinic ___________________ ICCU/Telemetry Pharmacy Gift Shop Information Systems Rehab Services _______________ Diagnostic Imaging Laboratory Respiratory Therapy Dietary Laundry SDS Elevator (which one? ______________) Maintenance/Shop Sterile Processing ER Materials/Dock Surgery Rm __________________ General Premises – Exterior Medical/Surgical Wound Care/Coag. General Premises – Interior Other: _______________________________________________________________________________________________________ Exact location in the above marked area: ________________________________________________________________ What part of the employee’s workday? Entering or leaving work Performing normal work activities During meal period During break Working overtime Other: ______________________ Names of witnesses (if any): ___________________________________________________________________________ Brief narrative of incident: ___________________________________________________________________________

4. Internal Employee Incident Report Cont • Step 3: Why did the incident happen? • Unsafe workplace conditions: (check all that apply) Unsafe acts by people: (check all that apply) Inadequate guard Operating without permission Unguarded hazard Operating at unsafe speed Safety device is defective Servicing equipment that has power to it Tool or equipment defective Making a safety device inoperative Workstation layout is hazardous Using defective equipment Unsafe lighting Using equipment in an unapproved way Unsafe ventilation Unsafe lifting Lack of needed personal protective equipment Taking an unsafe position or posture Lack of appropriate equipment / tools Distraction, teasing, horseplay Unsafe clothing Failure to wear personal protective equipment No training or insufficient training Failure to use the available equipment / tools Other: ________________________________ Other: ________________________________ • Step 4: How can future incidents be prevented? What changes do you suggest to prevent this incident/near miss from happening again? Stop this activity Guard the hazard Train the employee(s) Enforce existing policy Redesign task steps Train the supervisor(s) Routinely inspect for the hazard Redesign work station Write a new policy/rule Personal Protective Equipment Other: ___________________________________________ • What should be (or has been done) to carry out the suggestions(s) checked above? ___________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ • Step 5: Who completed and reviewed this form? (please print) Supervisor / Manager / Director: ________________________________________________________________ Department: __________________________________________________ Date: ________________________ • Step 6: Route to Occupational Health Director Date Received: __________________________________ Signature: ________________________________________ FROI : No Yes Claim #_______________________ Surety Contact: _________________________________________________________________________________________ OSHA Reporting: No Yes 300A Form Complete? No Yes

5. Quality, Safety, & Trending for Improvement • Monthly reporting of all internal employee injuries to the BGH Quality Committee and Safety Committee for tracking of injury types and if there is a trend that may initiate organizational focus on resources for: • New education / additional education for staff • New medical safety devices for use in patient care • New medical equipment. • New Processes to improve safety for employees

6. Managing Risk, Internal Coordination and MOD rate • Establishing an internal pathway for reporting all incidents and which ones need an FROI report. • Developing a relationship with a Preferred Provider to help coordinate care and the RTW process for worker injuries. • Trending for injury types for identification of areas of improvement and where to focus company resources.