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Improving the safety culture in 2014

January 8, 2014
by Steve Wilder, CHSP, STS
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I had the privilege of visiting several long-term care (LTC) facilities last year, and I saw an array of safety management programs. They ran the gamut between nonexistent and outstanding. In those organizations with less-than-stellar programs, I saw some commonalities:

  • They didn’t want to hear what I was telling them, so they considered it nonsense.
  • Their mind-set was that “not having it in the budget” was a defense for noncompliance.
  • They figured the chances of visit by the Occupational Safety and Health Administration (OSHA) were slim to none, so they weren’t worried about it.

As they say in baseball, three up and three down. I’m not faulting these facilities. This is a tough industry, and every administrator whom I visit reminds me how challenging it is to provide quality care, recruit and retain good employees, and make budget. I understand that, but I’m not the one you have to worry about.  

Fortunately, it’s not too late to change your culture and make workplace safety a way of life in your facility or community. It starts with knowing where the greatest hazards exist, and where to begin to remedy them.

When I perform a safety audit at a client site, I typically start by looking at the areas that an OSHA safety and health compliance officer (SHCO) would look at on a compliance visit. If you look at these areas and take the necessary steps to be compliant with the regulatory standards, you’ll start to see a dynamic improvement in your safety management program.

Let’s explore the areas where the majority of your losses occur and where the SHCO will put the bulk of his or her time and attention.


In this blog, I use the term ergonomics as it relates to resident handling. You know about the back and shoulder injuries that result from improperly lifting and transferring residents. You’ve heard enough on that topic By the same token, every facility or community must have a written safe resident handling plan that addresses these high-risk activities and prescribes methods to minimize the risk to workers.


Every area of your building presents potential slip, trip and fall hazards. Your challenge is twofold: (1) to create a culture where every employee knows that he or she is responsible for eliminating the hazards, and (2) to have an organized program in place to perform periodic safety assessments, identify hazards and implement corrective actions.

Most of the time, when we think of slip, trip and fall hazards, wet floors come to mind, and rightfully so. Slippery and wet floors do create a serious hazard that must be managed. Beyond slippery and wet floors, however, we also must think about broken floor tiles, carpet seams that are coming unraveled, unguarded floor openings, elevated work surfaces and other such hazards. Fix these, and you’ll be well ahead of the game.


Bloodborne pathogens consistently are the killer citations. What started out as a simple program to protect workers from exposure to blood and other potentially infectious materials has now become a monster. It has become detailed and complicated. Do not take this area lightly. Get serious about compliance. The key areas for which citations are issued recognize:



Steve Wilder

Steve Wilder


Steve Wilder, CHSP, STS, is president and chief operating officer of...