Health Care Workers Story

Lessons and learnings

What does ISO 45001 have to do with our safety at work?

By A/Prof David Allen, Consultant Occupational and Environmental Physician.

Hospitals are like small towns or cities with many varied and complex tasks and hazards. These include hazardous substances, manual handling risks, mental health issues, radiation, violence, and infectious diseases like COVID-19. Costs of injuries and illnesses in healthcare can be huge, and a big drag on the bottom line. Good safety management systems can help to control those costs and ensure that scarce funds are not wasted on preventable injuries or illnesses.

ISO 45001 is an international standard for a safety management system published by the International Standards Organisation Standards Australia also has an SMS (safety management system) standard, AS/NZS 4801 (Occupational health and safety management systems) but this is older, and many organisations are moving to the newer ISO 45001 standard. Common standards include areas like environmental management, medical devices, quality management systems, food safety, camera film speeds, telehealth, seatbelts etc.

One pertinent standard is AS/NZS 1715 “Selection, use and maintenance of respiratory protective equipment”. When respiratory protection is needed, a respiratory protection program should be drawn up, covering:

  • assessment of exposure to airborne contaminants.
  • selection of appropriate respirators.
  • assessing employee health to ensure they can wear a respirator.
  • fit-testing and regular training of employees regularly.
  • inspection, repair, cleaning, storage, and replacement of respirators
  • review of program to ensure it works.
  • maintaining records of all of this.

An example of respirator selection for industry is here. As you can see, there are no surgical masks listed. And even of non-hazardous “nuisance odours” i.e. bad smells, the minimum recommendation is N95 standard! COVID-19 is much worse than a bad smell!

Safety can be defined as reduction of risk to a level that is as low as is reasonably practicable. A safety management system is a proactive and integrated approach to managing safety including the necessary organisational structures, accountabilities, policies and procedures. It is a holistic way to identify and monitor hazards and control risks as well as maintaining confidence that these risk controls are effective.

It is not just a bunch of documents and paperwork, but requires safety management to permeate all activities of an organisation. This means developing a pervasive culture that reflects safety objectives. It is “how an organisation does business”. Safety is considered in all business decisions, and at the highest level of the organisation – CEOs and board. Thus, it is pushed down by them with a serious commitment to make it better. Every person must work towards better safety for all.

Organisations have an implied moral and legal obligation  to protect the health, safety and welfare of their workforce (and visitors) and there is ample research to show that good safety management saves money for organisations by reducing the costs associated with workplace injuries and accidents. Indeed, for larger organisations it can be the difference between making a profit and going broke.

Workers compensation premiums can rise dramatically if there are many claims – and they are “geared” to be much greater with bigger payrolls. The expectation is that bigger organisations (as opposed to small businesses) should have better resources, staff, and an obligation to better manage safety.  In a nutshell, good safety is good business.

A typical safety management system should include:

  • An over-arching commitment by senior management and staff to improve safety and health
  • Activity schedules and improvement plans
  • Documentation and record keeping
  • All staff having a clear understanding of their responsibilities
  • Clear processes to cover all tasks performed
  • All staff are involved in safety management
  • Identifying hazards with regular inspections of environmental issues which could impact upon the health of employees
  • Systematic maintenance of all plant and equipment
  • Investigation of accidents, incidents and near misses
  • Managing all contractors and sub-contractors
  • Training and record keeping of training activities
  • Managing staff wellbeing
  • Scheduled audits of the safety management system to ensure it is working

Ideally the system should be audited regularly by an auditing organisation e.g. GlobalMark or Lloyds, to ensure that is genuinely being implemented and is working for the organisation. This oversight pushes the organisation to drive the system. In my experience this is very important and good discipline.

This also allows the issue of a formal certificate to the organisation (e.g. there is only one public hospital in Victoria with ISO 45001 certification, Austin Health in 2018-2019). This “stamp of approval” is good for the reputation of the organisation, makes them a more attractive employer, and is good for the bottom line. It is designed such that is pays for itself and assists in saving money and preventing harm.