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Standard Operating Policy
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Work Related Fatigue Mitigation and Management Policy
Document No.
File No.
Date issued Contents Policy Statement Work Related Fatigue Mitigation and Management Policy
Guideline G1: Definitions of Fatigue Mitigation and Management Options
Protocols P1: Assessment of fatigue level P2a: Notification of fatigue (no on call component / corporate) P2: Notification of fatigue P3: Return to full availability P4: Post-fatigue Management
Examples E1: Sample Timesheet
Appendices A1: Rostering Protocol E4 (Notification of Fatigue) A2: Rostering Protocol E5 (On Duty Planned Leave)
Author Branch General Manager Operations
Branch Contact Ken Pritchard
Division Operations – State Headquarters
Summary The purpose of this policy is to set out the fatigue mitigation and management framework for Ambulance employees.
Applies to All Ambulance staff and Volunteers
Review Date June 2014
Previous Reference SOP2008-005
Status Active
Approved by Chief Executive
Related Documents Rostering Protocols and Procedures Fatigue-related Control Centre Protocols and Procedures WorkCover Code of Conduct Work Health & Safety Act 2011
Revision History Version (Circular Review V0.1 Sept 13 ) Amendment notes
Sept 13 SOP2012-xxx
Approval for issue
Compliance with this policy directive is mandatory
Standard Operating Policy
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Policy Statement: Work Related Fatigue Mitigation and Management PURPOSE The purpose of this policy is to set out the fatigue mitigation and management framework for Ambulance employees. The management of fatigue is a shared responsibility between Ambulance and its employees. The objective of this policy is to:
• promote a safe and healthy working environment free of work related injury or illness; • minimise the risks of employees presenting for work or conducting work while impaired; • establish appropriate steps to manage employees who are affected by fatigue; and • encourage employees affected by fatigue to seek assistance.
WHAT IS FATIGUE? Work related fatigue is a state of mental or physical exhaustion that can affect a person’s ability to function normally at work. More than feeling tired and drowsy, work related fatigue is a physical condition that can occur when a person’s physical or mental limits are reached. Fatigue is cumulative and directly correlates to periods of sleep and activity. Where employees are ‘on call’ and do not get adequate rest and sleep between periods of activity, they may experience mental or physical tiredness. This may manifest as:
• difficulty in concentrating and becoming easily distracted; • poor judgment and decision making; • reduced capacity for effective interpersonal communication; • reduced hand-eye coordination and visual perception; • reduced vigilance; • slower reaction times; and • reduced memory.
Fatigue related impairment is an identifiable workplace hazard. The most effective means to manage fatigue is to have adequate restorative sleep. RESPONSIBILITIES FOR MANAGING FATIGUE Employees Are responsible for commencing a shift, or a series of shifts, in a fit and proper physical and mental state. Rostered days off provide an opportunity to rest and employees should ensure that activities undertaken while off duty do not leave them fatigued at the commencement of a rotation of rostered shifts. Employees are also responsible for:
• Participating in education and training as provided in order to gain an understanding of fatigue; • Avoiding behaviours and practices that contribute to fatigue, and which could place themselves and others at
risk – for example, secondary employment, or not using time off work to recuperate; • Recognising signs of fatigue that could place the health, safety and well-being of themselves or others at risk
and reporting this to their manager or supervisor. Supervisors & Managers Have a responsibility to monitor access to fatigue mitigation and management strategies. These responsibilities include:
• Applying risk management strategies in consultation with staff; • Providing opportunities for employees to obtain adequate rest from work; • Monitoring workloads, work patterns and rostering arrangements; • Providing information, instruction and training about risks to health, safety or welfare of employees involved
with shift work, extended hours and on-call arrangements; • Ensuring employees performing shift work have proper supervision and that tasks are undertaken safely; • Assisting employees with non-work fatigue related issues.
Control Centres
Standard Operating Policy
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Have a responsibility to consider fatigue in dispatching resources and to monitor access to fatigue mitigation and management strategies. These responsibilities include:
• Communicating at handover staff who have or are accessing fatigue options • Providing opportunities for employees to obtain adequate rest from work, for eg; Providing crib breaks and
minimising unnecessary extension of shift • Proactive management of demand during on duty and on call periods, in particular consideration to responses
at near or end of shift • Applying risk management strategies in consultation with staff and relevant supervisors & managers;
FATIGUE IN EMPLOYEES ROSTERED WITH NO ON CALL COMPONENT Fatigue management is an essential component of work and health safety and patient safety. The Operational Ambulance Officers Award provides for a minimum 10 hour break between shifts except in case of an emergency and by agreement between the Service and the employee (Clause 22(e)(i)). The Award also provides that an employee who works so much overtime after the completion of their shift on any day that results in less than eight consecutive hours off duty before the commencement of their next shift will be released after the completion of such overtime until they have had eight consecutive hours off duty, with no loss of pay for ordinary working time occurring due to such absence (Clause 22(e)(ii)). Employees who work according to a roster which does not have an on call component, and who experience fatigue should refer to Fatigue Protocol 2a in consultation your duty supervisor. FATIGUE IN EMPLOYEES ROSTERED WITH AN ON CALL COMPONENT Employeesrostered with an on call component and who have identified that they are fatigued are able to access a sleep in, reduced availability or rest in order to mitigate and manage their fatigue. There is no objective measure of fatigue for employees, and fatigue affects individuals differently. Employees rostered with an on call component are encouraged to continually assess their fatigue levels during periods of duty. Work arrangements for individual employees who experience ongoing fatigue when fulfilling on call duties may be reviewed by their supervisor/manager. This review may include temporary or permanent options to alleviate the impacts of fatigue. The fatigue mitigation and management options for employees rostered with an on call component are Sleep-in, Limited Availability and Rest (refer Guideline G1 for definitions and Fatigue Protocols 1-4 for application).
Standard Operating Policy
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G1 Work Related Fatigue Mitigation and Management Guideline DEFINITIONS 1. Assessment of Fatigue
• Employees should monitor and assess their fatigue level by: − Monitoring their own alertness and checking for fatigue related symptoms (such as difficulty in
concentration, loss of energy and initiative, lethargy, weariness, memory lapses and errors in decision making);
Using an Individual Assessment Tool • An Individual Assessment Tool (IAT) is a provided in this policy as a guide for all employees Sleep-in (up to
50% of the next shift length) • Sleep-in is a fatigue management strategy for employees rostered with an on call component. This allows an
individual paramedic to return to station and commence duty up to half way through their next rostered shift. • During the sleep-in period, the paramedic is an available resource and following a risk assessment by the
Control Centre may be tasked for all levels of responses. • In instances of repeated recall to duty whilst on sleep in the paramedic can extend the sleep in if necessary
2. Limited Availability (From time of notification and up to 50% of the next shift length ) • Limited availability is a fatigue management strategy for employees rostered with an on call component. This
allows an individual paramedic to return to station and commence duty up to half way through their next rostered shift.
• During the limited availability period, the paramedic is an available resource and following a risk assessment by the Control Centre may be tasked for 1A, 1B, 1C and other immediate responses.
• In instances of repeated recall to duty whilst on limited availability the paramedic can extend if necessary • Rest (From time of notification and up to 50% of the next shift length ) • Rest is a fatigue management strategy for employees rostered with an on call component. • It provides undisturbed rest from the time of notification and up to 50% of the next rostered shift.
NOTES
• Increased rest time: Where employees require an increased rest time greater than that provided in this policy supervisors &/or managers will make arrangements to reallocate subsequent on call wherever possible to provide employees time to recover from fatigue.
• Vehicle access plan: During a period of Limited Availability or Rest, operational continuity must be maintained by ensuring that the vehicle is accessible when necessary.
• Specialist Skills: Employees who are certified with specialist skills, such as Rescue, Special Operations and SCAT, are not to be used for specialist or technical deployments for up to 24 hours following the completion of a period of Limited Availability or Rest unless a comprehensive risk assessment is undertaken and documented.
• Repeated access to Limited Availability and Rest: Employees are not to be considered by supervisors & managers for overtime or additional on call duties in the first 24 hours of their days off.
• Staff welfare: Where employees have repeated instances of repeated access to limited availability or rest provisions then the supervisor/manager will conduct a welfare check and document this action. This provides employees time to recover from fatigue before returning to any type of duty.
• Recording access to fatigue mitigation and management options: Each Control Centre is responsible for recording instances of Sleep In, Limited Availability and Rest and updating this record when advised of changes.
• Crib penalties: Employees who access Sleep in, Limited Availability or Rest over their crib period may not claim crib penalties.
Standard Operating Policy
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Work Related Fatigue Mitigation and Management Procedure ASSESSMENT OF INDIVIDUAL FATIGUE LEVEL Purpose The purpose of this protocol is to guide employees rostered with an on call component in assessing their fatigue level. The assessment tool below utilises a matrix system to provide an indication of a person’s likely fatigue state. It works very similar to that of the Severity Assessment Code (SAC) scores used in the IIMS system. To determine a fatigue score the employee determines the amount of sleep obtained in 24hrs across the top, then determines the amount of sleep obtained in 48hrs down the side. Where these two scores intersect determines the overall fatigue score. Each matrix box is labelled with the recommended course of action to take however individual requirements may vary.
Standard Operating Policy
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P2a (No on call component) Work Related Fatigue Mitigation and Management Procedure NOTIFICATION OF FATIGUE Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage the identification and notification of fatigue in employees who undertake on duty activities.
Fatigue Protocol 2a (No on call component): Notification of fatigue
Fatigue Protocol 2a (Corporate): Notification of fatigue
Paramedic DOM Employee Manager
Paramedic feels fatigued and
cannot continue working
Call sick phone (Duty DOM)
Follow Protocol Rost E5 for on duty unplanned
leave
End
Employee feels fatigued and
cannot continue working
Call manager Authorise sick leave
End
Standard Operating Policy
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P2 Work Related Fatigue Mitigation and Management Procedure NOTIFICATION OF FATIGUE Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage the identification and notification of fatigue in employees rostered with an on call component.
Fatigue Protocol 2: Notification of Fatigue
Paramedic Duty Operations Manager Control Centre
Is IAT >5?
Do you need to mitigate fatigue?
Continue to monitor
Yes
Yes
No
No
Paramedic has conducted IAT
Is DOM on duty? Yes Call Duty DOM
No
Contact Control
Follow Protocol Rost E4
Request access to fatigue mitigation or management
option as per IAT; discuss vehicle
access plan
Ensure mitigation or management
option is recorded
Exercise fatigue mitigation or management
option
End
Standard Operating Policy
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P3 Work Related Fatigue Mitigation and Management Procedure RETURN TO FULL AVAILABILITY Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage a paramedic returning to full availability after accessing a fatigue mitigation or management option (for employees rostered with an on call component).
Fatigue Protocol 3: Return to full availability after accessing fatigue mitigation and management option
Paramedic Control Centre
Record sleep-in/Limited Availablity/Rest on timesheet and sign-on book
Paramedic is ready to return to
full availability
Contact Control Check paramedic welfare
End
Standard Operating Policy
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P4 Work Related Fatigue Mitigation and Management Procedure POST-FATIGUE MANAGEMENT Purpose The purpose of this protocol is to establish the activities, roles and responsibilities required to manage employees post-fatigue.
Fatigue Protocol 4: Post-Fatigue Management
Duty Operations Manager
End
Follow Protocol Rost E4
Contact control centre supervisor for fatigue update
Are roster changes required?
Yes
No
End
Confirm paramedic time of return to duty is
correct in myShift; check next on call,
check next overtime
Contact paramedic to check welfare
Run myShift fatigue report at
commencement of shift
Standard Operating Policy
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E1 Work Related Fatigue Mitigation and Management Example SAMPLE TIMESHEET FOR EMPLOYEES WHO PERFORM ON CALL ACTIVITIES
AM
BU
LA
NC
E S
ER
VIC
E O
F N
EW
SO
UT
H W
ALE
S
JO
B S
HA
RE
Empl
oyee
Wor
k Pa
ttern
FT
P/T
R
ED
UC
ED
HO
UR
SE
MPL
OYE
E T
IME
SH
EE
TTI
ME
SHEE
T1
OF
1
ALLO
WAN
CES
Day
Dat
eSt
art
Stop
Star
tSt
opSt
art
Stop
Star
tSt
opSt
art
Stop
OR
DP/
HO
RD
DB
LEP/
HO
RD
DB
LEP/
HTR
AVM
CP<
12C
P1C
P2C
A<12
CA1
CA2
OC
HD
LAH
C
A
LLO
WAN
CES
Day
Dat
eSt
art
Stop
Star
tSt
opSt
art
Stop
Star
tSt
opSt
art
Stop
OR
DP/
HO
RD
DB
LEP/
HO
RD
DB
LEP/
HTR
AVM
CP<
12C
P1C
P2C
A<12
CA1
CA2
OC
HD
LAH
C
CA
2: S
econ
d C
rib M
eal A
way
CP1:
Firs
t Crib
Pen
alty
CP2:
Sec
ond
Crib
Pen
alty
CA
<12:
Crib
Mea
l Aw
ay fo
r <12
hou
r shi
ftCP
<12:
Crib
Pen
alty
for s
hifts
<12
hour
s
Cla
ssifi
catio
n:
STA
TIO
N:
Cal
l Out
s
CA
1: F
irst C
rib M
eal A
way
C -
XXXX
Xsl
eep
in
Cal
l Out
sO
verti
me
AO
- XX
XXX
2109
slee
p in
C -
XXXX
X20
02
1800
C -
XXXX
X22
17
slee
p in
R
R
C -
XXXX
X02
11
0800
0800
Che
cked
By:
Perio
d En
ding
:
Ove
rtim
e
1030
1800
R
1800
0800
1800
R19
10
1800
0800
C -
XXXX
XLi
m A
v
0008
0529
0317
WED
23-S
ep
21-S
ep18
0018
00
1800
22-S
ep08
00
O/T
Empl
oyee
Dec
lara
tion
OFF
CO
ST
CEN
TRE
1811
Det
ails
of H
ours
Act
ually
Wor
ked
WEE
K 1
0537
0700
0645
1045
0433
0645
AO
- XX
XXX
R10
30
2021
1800
0700
R
C -
XXXX
X
OFF
OFF
15-S
epTH
U
WED
14-S
ep
19-S
ep
Ros
tere
d Sh
ift
OFF
20-S
ep09
30
0800
1200
1200
0930
R
1800
1800
C -
XXXX
X
R/S
R/S
O/T
O/T
O/T
O/T
R/S
R/S
O/T
O/T
O/T
CO
ST
CEN
TRE
OFF
ICE
USE
R/S
R/S
O/T
R/S
R/S
O/T
R/S
O/T
R/S
R/S
OFF
ICE
USE
R/S
O/T
O/T
R/S
O/T
R/S
1700
12-S
ep11
2707
00C
- XX
XXX
0527
Res
t01
0402
3502
5904
1604
5005
27
Wee
k 2
FRI
13-S
ep
Empl
oyee
Num
ber:
Em
ploy
ee N
ame:
1800
2010
10-S
ep
Ros
tere
d Sh
ift
0116
0223
0450
C -
XXXX
X
I cer
tify
the
hour
s w
orke
d ar
e co
rrect
0700
1700
Tota
l Shi
fts
THU
FRI
TUE
0700
1700
SAT
MO
NC
- XX
XXX
SUN
0700
1800
0209
0407
C -
XXXX
X11
-Sep
18-S
ep
17-S
ep
16-S
ep
0800
SAT
SUN
OFF
1800
Tota
l Hou
rs
MO
N
TUE
0800
0800
1800
0800
C- X
XXXX23
4510
4518
00
1127
1700
R
R
Det
ails
of H
ours
Act
ually
Wor
ked
WEE
K 2
X
Standard Operating Policy
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A1 Paramedic Rostering – Fatigue Notification (Protocol Rost E4) (Protocols and Procedures for Paramedic Rostering, p. 52)
PARAMEDIC ROSTERING – FATIGUE NOTIFICATION PROTOCOL ROST E4
The purpose of this protocol is to establish the activities, roles and responsibilities required to manage paramedic fatigue notifications.
Paramedic Duty Operations Manager Control Centre Supervisor
There is a need to exercise a fatigue
mitigation or management option per the Fatigue
Policy
Notify the Control Centre Supervisor
of the change to the roster
Notify the dispatcher of the
instance of fatigue, note change to the
roster
Follow Procedure Rost D6.1 Backfill
vacancy
1 hr prior to day shift, review
operational need & contact the Zone
Manager if required
Are additional resources
authorised?
Notify the DOM and Control Centre upon
return to duty
End
Is the time of return different to
the myShift record?
No
Update the myShift record with the actual
shift start time
Yes
Notify the Control Centre Officer of the
outcome
Notify the Control Centre Supervisor of
the outcome
Log the instance of fatigue in myShift per Procedure Rost E4.1
Notify the Control Centre Supervisor
of the outcome
Exercise Rest Option as agreed
with the DOM
Is DOM on duty?
YesYes
NoNo
Call the duty phone to speak to
the DOM
Contact Control Centre Supervisor
Is DOM aware of paramedic
fatigue?YesYes
NoNo
Contact DOM at commencement of
shift
YesYes
NoNo
Notes Where, due to overtime commitments, a continuous break of 8 hours between shifts has not occurred prior to shift commencement, an amended re-commencement time needs to be confirmed with the paramedic and the Duty Operations Manager in accordance with Ambulance Officers (State) Award Clause 22(e)(ii). * As per the Ambulance Officers (State) Award Clause 23 (c), an employee who is called out for duty totalling 4 hours or more actual work within 8 hours of the scheduled commencement of their next rostered shift is entitled to exercise the Rest Options provision of the Service’s Fatigue Management Standard Operating Policy (SOP2008-005 or its replacement).
Standard Operating Policy
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A2 Paramedic Rostering – On Duty Planned Leave (Protocol Rost E5) (Protocols and Procedures for Paramedic Rostering, p. 53)
PARAMEDIC ROSTERING – ON DUTY UNPLANNED LEAVE PROTOCOL ROST E5
The purpose of this protocol is to establish the activities, roles and responsibilities required to manage situations where a paramedic reports that he/she requires on duty unplanned leave, e.g. due to sickness or injury.
Note: At times when the Deployment Officer is off duty, the Duty Operations Manager should carry out the activities of the Deployment Officer.
Paramedic Duty Operations Manager Deployment Officer Control Centre
Supervisor
Contact the DOM on the Duty Phone
Check on the welfare of the
Paramedic
Identify the need for on duty unplanned leave
Yes
No
Is a replacement
resource required?
Notify the Control Centre Supervisor
Update the Unplanned Absences register in
myShift per Procedure Rost D1.3
Follow Procedure Rost D6.1 Backfill
vacancy
Notify the Control Centre Officer of the
change to the area staff sheet
Notes
• If a paramedic does not attend training due to sickness, the training instructor should notify Sector Office. Refer to Protocol Rost D2 Training Change Requests.
• The Duty Operations Manager should review operational needs to determine whether replacement resources are required.
• The DOM should advise the paramedic to submit Form 243 and other necessary paperwork to the Officer in Charge as soon as possible.
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