safety and security - cranaplus baxter executive director nursing and midwifery, country health...
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SAFETY AND SECURITY GUIDELINES FOR REMOTE
AND ISOLATED HEALTH
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ii
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INTRODUCTION 02
HOW TO USE THE GUIDELINES 04
GUIDELINES SUMMARY 05
GUIDELINES AIMS AND ACTIVITIES 06
1AlwaysBeingAccompanied(NotAlone) 06
2BeingPreparedforRemoteHealthPractice 07
3EnsuringStaffResilienceandManagingFatigue 08
4CreatingaStableWorkforce 09
5TheEssentialNatureofCommunication 10andConnectivity
6TheAbilitytoPreventandDe-escalate 11
7IdentifyingHazardsandManagingRisks 12
STAKEHOLDER ROLES AND CONTRIBUTION 13
CONTENT
Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 1
CRANAplusacknowledgestheAboriginalandTorresStraitIslanderpeoplesasthetraditionalcustodiansofAustralia,manyofwhomliveinremoteareas,andwepayourrespecttotheirEldersbothpastandpresent.CRANApluscontributessignificantlytoimprovingthehealthofAboriginalandTorresStraitIslanderpeoplesbybuildingthestrengthoftheremoteandisolatedhealthworkforce.
CRANAplusSafetyandSecurityGuidelinesforRemoteandIsolatedHealth,2017,©CRANAplus,CairnsQLD.
Copyrightprotectsthispublication.ExceptforpurposespermittedbytheCopyrightAct1968,reproduction,adaptation,electronicstorage,andcommunicationtothepublicisprohibitedwithoutpriorwrittenpermission.EnquiresshouldbeaddressedtoCRANAplusPOBox7410,Cairns,[email protected]
TheprojecttodevelopthispublicationwasfundedbytheAustralianGovernmentDepartmentofHealth.
www.crana.org.au
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 2
INTRODUCTION
Workplace violence in remote health is an ongoing and escalating concern that presents unique challenges not faced in urban areas.
ThedrivetoimprovethesafetyandsecurityoftheremotehealthworkforcebecameanindustrywidepriorityfollowingthetragicmurderofremoteareanurseGayleWoodfordin2016.Thiscausedtheremotehealthindustrytocriticallyreflectonlongheldpracticesandchallengeitsacceptanceoftherisksthatwereroutinelyconsidered‘justpartofthejob’.
Inthe2016–2017financialyear,CRANAplusreceivedfundingbytheCommonwealthDepartmentofHealthtoundertakearemotehealthworkforcesafetyandsecurityproject.
Adiverserepresentativeexpertadvisorygroupinformedtheentireproject.Themembersofthisgroupincluded:
Christopher CliffeCEOCRANAplus,VIC;(Chairperson)
Geri MaloneDirectorProfessionalServices,(DeputyChairperson)CRANAplus,SA
Marie Baxter ExecutiveDirectorNursingandMidwifery,CountryHealthService,WA
Julianne Bryce SeniorFederalProfessionalOfficerANMF
Michelle GarnerExecutiveDirectorNursingandMidwifery,MountIsaQLD
Heather KeighleyActingChiefNursingandMidwiferyOfficer,NT
Assoc. Prof Sue LenthallCentreforRemoteHealth,NT
Dr. Jennifer MayDepartmentofRuralHealth,TamworthNSW
Rod MenereProfessionalOfficer,CRANAplus,NSW(ProjectOfficer)
Johanna NevilleRemoteAreaNurse/MidwifeApunipimaCapeYork,QLD
Lesley PearsonDirectorofClinicalOperations,SilverChainWA
Bobbi SawyerSocialWorker,TeamManager,CAMHS,SA
Rob StarlingChiefInformationOfficer,NACCHO,ACT
Tony VaughanChiefOperatingOfficer,RFDS,SA
ThecompletionofphaseoneoftheprojectsawthereleaseoftheNationalRemoteHealthWorkforceSafetyandSecurityReport:LiteratureReview,Consultation,andSurveyResults,inJanuary2017.ThereportincludedaliteraturereviewbuildingontheworkoftheWorkingSafeinRuralandRemoteAustraliaProject.Additionally,utilisingworkshops,surveysandsocialmedia,CRANAplusundertooka‘nationalconversation’withremotehealthstakeholders.
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 3
Thisprovidedanopportunitytoseektheviewsoftheworkforce,employers,andotherstakeholders,andtestexistingassumptionsontherealandperceivedissuesaroundsafetyandsecurity.
Thereportidentifiedseveralsignificantissues:
• Theneedforemployersandstafftoconducthazardidentificationandriskassessment,eventreporting,andworkplacereviewofsignificanteventsandnear-misses;
• Theneedforstafftobeaccompaniedon-call,andatothertimeswhenrisksareidentified;
• Theneedformorecomprehensiveandtimelyorientationofnewstaff;
• Theneedtopromoteindividualresilienceandmanagetheriskoffatigue;
• Theneedtoaddresshighworkforceturnoverandissuesrelatingtobullyingandharassment;
• Theneedforreliable,accessibletransportandemergencyafterhourscommunicationsystems,includingmonitoring,supportedbystafftraininginequipmentuse;
• Theneedtoprovideaccesstopatientinformationanddatainstaffaccommodation;
• Theneedforstafftrainingandpracticeincommunicationandde-escalationtechniques,tomitigatetheriskofconflictleadingtoviolence.
ThefullreportcanbeaccessedontheCRANApluswebsitewww.crana.org.au.
Recognisingthatthesafetyofstaffandservicesareessentialfortheeffectiveprovisionofhealthservices,theguidelinescontributetosupportingtwosignificantgovernmentinitiatives:TheCommonwealthWorkHealthandSafetyAct;andtheNationalSafetyandQualityHealthServiceStandards(StandardOne:GovernanceforSafetyandQualityinHealthServiceOrganisations).
Thegoaloftheseguidelinesistoprovidebroadstatementswithexamplesofactivities,whichcanbeimplementedbyemployers,serviceproviders,communities,clinicians,andotherstakeholderstoestablishandmaintainsafeandeffectiveoperatingsystemsinremotehealthservices.
Theguidelinesidentifysevensafetyandsecuritypriorityareas,eachofwhichistobeconsideredthroughthelenseoftheindividual,theteam,theemployer,theinfrastructure,theenvironmentandthecultureandcommunity.
Theseguidelinesprovideastructuredpathwaytoidentifyriskandprioritiseareasforimprovement.Ultimately,itwillbehighlyvaluabletodevelopagreednationalstandardsforremotehealthworkforcesafetyandsecurity.Standardswillprovideclear,measurableexpectationsonsafetyandsecurityissues,providinggreaterimpetustodrivereform.
Althoughdevelopedprimarilyforsmallremotetownsandcommunities,theseguidelinescanbecontextualisedtoanyareaorindustrythatrequireshealthserviceprovisioninanisolatedsetting.
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 4
1. Theinfographicprovidesasummaryoverviewoftheguidelinesandlenses.
2. Thesummarytableassiststoidentifythecomplexityofissues,rolesandresponsibilitiescontributingtoremotehealthworkforcesafetyandsecurity.
3. Moredetailedinformation,isprovidedundertheheadingofGuidelines,AimsandActivities.Thisinformationisprovidedasaguideonly.Activitiesshouldbedevelopedaccordingtothecontextofindividualservicesandcommunities,andwiththecontributionoflocalstakeholders.
4. Thefinalcomponentofthisdocumentprovidesactivitiesonhowdifferentremotehealthstakeholderscancontributetosafetyandsecurityissues.
Improved Safety and
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Safe
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Guidelines for Remote and Isolated HealthIndividual
Environment
Team
Infrastructure
Employer
Culture &Community
Workforce Stability Communication & Connectivity Prevention & De-escalation
Hazard Iden
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tion &
Risk
Man
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Alw
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panie
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lone) Preparation for Remote Practice Sta� Resilience & Fatigue Management
HOW TO USE THE GUIDELINES
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 5
GUIDELINESLENSES
Individual Team Employer Infrastructure Environment Culture and community
Always accompanied (not alone)
Adheretoworkplacesafetyguidelines.
Clinicpracticespreventexcessiveon-call.
On-callguidelinesreflect‘alwaysaccompanied’fullcomplementofskilledstaff.
Transportandcommunication.Reliablecommun-icationwithon-callsupportworker.
Zerotoleranceofviolence
Communitypartnershipsandsupport.Afterhoursserviceforemergencyonly.
Preparation for remote practice
Bepreparedfortheworkplace,undertakeorientation.
Providelocalorientation.Earlyhazardidentificationandprevention.
Comprehensiveorientationtobeprovided.Embedacultureofsafetyandreporting.
Securebuildings,adequatelighting,andpreventivemainte-nance.Monitoringandreviewofsystems.
Hazardandriskassessmenttraining.Workhealthandsafetyhierarchyofresponses.Industrycultureofsafety.
Orientation.Culturalsafetyeducation.Communityemergencyplan.
Staff resilience and fatigue management
Engageinclinicalsupervision,mentoringandself-carepractices.
Equitabledistributionofworkload.Proactiveresponsetocriticalevents.
Managementtraining.Supportivestaffsupervision.Proactiveresponsetofatigueandwellbeingissues.Servicefullystaffed.
Fitforpurposeandwellmaintainedequipmentandinfrastructure.
Serviceresponsetomanageclimateandmajorevents.Limitedworkandtravelhours.Manageteamtensions.
Improvecommunities’healthliteracyandcapacitytoreduceburdenonafterhoursservices.
Workforce stability
Careergoalsandplans.Communityparticipation.
Supportiveworkplaceculture.Shareworkloadandclinicalinterests.
Professionaldevelopment.Remotestaffrecreation.Exitinterviews,supportandcounselling.Leaveentitlements.
Safe,secure,adequatelyequippedandmaintainedaccommodation.Goodinternetaccess.Vehicleuseforrecreationalactivities.
Supportiveorganisationalculture.Proactiveresponsetobullying.
Communityeducationandprocessestoattractstaffandlimitattrition.Exitinterviewfeedback.
Communication and connectivity
Logallon-callworkandlocation.Establishandmaintainowncommunicationnetworks.
Teamdevelopmentandsupport.On-callstaffmovementsmonitoredbyobjectiveprovider.
Businesshoursandafterhourscommunicationsystems.Proactiveresponsetopossiblehazards.
Voice,datacommunicationwithinandoutsidecommunity.Powerbackupsystem.Clinicandmobile/emergencycommuni-cationandtransport.
Emergencycommunicationandtransportplan.
Healthserviceandcommunitymeetings.Problemresolutionprocess.
Prevention and de-escalation
Communicationandde-escalationskillsandexperience.
In-servicetraining.Alertsystemforhighriskpatients.Monitoringandreviewevents.Peersupport.
Maintainsafetypriorities.Supportcommunicationandde-escalationforstaff.
Abilitytocontrolclinicaccess.Goodaccessandegress.Saferoom.Noserviceprovisionatstaffaccommodation.
Culturalsafetyeducation.Positivecommunityandstaffrelations.
Localemployedstaff.Communityandhealthservicepartnerships.Communitytoalertstafftohazards.
Hazard identification and risk management
Orientation.Safetyprioritised.WorkplaceSafetyGuidelines.Auditandriskassessmenttools.
Ongoinghazardidentificationandresponse.Teamresponsetosafetyandsecurityissues.
Workhealthandsafetyrequirements.Workplacesafetyguidelinesdeveloped,resourced,monitoredandreviewed.
Programmedmaintenance.Infrastructureandequipmentaudit.Prioritisedresponseprocessforacutehazards.
Reduceimpactofisolation.Emergencyresponseplans.
Localculturalsafetyeducation.Communityalertstaffabouthazardsandparticipateinresponse.
GUIDELINES SUMMARY
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 6
1. Always Being Accompanied (Not Alone)
AIM
Cliniciansarenottobealonewhenattendingcall-outsafterhours,orduringbusinesshoursiftheyareattendinganunknowneventorhaveconcernsfortheirsafety.
ACTIVITIES
Individual• WorkwithintherequirementsandexpectationsofWorkplaceHealthandSafety
ActsandRegulations.
• SupportandadheretoWorkplaceSafetyGuidelines.
• Nottoworkunaccompaniedorinisolationuntilsafetyconcernshavebeenresolved.
Team• On-callrostersareapprovedandreleasedinadvance.
• On-callallocatedequitably,withnewstafforientedbeforebeingrosteredon-call.
• Thecareofacutelyill/returningpatientsisclinicallyconsideredtoreduceanyafterhoursburden.
Employer• UpholdWorkplaceHealthandSafetylegislativeobligations.
• Resourcingrequirementstomeetremotehealthservicesafetyguidelinesrecognisedinfunding.
• Develop,resource,implement,monitorandevaluatesafetyprocessesinallhealthcentres.
• Recruitandmaintainafullcomplementofadequatelyskilledstaff.
• Staffarenotrequiredtoworkunaccompaniedifsafetyconcernsareidentified.
Infrastructure• Fitforpurposetransportandcommunicationresourceswillalwaysbeavailable.
• Clinicianswillhaveaccesstoreliablecommunicationwithon-callsupportworkers.
Environment• Conflictresolutionprocessdevelopedtoresolveanyproblemsorcomplaints.
• Services,clinicians,patientsandcommunitiessupportzerotolerancetoviolence.
Culture and Community
• Communityandhealthservicespartnershipsdevelop,manage,andresourceafterhours(alwaysaccompanied)guidelines.
• Afterhourshealthserviceattendancelimitedtoemergenciesandcriticaleventsonly.
• Acultureofsafetyintheworkplaceispromotedandencouraged.
GUIDELINES, AIMS AND ACTIVITIES
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 7
2. Being Prepared for Remote Health Practice
AIM
Thehealthworkforcewillhaveundertakenthenecessaryeducationtobebothprofessionallyandpersonallypreparedfortheirroleinremoteandisolatedpractice.
ACTIVITIES
Individual• Prospectivestaffwillresearchremotehealthsafetyandsecurityissues,includingpathwaystoremote
practice,priortoseekingremotehealthemployment.
• Staffwillcompletepersonalpreparations(educational,financial,nutrition,emotional,andsocial)priortocommencingworkinremoteorisolatedsettings.
• Staffwillparticipateinworkplace/communityorientationpriortoplacementandonarrival,engageinmentoringpartnerships.
Team• Localorientationofnewstaff.
• Hazardanticipation,riskassessmentandpreventionundertakenroutinelyintheworkplace.
• Teammeetingsrespondtosignificanteventsandnearmisses.
Employer• Recruitmentagenciesandemployersshouldsupplypre-employmentinformation/preparationfor
applicantswhoaregoingtonewareasorcommunities.
• Initialemployerorientationshouldbecompletedpriortocommencingwork,withlocalorientationandcommunityculturaleducationoccurringonarrivalattheworkplaceandpriortocommencementofservicedelivery.
• Healthservicesshouldresourceandmonitorworkplacesafetystrategies.
Infrastructure• Securebuildings,vehicleparking,adequatelighting,maintenance,monitoringand
evaluationofsystems.
Environment• Hazardandriskassessmentincorporatedintomanagementschedules,withclinicstaffassessingand
respondingtoemergenthazardsandrisks.
• Workplacehealthandsafetyhierarchyofresponsesusedtoguideinterventions.
Culture and Community• Communitiesshouldcontributetoworkplaceorientationandculturalsafetyeducationpromotinga
communitypartnershipapproach.
• Communities,healthservicesandclinicstaffdevelopandpracticeemergencyresponses.
GUIDELINES, AIMS AND ACTIVITIES
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 8
3. Ensuring Staff Resilience and Managing Fatigue
AIM
Staffarepersonallyandprofessionallyabletorespondtothechallengesofremotepractice.Theriskoffatigueisminimisedthroughworkloadmanagement,supportivesupervision,timelyuseofleaveopportunities,andprioritisingofself-care.
ACTIVITIES
Individual• Accessclinicalsupervisionandmentoring.
• Monitorandprioritiseself-care,healthandwellbeing.
Team• Shareclinicroles/clinicalinterestsandon-callresponsibilitiesandparticipateinpeersupport.
• De-briefaftercriticaleventsandnear-misses.
• Pro-activeresponsewhensignificantissuesaffectingteammembersareidentified.
• Educatethecommunityontheroleofafterhoursservicesandthatcliniciansworkinglonghourson-callimpactonthefunctionoftheservicethenextday.
Employer• Ensureremotehealthmanagershaveinterpersonalandmanagementskillsand
trainingopportunities.
• Allocateprogrammeandon-callworkloadsequitably.
• Workwithcliniciansandcommunitiestolimitafterhoursserviceexpectations.
• Supportivesupervisionofclinicstaffwiththeopportunityfor‘timeout’followingcriticalincidents.
• Schedulestaffleave,limitingcapacitytodeferorclusterleaveentitlements.
• Monitor,identifyandrespondtoissuescreatingstafffatigueandchallengingwellbeing.
• Planandrecruittoensureafullcomplementofappropriatelyskilledstaff.
Infrastructure• Accommodationandclinicbuildings:designedandbuiltfitforpurpose;cycloneratedinnorthern
Australia;adequatelyequippedandmaintained.
Environment• Flexibilityofworkhourstoaccommodateclimateextremesorsportingandculturalactivities.
• Identifyworkrelatedtravelaspartoftheworkingday.
• CliniciansandManagersproactivelyrespondtotensionswithinteams.
Culture and Community• Buildcommunityhealthliteracytoself-manageminorailmentsafterhours.
• Limitafterhourshealthserviceexpectationstocriticalcareandemergencies.
GUIDELINES, AIMS AND ACTIVITIES
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 9
4. Creating a Stable Workforce
AIM
Maintainaregularandreliableworkforce,alongwithareduction/managementofstaffturnoverandchurntopromotesafe,qualityandreliableremoteserviceprovision.
ACTIVITIES
Individual• Developamedium-termcareerplan.
• Engagewithcommunityresidentsandothers–participateinsocialactivities.
• Identifypersonalneedsandhowyoucanachievethesewhileworkinginremotehealth.
Team• Shareworkloadandclinicalinterests.Adjustrolestoincludetheinterestsofincomingstaff.
• Worktogethertocreateandsustainasupportiveteamenvironment.
Employer• Structuredrecruitmentandorientationprocessestopreparestaffforplacement.
• Supportivestaffsupervisiontoensuremanagersintervenebeforestaffburnout,andtoreducethepotentialforbullyingwithinteams.
• Plancliniciancoversostaffcanscheduleleaveentitlements.
• Managersareeducatedandpreparedfortheirroles,includingstaffwellbeingandcreationofworkforcebenchmarkstomonitorsuccess.
• Structuredexitinterviewwithresultsconsideredindividuallyandcollatedforreviewbymanagementandcommunities.
• Respondtorecognisedstafffrustrationsincluding:accommodationsafety;excessiveon-calldemands;andlackoflocaltransportforstaff.
Infrastructure• Safe,secure,adequatelyequipped,cleanandwellmaintainedaccommodation.
• Internet/datalinkandphoneconnectioninstaffaccommodationwithcostsco-shared.
• Healthservices,communitiesandcliniciansconsiderinnovativewaystomakeafterhourstransportaccessavailableforstaffwhohavenolocaltransport.
Environment• Supportiveclinicalandhumanresourcemanagementculture.
• Pro-activemanagementresponsetobullyingandotherissuesaffectingstaffwellbeing.
Culture and Community• Communityeducationaboutlimitingstaffattrition,includingexitinterviewfeedback.
GUIDELINES, AIMS AND ACTIVITIES
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 10
5. The Essential Nature of Communication and Connectivity
AIM
Ensurethatreliableandeffectivecommunicationandtransportsystemsareavailabletomitigateriskstotheremotehealthworkforce.
ACTIVITIES
Individual• Developandmaintainsocialcontactswithinandoutsidethecommunity.Utilisingsocialmedia,
participationinprofessionalorganisationsandpersonalsocialmediacontacts.
• Trainingforsafeandeffectiveuseofhealthservicetransportandcommunicationequipment.
Team• Orientincomingstafftosafe,effectiveuseoftransportandcommunicationequipment.
• Scheduledauditandtestoftransportandcommunicationequipment,includingmaintenance,repair,safetyandsurvivalequipment.
• Scheduledteammeetingstoidentifyissues,reviewsignificanteventsandnearmisses.
Employer• Developandimplementanon-callcommunicationsystemthatmonitorsandrecordslocationofstaff
anddurationofcallout,includingrealtimemonitoring24/7.
• Ensurethatremotehealthserviceshavereliable,effectivephoneanddatacommunication,includinginallvehiclesandaccommodation.
• ArobustmaintenanceschedulewithauditedcomplianceagainstKPIsforrespondingtofaults.
• Ensurethatstaffaretrainedandexperiencedinusingallequipment,includingtrouble-shootingproblemswithsatellitephonereception.
• Fitforpurpose,adequatelymaintainedvehiclessuppliedtoremotehealthfacilities,withstafftrainedintheiruse.
• Trainingandexperienceindistancetravelonbushroadsinvaryingconditionsdayandnight.
Infrastructure• Reliable,effectivevoiceanddatacommunicationwithinandoutsidethecommunity.
• Emergencypowerback-upsystemforcommunicationsequipment.
• Mobilecommunications,monitoringand/oremergencyassistequipmentavailable.
Environment• Emergencytransportandcommunicationsplantomanageseasonalextremesand
environmentalrisks.
Culture and Community• Regularmeetingswithhealthservicestaff,managersandcommunityrepresentatives,including
policeandeducation.
GUIDELINES, AIMS AND ACTIVITIES
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 11
GUIDELINES, AIMS AND ACTIVITIES
6. The Ability to Prevent and De-Escalate
AIM
Theremotehealthworkforceisequippedwitheffectiveinter-personalcommunication,preventionandde-escalationskillstomanagebullyingandharassment,andreducetheincidenceofeventsescalatingtoviolence.
ACTIVITIES
Individual• Includecommunication,de-escalationandsafetyinprofessionaldevelopmentpriorities.
• Practiceandreflectoncommunicationandde-escalationstrategies,includingself-awarenessandyourroleinescalatingorsettlingpotentialconflict.
• Researchyourrightsandresponsibilitiesinrelationtobullyingandharassment.
• Processexperiencesandeventsthroughclinicalsupervision,mentoring,communityengagementand/orcontactwithBushSupportServices.
Team• Ongoinghazardidentificationandresponse,includinghi-riskclientregister/alertsystem.
• Promotesupportiveteamculturetomanage/reviewsignificanteventsandnearmisses.
Employer• Workplacehealthandsafetyrequirementsfulfilled
• Allafterhourscaretobeprovidedintheclinic,notatstaffaccommodation.
• Monitorandreviewepisodesofworkplaceviolence,respondingtohazardsandrisks.
• Educationandtrainingoncommunication,de-escalationandemergencyresponsestrategiestodevelopstaffcapacitytodefuseescalatingsituationsandprioritisetheirownsafety.
• Supportivestaffsupervision,engagingandrespondingearlytoemergingevidenceofdeterioratingstaffwellbeingorindicationsofbullyingandharassment.
• Supportive,rapidresponseforstaffwhohaveexperiencedtraumaticevents.
Infrastructure• Saferoominclinicwithdualaccessandinternalcommunicationlink(phone/radio).
• Clearviewofclinicentrances,withaccessabletoberestricted/controlled.
• Clinicandaccommodationalarmsystemswithinternal(community)alarmsandexternalmonitoring.
Culture and Community• Localcommunityprovidesculturalsafetyeducation.
• Communityalertstaffaboutemerginghazardsandcooperateindevelopingandimplementingasaferesponse.
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 12
7. Identifying Hazards and Managing Risks
AIM
Aproactivescheduleofmonitoring,evaluationandworkplaceauditstoidentifyandrespondtohazardsandrisks.
ACTIVITIES
Individual• Developskillsusingworkplacesafetyguidelinesandriskassessmenttools.
Team• Hazardidentificationandriskmanagementanagendaiteminteammeetings.
• Reviewandrespondtoallnear-missesandsignificantevents.
Employer• WorkHealthandSafetyobligationsfulfilled.
• Workplacesafetyguidelinesresourced,implemented,monitoredandreviewed.
• EmployerWorkHealthandSafetyreviewsscheduled.
• Reviewandrespondtoallsignificanteventsandnearmisses.
• Eventsandnear-missesreported,datacollatedandusedinqualityimprovementactivities.
• On-callandbusinesshourssafetyplanimplemented.
• Orientationincludesuseofworkplacesafetyguidelinesandriskassessmenttools.
Infrastructure• Safe,secure,well-litclinic,accommodationandvehiclestorage.
• Bi-annualinfrastructureandequipmentauditcompleted.
• Alertsystemsinplaceforrespondingtoimmediatehazardsthroughanemergencymaintenancesystem.
• Aplanforstaffsafetyifinfrastructureistemporarilyinsecure.
Environment• WorkplaceHealthandSafetyGuidelinesreduceimpactofisolationandenvironmenton
staffandservices.
• Emergencyresponseplansdeveloped,resourced,andpracticed.
Culture and Community• Culturalsafetyeducationdevelopedandprovidedbylocalcommunity.
• Communityalerthealthstaffabouttransienthazards,andparticipateinresponse.
GUIDELINES, AIMS AND ACTIVITIES
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 13
STAKEHOLDER ROLES AND CONTRIBUTION
Employers
Role Contribution
Developandimplementtheadministrativeandclinicalservicesrequiredtoprovideasafeandsecureworkenvironmentfortheremotehealthworkforce.
Ensuresafeworkplace,accommodation,communicationandtransportfacilitiesandequipmenttoachieveNationalmodelOHSrequirementsandenableclinicianstoimplementsafetyprotocols.
FulfillegislatedOHSrequirementsie:workplacesafetycommitteeandworkplacesafetyrepresentatives.
Conductfacetofacemeetingswithcommunitymanagementandcouncilrepresentativestoensurecommunitiesareawareandsupportiveofsafetyprotocols.
Providetrainingandsupporttoensurecommunitiesareabletocontributeasrequiredtoimplementeffectivesafetyprotocols.
Informcommunityifspecificservicessuchason-callarebeingsuspended,orstaffarebeingevacuatedatanytimeduetocriticaleventsorsafetyguidelinesnotbeingabletobeimplemented.
Develop,resourceandimplementstandardoperatingprocedures/safetyguidelinestopromoteandfacilitatecliniciansafetyatwork,inemployerprovidedaccommodation,andwhileoncall.
Providetimelyorientationfornewstaffthatidentifiesworkplacesafetyandsecurityguidelines,andpracticalexperienceinuseoffacilitiesandequipment.
Incorporateinformationandtrainingaboutculturalsafetytraining,safety,security,andriskassessmentintostafforientation.
Ensurearapidandsupportiveresponsetostaffwhohaveexperiencedsafetyandsecurityproblems.
Thefollowingisalistofsignificantstakeholderswhocontributetothesafetyandsecurityoftheremotehealthworkforce.Farfrombeinganoverwhelmingandseeminglyintractableissue,therearemanyinterventionsabletobeimplementedthatwillcontributetoimprovingworkforcesafetyandsecurity.
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 14
STAKEHOLDER ROLES AND CONTRIBUTION
Workforce Agencies
Role Contribution
Promotethesafetyandsecurityofclinicians/employeesrecruitedtoremoteareahealthservicesthroughendorsementandimplementationoftheNationalGuidelines.
Agenciesseekwrittenworkplacesafetyguidelinesandconfirmationofimplementationfromemployersseekingtorecruitstaff.
Agenciesinformprospectiveapplicantsofbasicsafetyandsecurityguidelines,andacuteeventsplacingstaffatincreasedrisk.
Suspendrecruitmenttospecificserviceproviderpendingissueresolutionifstaffcontractedthroughyouragencyhaveidentifiedthatprotocolsarenotdocumentedorimplemented.
Collectivelydevelopsafetyandsecuritystandardsforthenurseagencyindustry.
New and Incoming Remote Area Staff
Prepareyourselfprofessionally,clinicallyandpersonallyforyourremoteareaworkforceexperience.
Beinformedabouttheprospectivejob,locationandprofessionaltransition.
Initialinternetandsocialmediasearchandfollowupidentifiedorganisationsandtopics.
ReadNationalSafetyandSecurityGuidelinesandenquirewithemployer/agencyregardingactiveuseofworkplacesafetyguidelines.
Askforacopyofworkplacesafetyguidelines,includingon-callprotocols
Applytoworkwithemployersandrecruitmentagenciesthatsupportidentificationanduseofsafetyandsecurityguidelines.
Considerseekingfeedbackfromotherstaffwhohaveworkedinthelocationyouareconsidering.Keepinmindthatexperiencescanvary.
Seekinformationandadvicefrompeakprofessionalorganisations.
The Existing Remote Workforce
Engagewithallrelevantstakeholderstopromoteimplementationandasrequired,developmentoforrefinementtoworkplacesafetyguidelinesbasedonan‘alwaysaccompanied’approach.
Contributeto,andworkaccordingtoworkplacesafetyguidelines.
Informandsupportincoming/newstafftoworkaccordingtosafetyguidelines.
Donotofferclinicalserviceorotherwiseplaceyourselfatriskuntilsafetyguidelinesaremet.
Ensureinformationaboutsafetyguidelinesisavailableinthehealthcentreandelsewhere.Opportunisticallydiscussguidelineswithotherstaffandcommunitymembers.
Promotecommunitycooperationin‘alwaysaccompanied’strategies.
Informemployerandcommunityrepresentatives,withasmuchnoticeaspossible,ifspecificservicessuchason-callavailabilityarebeingrestrictedduetoriskissues.
ContacttheBushSupportServices,CRANAplusoryourunionifsupportisneeded.
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 15
STAKEHOLDER ROLES AND CONTRIBUTION
Communities
Role Contribution
SupportlocalcliniciansintheprovisionofviableandeffectiveremoteareaPrimaryHealthCareServices.
Discussrequirementsofsafetyprotocolsandidentifyhowcommunitycontributioncanbeachieved.
Participateindiscussionsandnegotiationswithhealthservicemanagementaboutsafetyandsecurityissues.
Contributetoeffectiveimplementationofsafetyandsecurityguidelines.
Promoteresidentadherencetosafetyguidelines.
Agreeonandimplementbackupoptionsasneededtoensuresafetyprotocolsareabletobeimplemented.
CRANAplus – the professional body for remote and isolated health
Industryadvocacy,professionalsupport,andeducation.
Lead(andchampion)ImplementationofNationalremoteareasafetyandsecurityproject.
Industryinformationaccessthroughwebsite,magazineandprintresources.
Trainingthroughexistingandproposedcoursespromotingsafetyandsecurityaspartof,andinadditiontoclinicalroles.
Developmentofprofession(notworkplace)orientationforincomingclinicians.
Continuingadvocacyonsafetyandsecurityissues.
Participateinresearchinitiativesanddevelopmentofpublicationscontributingtobodyofworkonsafetyandsecurityinremoteandisolatedhealthsettings.
CRANAplus Bush Support Services
24-hourprovisionofpersonalsupport,counselling,andreferraloptionsfortheremoteareaworkforceandfamilymembers.
CounsellingService
PrintandOnlineResources
BullyingApp
ResearchandAdvocacy
Police
Protectionoflifeandproperty. Negotiateandliaisewithhealthservicesregardingco-operativesafetyandsecurity,planningandresponse.
Staffinremotesitesparticipateinacollaborativeresponsetoandmanagingsafetyandsecurityissues.
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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 16
STAKEHOLDER ROLES AND CONTRIBUTION
Researchers and Educators
Role Contribution
Educationandtrainingofprospectiveandexistingclinicians.
Prioritisingandconductingresearch,supervisingpostgraduateresearch.
InclusionofworkforcesafetyandsecurityinformationandNationalguidelinesincoreunitsofallprogramsacrossthesectorsinvolvedineducationprogramsfocusingonremoteandisolatedhealthincludingtransitionprograms.
Clinicaleducationincludesassessmentofstaffsafetyandsecurityinrelevantunits.
Newresearchproposalstoconsiderexistingandemergentsafetyandsecuritypriorities.
Industrial Organisations
Professionaladvocacy,industrialinformationandadviceformembers.
Documentinformationaboutsafetyandsecurityrisksandinterventionsonwebsiteandjournaltoempowerclinicianstopromotetheirownwellbeingandprovidesafe,effectivehealthservicesinremotecommunities.
Respondtospecificindustrialeventsorrequestsforassistancefrommembers.
Professional and Peak Bodies
Varyingrolesrepresentingandadvocatingformembershipissues,orspecificinterestgroupswithinmembership.
Advocacygroupssupportingdevelopmentofsafetyandsecurity,policyandbestpracticebymembership.
Sectoraladvocacy,policyandresearchsupport.
Worksafe Australia
Policy(Nationally)implementationandmonitoringoflegislated/regulatedworkplacesafetyandsecurityguidelines(StateandTerritory).
Remoteworkforcesafetyandsecurityissuesinformationandadvice,respondingtoproblemandpriorityimprovementnotices.
Provideadvicetoorganisationsandindividualsaboutrightsandresponses.
AllocateaPriorityImprovementNotice(PIN)toalocationorserviceproviderifsignificantsafetyrisksareidentified.
‘
Regulatory Authorities
Role Contribution
ClinicianRegulationandprotectionofthepublic.
ImplementPractitionerComplaintsSystem
Acknowledgecontextandseekexpertcontributioninmanagementandassessmentofcliniciannotification.
Governments
Legislationandpolicydevelopmentandreview.
ReviewofWorksafeguidelines(COAG)toconsiderhowWHSregulationscanbeimplementedandrespondedtoinatimelymannerinveryremoteareas.
Developmentofmandatedstandardsandincludeintherequirementsforfindingserviceproviders.
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Safety and Security Guidelines for Remote and Isolated Health
the peak professional body for the remote and isolated health workforce | www.crana.org.au 17
www.crana.org.au
CRANAplus DIRECTORYCAIRNS HEAD OFFICEADDRESSSuite2WallamurraTowers189–191AbbottStreetCairns,QLD4870
Tel 0740476400Fax 0740412661
POSTALPOBox7410Cairns,QLD4870
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www.crana.org.au
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