European Agency for
Safety and Health at Work
Sarah Copsey
The Agency: www.agency.osha.eu.int
• Provides information
• Networking
• Coordinates
• Information services
• Information projects
• Agency website –
dissemination means
Why the health care sector?
• European concern
• Sector has been highlighted as a
priority by the Member States
• Common risks across Europe
Most frequently identified
sectors at risk by OSH Authorities
(Agency 2000)
Se c to r D e sc rip tio n
C o n stru c tio n
To ta l N u m b e r
o f Tim e s
Id e n tifie d
M a n u fa c tu re o f
F a b ric a te d M e ta l
P ro d u c ts, e x c e p t
M a c h in e ry a n d
E q u ip m e n t
A gric u ltu re , H u n tin g
a n d re la te d se rv ic e
a c tiv itie s
H e a lth a n d So c ia l W o rk
M a n u fa c tu re o f F o o d
P ro d u c ts a n d B e v e ra ge s
Healthcare sector: greater risks of
• Violence
• Stress
• Bullying
• Work directed by social demands
• Reproductive hazards
• Biological infections
• Heavy loads, poor postures
• Occupational ill health/diseases
• Sickness absence
Plenary 1: The hospital –a staff
empowering workplace
Agency for
Safety and Health at Work
Thursday 19th May 2005
Health care sector: other risk factors
• Accidents
• Chemicals
• Shiftwork, hours
• Work organisation
• Content and forms of work
Report by the Dublin Foundation, “Working conditions in
hospitals in the European Union” 1995
Health care sector: risks
• Risks arise from
– Physical conditions
– Organisational restrictions
– Social environment
• 3 groups most at risk
– Nursing staff – includes assistents and
– Service and trade workers
– Laboratory staff and anaesthetists
Report by the Dublin Foundation, “Working conditions in
hospitals in the European Union” 1995
Good practice examples
• Violence prevention –
Dutch hospital
• Violence – Irish
• Stress prevention –
Spanish elderly care
• Stress audit tool –
Irish hospital
• Stress – improving
shift rotas, Finnish
• All EU languages
Safe care plan: prevention of violence in
hospitals - Netherlands
• Cooperation between hospital, regional police
and Public Prosecutors Department
• Cooperation between the management board and
works council
• Survey– most incidents in reception, accident and
emergency, psychiatry, evenings, nights and
• Working party from staff in at risk departments
draw up risk inventory
• On hospital room plan colour risk level -red –
high, yellow – medium, green – low
• Measures based on discussion of risk inventory
• Links to tripartite hospital
safety agreement
Safe Care Plan (2): No tolerance system
• All incidents reported
• Card system for serious aggression
• Yellow card for serious threats, reported to
• Red card for physical violence – reported
to police and brought before public
• Posters about policy in public places and
media to inform public
• Police provide information/advance notice
• Staff carry alarms, to alert security staff
• Cameras linked to alarms
Safe Care Plan (3) supporting measures
based on risk analysis:
• Patient environment
measures – e.g.
information about
waiting times
• Staff training about
all aspects
• On agenda of
consulting meetings,
police invited
• After incident
Violence to hospital staff - Ireland
• Visible management commitment
• New report form, reporting positively
encouraged, electronic database
• Multidisciplinary working group and h&s
consultants --> risk assessment and
prioritised recommendations
• Comprehensive framework - Measures
covering anticipation, prevention,
intervention, support and evaluation
Violence to hospital staff – Ireland:
measures (1)
• Safety of physical environment and work
• Non-violent crisis intervention programme –
staff trained as trainers
• Increased security presence
• Alarm systems and better CCTV coverage
• Closer working with the police. Police
liaison officer to work with hospital
• Prosecutions in serious cases
• Information for staff, public awareness
through local media
Violence to hospital staff – Ireland:
measures (2)
• Improvements for
patients, e.g. waiting time
• Staff feedback system
Stress prevention in an old people’s home
– Spain – (1) how:
• Cooperation between management, trade
unions and the local insurance
• Risk assessment of the work and a staff
• Problems found included:
High work load
Lack of information
Lack of decision making responsibility
Little possibility of promotion
Unforeseen events/changes of plan
Physical work conditions and physical effort
Stress prevention in an old people’s home
– Spain – (2) solutions:
• Increase staffing levels during peak
• Staff training to deal with emotional
• Specifying functions and competencies
of nursing assistants –e.g drug
• Communication protocol for risks
• Increasing worker autonomy, discretion
• Clear definitions of content of tasks
and responsibilities, in an agreement
• Providing lifting aids, hoists
• Promoting worker
Stress prevention in an Irish hospital (1)
Problem identification:
• Workshops about stress and solutions
• Anonymous questionnaire
• Group discussions of the results
Problems included:
• Shifts and the starting time of shifts
• Lack of showers and other facilities
Stress prevention in an Irish hospital (2)
• Change shift starting times
• Consultation with an expert to establish a
new shift system
• Installation of showers in an unused area
Physiotherapist’s work rotas - Finland
Objective – to increase employee control
over their work rotas
• Supervisor set a framework for rotas
• Employees plan own rotas within
• Training on the system and planning rotas
Result – better compatibility with home- life,
improved services for the hospital
Success factors in psychosocial risk
prevention initiatives
• Adequate risk analysis
• Thorough planning and a stepwise approach
• Combination of measures covering anticipation,
prevention, intervention, support and evaluation
with main focus on collective prevention
• Context-specific solutions
• Experienced practitioners and evidence-based
• Social dialogue, partnership and workers’
involvement. Continuing staff feedback
• Violence - liaison with external bodies – police,
judiciary, local community – includes prosecution
• Sustained prevention and top
management support and resources
Elements of empowerment in OSH processes
Informed and Trained
Involved through participation
Given control, responsibility
• No-blame approach
• Commitment – to participation and
prevention at source
• Participatory arrangements
• Involvement in: identifying problems and
solutions, implementation,
monitoring and feedback

No Slide Title