Keeping an eye on safety pays off. (Not-for-Profit Report).

Whether you work at Disney World, Wal-Mart, XYZ Construction or a long-term care organization, safety is elemental in providing a quality work environment. Employees expect to leave work in the same condition as they arrived. Often, though, this doesn't happen. A trip, slip, stumble or fall can trigger a domino effect of problems: lost workdays, workers' compensation claims, medical bills, short staffing, increased insurance premiums and poor staff-retention rates.

As The Evergreens in Moorestown, New Jersey, grew from a 100-bed nursing home to a continuing care retirement community, our staff size doubled and our resident population tripled. With growth came increased workplace injuries and, in 1996, our management took a major step in heading off this growing problem by forming The Evergreens Safety Committee, whose mission statement is "to evaluate unsafe conditions that affect our residents, visitors, employees and facility; be continually aware of our surroundings and recommend to administration issues that will correct/improve unsafe conditions and make The Evergreens a safe place to live and work."

To execute this philosophy, the Safety Committee met with our insurance broker and agent, who provided valuable insights and statistics on slips, trips, falls and back injuries. We supplemented this input by talking to other facilities about their safety issues and how they resolved them. We educated ourselves with OSHA and other safety guidelines. Our facilities manager asked our local police, fire and EMT services about what they needed us to do to optimize their effectiveness on an emergency call.

Armed with this information and a common-sense approach, The Evergreens Safety Awareness Program has gone beyond focusing on preventing work-related accidents and injuries; we reach out to our residents and provide helpful safety advice and intervention. One of the biggest hits from the residents' viewpoint has been the inclusion of weekly safety tips aired on the in-house TV channel. The tips are fun and are often suggested by residents who are not officially Safety Committee members. Our program also includes monthly audits of work and residence areas, as well as monthly meetings to discuss safety issues and ways to implement corrective actions.

The committee is an across-the-board representation of our entire population, which means that we approach safety from a variety of perspectives. For instance, a nurse will be more aware of an unlocked med cart than would someone in maintenance. On the other hand, that same maintenance worker is more apt to observe a potential hazard from a different perspective--the med cart has a broken caster. Meanwhile the DON observes that it was left unattended in an area where residents gather. Perspectives such as these expand the range of observations that identify potentially unsafe conditions. If our staff and residents weren't "safety savvy," these hazards might go unnoticed.

A dramatic illustration of our safety program happened during our expansion:

Problem. Administrative staff discovered a shortcut through a linoleum-floored corridor at the back of the kitchen. Although spacious, it was filled with utility carts and hot-meal delivery wagons. To facilitate delivery, the floor was sloped, which didn't initially present a problem because dietary staff wear the proper footwear for this environment. Within a six-month period, there were three falls by administrative staff using this corridor wearing street shoes.

Solution. On the recommendation of our insurance broker and our agent representative, the Safety Committee contacted a manufacturer that for less than $1,000 installed a pebbly traction runner in that corridor. Now, six years later, it's still there and not one fall event has occurred. The savings from medical expenses and lost workdays has paid for that flooring and has enabled management to direct these savings to other programs.

The Evergreens Safety Committee is the champion of our organization's safety culture. Committee membership is open to everyone. It has become an opportunity to develop and/or recognize staff with leadership potential. Working with the committee, I really got to know which people displayed leadership qualities that we could target for other roles in the organization. Serving on the committee gives an employee a chance to stand up and be heard.

Another benefit of the program is that day-to-day management of claims keeps costs under control. Knowing the status of each injured worker, making modified duty accommodations, if needed, and showing the company's concern are top priorities. By managing each claim, overall results improve and are reported at management meetings. It's a big deal. Our insurance broker and agent make a presentation, and all Safety Committee members are invited. The president acknowledges everyone's efforts; then the committee presents the results using graphs, charts and written documentation that give credence to the importance of safety. The meeting gives line staff exposure to the financial impact of the program, as well as individual recognition for their contributions. They hear firsthand that "we've had another great year. Injuries are down." They also hear actual statistics, such as "Claims have dropped 72%." These meetings show the business side of our efforts. That's something I think we often miss with our line staff--a connect-the-dot cause and effect. It gives them a chance to see the big picture and their roles in it.

Committee members also reinforce The Evergreens' safety "conscience" through an annual safety fair. The fire department hands out pamphlets on every fire safety concern, from the use of fire extinguishers to what to do in a home or work fire situation. We also provide health screenings, such as blood pressure testing. Our insurance provider has sponsored chair massages for fair attendees. Our environmental services company has also participated, providing valuable information about the chemicals we use for cleaning. Virtually any vendor can participate to offer advice, provide safety education or interact with customers, whether they are CNAs, administrators, nurses, maintenance personnel, etc.

The key is to not only have the fair be informative, but also fun. We bring in the popcorn machine, decorate and provide little giveaways. One year we gave away whistles to illustrate our concerns about personal safety for our employees and residents. It also gives us a chance to recognize the committee members for their efforts with a recognition pin, boutonniere or corsage.

At The Evergreens, we have created nearly 20 new procedures as a result of safety initiatives. Our commitment to safety has proven itself statistically, as well as in high morale and resident confidence. In 1994, our turnover rate was well above 50%, but we project we'll end the year in the mid-teens. That drop is a result of good management and especially the safety program. High retention translates into better resident care because of the consistency and stability in staffing. In 1996, our experience modifier, which is the basis for computing workers' compensation premiums, was 1.36 (1.0 is average). Our current modifier is 0.83. That reduction caused our premiums to drop every year for five years. Our average claims costs have decreased more than 72%. Most importantly, we have had no injuries that resulted in lost workdays for two consecutive years. And the biggest investment we've made to achieve all this has been our time.

Cindy Bowers is vice-president of resources at The Evergreens in Moorestown, New Jersey. For more information, phone [phone], fax [phone], e-mail [e-mail] or visit www.evergreens.org.