Practice Tips

Online library

Environmental Safety in the Physician Office Practice

Proactive safety management helps to ensure a safe environment in the physician office practice. Use the following recommendations as a guide in the development of an environmental safety program.

  1. Environmental Safety Plan

    Operational

    • Develop a safety plan that describes how to maintain a safe environment. Include the role of the physicians and employees.
    • Conduct walk-around inspections on a regular basis to identify potential risks. Correct identified risks.
    • Encourage physicians and employees to report unsafe or potentially hazardous conditions. Immediately remedy high risk situations.

  2. Plan Elements

    Life Safety: Office Setting

    • Arrange furniture away from traffic areas.
    • Remedy sharp table corners and worn carpeting.
    • Install call bells and safety bars in patient restrooms.
    • Remove clutter, equipment and obstacles from walkways.
    • Limit height of stacked materials to prevent collapse.
    • Maintain stairwells with firmly attached handrails and adequate lighting.
    • Identify glass doors with emblems.
    • Clearly mark all exits.
    • Check emergency exit signs for visibility and lighting.
    • Test emergency lighting.
    • Allow only toys large enough to prevent swallowing with no breakable pieces or sharp edges; clean toys routinely.

    Life Safety: Grounds and Parking Areas

    • Remove snow from parking areas and walkways as needed.
    • Frequently sand/treat icy areas.
    • Repair uneven surfaces, potholes, and cracks.
    • Remove debris.
    • Maintain adequate lighting to minimize shadows; replace burned out bulbs.
    • Install signage to identify parking entrances and exits.

    Life Safety: American Disability Act

    • Access from entrances, sidewalks, and parking facilities through the door of the facility is barrier free.
    • Access to areas in which the services or goods are made available to the public are barrier free.
    • Access to restroom facilities for the patient or client is barrier free.

    Fall Prevention

    • Closely monitor occupants of waiting areas. Observation may be accomplished with mirrors.
    • Clearly identify wet floors and steps with a warning sign.
    • Seat the patient in a chair in the exam room, not on the exam table, while awaiting the physician. Do not leave a patient alone if they are at risk for a fall.
    • Provide chairs in exam rooms that are stable (no wheels) and have armrests. Provide exam tables that are stable with easy access for patients.
    • Assist unstable patients with accessing the exam table, opening doors or maneuvering through corridors.

    Electrical Hazards

    • Keep electrical outlets in good condition.
    • Store electrical cords appropriately to prevent tripping hazards.
    • To maintain child safety, utilize plugs for electrical outlets or install child safe outlets.

    Equipment Safety

    • Properly ground equipment.
    • Inspect office equipment for functionality and integrity.
    • Follow manufacturer requirements for safe usage.
    • Store oxygen tanks that are not in active use in upright stands or chained together to prevent falling and explosive discharge of contents. Store oxygen away from flammable items.
    • Preventatively maintain equipment.

    Fire Safety

    • Check for signage warning that elevators are not to be used in a fire emergency.
    • Place fire alarms and fire extinguishers in an accessible area.
    • Service fire extinguishers annually.
    • Install No Smoking signage in designated areas.
    • Routinely inspect sprinkler system.

    Hazardous Materials; Infection Control

    • Label and store hazardous products in appropriate containers in a locked storeroom.
    • Provide sufficient supplies of personal protective equipment.
    • Store Material Safety Data Sheets (MSDS) in a central office location.
    • Obtain a spill kit to manage accidental spills of contaminated material.
    • Provide alcohol-based handrub when sinks are not accessible.
    • Store needles and syringes in a locked area and dispose of in approved containers that are puncture resistant and have a lid that prevents reaching in. Label as hazardous material.

    Emergency Preparedness

    • Ensure federal, state and local standards have been met regarding disaster preparations.
    • Conduct various mock emergency drills to test response, skills, equipment and proficiency.

    Medical Emergency

    • Locate emergency equipment in an accessible location.
    • Inspect emergency equipment monthly for proper functioning and record on a log.
    • Inspect the emergency drug box monthly for supply adequacy and medication outdates. Record inspections on a log stored inside the drug box.
    • Resupply the emergency drug box after each use and at designated intervals when necessary (monthly).
    • Maintain a breakaway lock on the emergency drug box and store in a central location inaccessible to patients

    Medication Safety

    • Store medications throughout the practice in a lockable space accessible only to authorized personnel.
    • Inspect medications for out-dates monthly and document inspection and lot number on a log; include medications in exam rooms and storage areas. Return outdated samples according to the established standards in your city/town. Please reference our practice tip, Medications: Distribution of Sample Medications in the Practice Setting.
    • Secure prescription pads from unauthorized access. Never pre-sign or postdate a prescription. Do not store prescription pads in a drawer in an examination room where they are accessible to patients who may be unattended.
    • Dispose of opened multi-dose medication vials 28 days after opening. Label opened multi-dose vials with date opened and/or date of expiration. For Joint Commission accredited facilities, label with date of expiration. Per the CDC Immunization Program, discard opened multi-dose vaccines according to the manufacturer's expiration date.
    • Perform refrigerator temperature checks each day (twice daily for vaccines) and record on a monthly log.
    • Store controlled substances in a double-locked space with access restricted to authorized individuals.
    • When adding a new sample in the drug inventory, choose a storage location that separates it from other drugs with a look-alike or sound-alike name and/or similar packaging.

  3. Environmental Safety Education
    • Educate new physicians and staff on safety practices and expectations.
    • Provide annual safety education to physicians and employees.
    • Train physicians and staff on the proper use of equipment and recognition of product hazards.

Medical office practices should review the Occupational Safety & Health Administration (OSHA) A Guide to Compliance with OSHA Standards to assure your practice is in compliance with all OSHA standards. The guide can be found at: https://www.osha.gov/Publications/OSHA3187/osha3187.html

Additional essential information on safety in the physician's office is located within the following MMIC Practice Tips. A Safety Walk-around Checklist is accessible in the forms section of our website.