Practice Tips

Proactive safety management helps to ensure a safe environment in the physician office practice. The following recommendations can be used as a guide in developing an environmental safety plan.

Environmental Safety Plan

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

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.
• Regular testing and maintenance and education for staff for all call bells and safety bars.
• 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; if office has toys, make sure cleaning is scheduled and done 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.
• Install signage to identify walkways.

Life Safety: Americans with Disabilities Act (ADA)

• The Americans with Disabilities Act (ADA) requires medical care providers to make their services available in an accessible manner.
• Requirements under the ADA can be found at this link: https://www.ada.gov/medcare_mobility_ta/medcare_ta.htm

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. If possible, make sure the patient is not alone if they are a known fall risk.
• 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.
• Inspection of office equipment for functionality and integrity. Use a specific tag from facilities to show the inspection has been completed. Facilities or clinical engineering should have proper training and be competent to complete inspections.
• Follow manufacturer requirements for preventative maintenance and safe usage.
• Store oxygen tanks that are not in active use in upright stands to prevent falling and explosive discharge of contents.
• Store oxygen away from flammable items.

Fire Safety

• Develop a fire safety plan for your practice.
• Conduct fire drills as required by state and local ordinances.
• Identify evacuations routes for office practice.
• Ensure elevators have signage warning not to use 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.
• Maintain Safety Data Sheets (SDS) in a central office location or electronically. Ensure that all employees have access to the SDS.
• Obtain a spill kit to manage accidental spills of contaminated material.
• Provide alcohol-based hand rub when sinks are not accessible.
• Store needles and syringes in a locked area.
• Proper process in place to dispose of needles and sharps in approved containers that are puncture resistant and have a lid that prevents reaching in. Label as hazardous material. If this is a contracted service, review the contract annually.

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

• Develop a plan for addressing medical emergencies in the practice.
• Train staff to respond to medical emergencies.
• Conduct periodic drills of your medical emergency plan.
• Locate all emergency equipment in an accessible location.
  • Inspect emergency equipment monthly for proper functioning. Record inspections on a log.
• If applicable, emergency drug box is maintained by completing the following:
  • 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.
  • Maintain a breakaway lock on the emergency drug box.
  • Store in a central location inaccessible to patients.

Medication Safety

• Store medications throughout the practice in a lockable space accessible only to authorized personnel.
• Secure prescription pads from unauthorized access. Do not store prescription pads in a drawer in an examination room.
• Perform refrigerator temperature checks each day (twice daily for vaccines) and record on a monthly log.
• 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 (Centers for Disease Control) Immunization Program, discard opened multi-dose vaccines according to the manufacturer's expiration date.
• If medication samples are in the office practice, please reference our practice tip Medications: Distribution of Sample Medications in the Practice Setting.

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’s  Compliance Assistance Quick Start to ensure your practice is in compliance with all OSHA standards.

Resources

Americans with Disabilities Act