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.
- Environmental Safety Plan
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Ensure federal, state and local standards have been met regarding disaster preparations.
- Conduct various mock emergency drills to test response, skills, equipment and proficiency.
- 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
- 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.
- 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.
Medical Mutual Insurance Company of Maine's "Practice Tips" are offered as reference information only and are not intended to establish practice standards or serve as legal advice. MMIC recommends you obtain a legal opinion from a qualified attorney for any specific application to your practice.