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Establishing a Personal Safety Response System:
What Organizations Need to Know
Frances Ziesmann, PSHSA Consultant
Presenter
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Frances Ziesmann PT, CRSP BSc, BScPT, MHM, DOHS PSHSA OH&S Consultant Health & Community Services Public Services Health and Safety Association Workplace Violence Project Lead
Workplace Violence Prevention
3
Agenda
• Background Violence Aggression and Responsive Behaviour (VARB) Project
• Purpose of the PSRS Toolkit • Legislation review related to PSRS • PSRS Definitions and Description • PSRS Part of Workplace Violence Prevention and Emergency
Management • PSRS using a systematic approach • PSRS Device Categories • Overview of PSRS Tools
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VARB Project
Solution Focused Approach PSHSA Toolkits
1. Workplace Violence Risk Assessment
2. Individual Client Risk Assessment
3. Flagging
4. Security
5. Personal Safety Response System
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6
Literature Review Jurisdictional Scan Focus Group
Confirm Priority Areas Design Toolkit Marketing Strategy Research & Evaluation Plan
Toolkit Pilot Implementation Knowledge Translation Education
Phase 1: Discovery
Phase 2: Design
Phase 3: Delivery
Steering Committee Leadership
Working Group Expertise
VARB Project
Prevention Framework
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PSRS is primarily in the prevention and protection sections of a prevention framework
PSHSA VARB Tools http://www.pshsa.ca/workplace-violence/
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https://workplace-violence.ca/
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VARB Tools: PSRS Toolkit
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https://workplace-violence.ca/tools/personal-safety-response-system/
PSRS Toolkit Purpose
• Assist organizations to establish an effective PSRS – not just about devices
• Provide definitions and background on PSRS
• Provide easy to use tools
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PSRS Toolkit Appendices 1. PSRS Legislation Checklist / Considerations 2. PSRS Gap Analysis and Action Plan Tool – PDCA cycle 3. PSRS Device Needs Assessment Tool 4. Overview of PSRS Devices & Features Tool 5. PSRS Device Assessment Summary Tool 6. PSRS SWOT Analysis Tool 7. PSRS Policy and Procedure Guidelines 8. PSRS Training Considerations and Evaluation 9. PSRS Awareness Fast Fact
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Occupational Health and Safety Act Section 32.0.2 (1) Employer shall develop and maintain a program to implement
the policy with respect to workplace violence required under clause 32.0.1(1)(a)
(2) Without limiting the generality of subsection (1) the program shall,
(b) include measures and procedures for summoning immediate assistance when workplace violence is to occur or is likely to occur
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Toolkit Page 2-3
Legislation Checklist Appendix A
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Topic Legislation PSRS Considerations
Compliance Yes / No / Partial
OHSA Employer Section 25
OHSA Supervisor Section 27
OHSA Worker Section 28
OHSA Joint H&S Committee Section 9(18)
OHSA Health & Safety Rep Section 8
OHSA Workplace Violence Section 32.0.2-32.0.5
Health Care Regulation Equipment
Section 44
Health Care Regulation Measures & Procedures
Sections 8 &9
Health Care Regulation Personal Protective Equipment
Sections 10 Toolkit Pages 42-54
What is a PSRS?
“The means or methods of communication and actions to manage an emergency such as a workplace violence occurrence or incident.
It includes measures such as PSRS devices, and procedural best practices or steps that operate together to help protect a worker(s)
from physical and/or psychological harm.”
Toolkit Page 4
15
What is a PSRS Device?
“Equipment (measure) that can be used to summon immediate assistance when violence occurs or is likely to occur, or when other emergencies occur that threaten a worker’s health and
safety.”
Toolkit Page 4
16
What is the Importance of PSRS? • Leverages technology and procedural best practices to
manage violent events and reduce harm
• Enables early identification and notification of workplace violence
• Fosters time for safe egress
• Facilitates rapid response and/or rescue of workers and others
17
Toolkit Page 5
PSRS Sequence of Events
Imminent Danger
Incident or Emergency
Alert Signal
Incident/ Emergency Response
A situation or event occurs threatening imminent danger to a worker or it may be workplace violence in progress or another emergency Signalling device
summons immediate assistance and this alert signal triggers an incident / emergency response
Response is a sequence of steps and actions to respond to an emergency, or incident e.g. code white, security, police response
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Toolkit Page 6 Figure 1. PSRS sequence of events
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Incident • A resident becomes
physically aggressive to a nurse while giving medications in the patient's room on the night shift
Alert Signal • Nurses presses her
personal panic alarm that is linked to other staff in the building who have been trained on security roles to respond and assist
Incident Response • Designated Co-worker
calls a code white and calls the police, and all code team members respond to assist
Putting Your Knowledge to Work
Incident •Community Nurse visits high risk client •Client in home becomes physically aggressive •Worker fails to check in at pre-determined web -based device check-in time
Alert Signal • Nurse activates her panic alarm e.g., Life Line, Go Safe device •Web-based (WB) operator is also alerted by wireless device that community worker has not checked-in.
Incident Response • Life line contacts worker and if in distress calls police immediately •If worker unable to activate alarm - WB operator is alerted by device of non check-in and calls Police
Incident •A nurse in emergency
department is checking on a patient who becomes highly agitated, physically threatening and blocks nurse's egress
Alert Signal • The nurse uses her two way
communication badge with GPS locator and calls for help • The nurse maintains ongoing
communication with security
Incident Response •Security responds
immediately and calls a code white conveying the nurses exact location •Security and Code white
team responds immediately
Figure 2. Sample PSRS sequence of events in health and community care
Workplace Violence Program and Emergency Management
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Preparedness
Response Recovery
Prevention &
Mitigation
Prevention: Actions taken to prevent an emergency or disaster Mitigation: Actions taken to reduce the effects of an emergency or disaster Preparedness: Actions taken prior to an emergency or disaster to ensure an effective response Response: Actions taken to respond to an emergency or disaster
Figure 3. Components of the Emergency Management System (Ontario Ministry of Community Safety and Correctional Services, 2016)
Toolkit Page 8
Key Considerations • Devices alone will not ensure help will be summoned
• People must be available:
o To receive the alert signal; and
o To respond to the alert
• Procedures and training on devices and emergency responses is required
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Systems Approach
• Adopt a OHS management system approach to PSRS development and implementation
• Plan-Do-Check-Act (PDCA) / Plan-Do-Study-Act (PDSA)
• Support sustainable PSRS and continuous quality improvement
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Plan-Do-Check-Act PLAN
Establish Senior Management Commitment Identify legal requirements Stakeholder participation including JHSC/HSR WPV Hazard Identification/Risk Assessment
DO Manage risks and develop preventative controls Implement PSRS
CHECK Evaluate PSRS
ACT PSRS Continuous Quality Improvement
23 Toolkit Page 10
PSRS PLAN Senior Management Commitment
Legislative Requirements e.g., OHSA, Reg. Stakeholder Engagement e.g., JHSC/HSR
Workplace Violence Risk Assessment
DO PSRS Device Needs Assessment Identify and Select PSRS Devices
PSRS Written Measures / Procedures PSRS Training Needs Assessment & Program
Integrate into WPV Program /E. Management Provide reports respecting OHS to JHSC/HSR
Ensure legal requirements are met
CHECK Identify PSRS quality indicators
Evaluate and Audit PSRS Identify gaps, corrective actions
Consult JHSC/HSR others Make recommendations to Management
ACT Act on approved PSRS CQI
Document and communicate PSRS improvements
Repeat Plan-Do-Check-Act
Toolkit Page 10-13 24
PDCA Gap Analysis and Action Plan Appendix B
25 Toolkit Page 55-60
PSRS Devices Generations 1. Physical Alarms e.g., hardwired alarms, flashing lights,
speakers, panic buttons
2. Telephony e.g., two way communications such as telephones, radios, pagers
3. Net-centric / Internet-based e.g., wireless Wi-Fi badge systems
PSRS Descriptions page 16-29
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Device Categories
• Wireless Internet-Based Communication Devices • Standalone Worker Communication Devices • Security Badges With GPS/Camera • Alerting Button Devices • Cellular Phones and Cell Phone App • Analogue and Digital Phones • Pagers • Two way radios • Public Address System • Physical Alarms e.g. panic alarm/buttons • Personal Noise Makers
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PSRS Device Considerations • Some PSRS can be integrated with other devices e.g. nursing
call systems
• PSRS technologies may work along side of security technologies e.g. CCTV
• One size may not fit all organizations and/or situations
• Multiple PSRS device may be required
• Organizations may also find taking an inventory of their existing PSRS helpful
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Selecting and Evaluating PSRS Devices Process
WPVRA • Review WP risk assessment to identify areas & situations of risk
APP. C • Conduct a PSRS device needs assessment
APP. D • Review PSRS Devices Options and Features
APP. E • Conduct a PSRS Device Needs Summary and Identify PSRS Devices
APP. F • Conduct a PSRS Device SWOT analysis to select devices
29 Toolkit Page 30-31
PSRS Device Needs Assessment Appendix C Who
What
Why
Where
When
How
• Who will: use it, hear it and respond to it?
• What will it be used for?
• Why will it be used?
• Where will it be used?
• When will it be used?
• How will it be used?
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What is the current situation and is it effective? Does it summon immediate assistance in all types of dangerous situations including while violence is occurring and the worker cannot escape.
Toolkit Pages 61-65
31 Toolkit Page 61-65
PSRS Devices Options / Features Appendix D • Overview of PSRS Device Options and Features Tool
• Review Table 1 for additional information on PSRS devices
• Select devices based on features and options that align with needs
32 Toolkit Page 66-70
Overview of PSRS Device Options and Features
Device
General PSRS Features
Comments
Audi
ble
Aler
t
Visu
al A
lert
Voic
e M
edia
ted
Mob
ile E
mer
genc
y / P
anic
Bu
tton
Au
tom
ated
Em
ploy
ee
Chec
k-in
& C
heck
-out
O
ne W
ay V
oice
Co
mm
unic
atio
n Tw
o W
ay V
oice
Co
mm
unic
atio
n GP
S Lo
catin
g Te
chno
logy
Two
way
text
mes
sagi
ng
No
mot
ion
or M
an D
own
Dete
ctio
n
Fall
Dete
ctio
n
Beac
on Lo
catio
n Te
chno
logy
24/7
Mon
itorin
g
Blue
Too
th W
irele
ss
Sate
llite
– R
emot
e or
O
ff th
e Gr
id
Ow
n an
d O
pera
te D
evic
es
Rem
ote
Host
Ope
rate
d
Oth
er
Wireless/Internet Web-Based
Communication e.g., Vocera
X X X X X X X X X X X Onsite Only Integrations with Clinical Applications
Standalone - Lone Worker Devices
X X X X X X X X X X X X X X On / Off Site, Remote, Driving
Cellular Phone with Working
Alone App
X X X X X X X X X On / Off Site
Cellular Phone X X X On / Off Site
Landline Phone / Digital Phone X X On / Off Site
Two Way Radio X X X On / Off Site
Pagers X X X On / Off Site
Alert Button or Security Badge X X X X X X X X X X X On / Off Site
Public Address System or Intercom
X X X X X X Typically Hardwired At
location Physical Alarms:
Panic Button with strobe, alarm,
siren
X X X X Typically Hardwired At
location
Noise Maker e.g., whistle, screamer
badges
X On / Offsite
Note that products options and features change with time. This chart is only to be used as a general guide.
33 Appendix D Toolkit Page 69-70
PSRS Device Needs Assessment Summary Tool Appendix E
34 Toolkit Page 71-73
PSRS Device SWOT Analysis Tool Appendix F • Purpose of the tool is to evaluate selected devices
• Review the provided evaluation criteria
• Identify the device strengths, weaknesses, threats and opportunities (SWOT)
• Consider and discuss the advantages and disadvantages of each device reviewed
• Make a decision on best device
35 Toolkit Page 74-77
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Sample Criteria • Ease of use • Ease of implementation • Multi-purpose e.g. worker/patient
communications • Infrastructure requirements • Capital Cost / Feasibility • Operating Cost / Feasibility • I.T. start up and support • I.T. software and hardware • Maintenance and servicing • Training requirements • Vendor service and reliability • Use on and/or offsite use • One and/or two way communication • GPS capabilities • Alert quality e.g. sound, voice, visual • Reflects best practice/evidence • Administrative efficiency • Measurability of impact/metrics • Good fit for need • Other Toolkit page 76
PSRS Policy, Measures and Procedures • OHSA requirement
• HCRFR requires written measures and procedures
• Address “summoning immediate assistance when violence occurs or is likely to occur”
• PSRS policy and procedure or it may be part of the Workplace Violence Program
37 Toolkit page 32
Sample PSRS Policy Appendix G • Purpose
• Policy Statement – commitment
• Goals and Objectives
• Definitions e.g., PSRS, PSRS device
• Roles and responsibilities e.g., workplace parties including JHSC HSR
Toolkit Page 78-79
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Sample PSRS Procedures Appendix G • Summon immediate assistance & emergency protocols • Administration of PSRS and device oversight • PSRS device needs assessment, selection & evaluation • Inventory and maintenance of devices • PSRS device use, care, limitations
o Standard operating procedures for each device o Testing, inspections and frequency o Reporting defects and repairs o Contingency planning o Practical hands-on training
• Communication, Training and Education – hands on training • Evaluation and quality improvement
Toolkit Page 83-86 39
PSRS Training Highlights
• Legal requirement for employers to provide training
• Training program framework including:
oAdministration
oDesign and development
o Implementation
o Evaluation
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Toolkit Page 35-38
Training Considerations Appendix H • Policy including definitions, roles and responsibilities • Access and activate PSRS process and implement procedures as well as emergency
protocols • Procedures on safe use, care & limitations of devices such as
o Safe operating procedures o Testing, inspections and frequency o PSRS maintenance e.g., battery o Reporting defects and repairs o Contingency planning when device does not work
• Practical hands on / interactive training • Importance of readiness and preparedness • Awareness of alarm fatigue and avoid complacency • Training frequency e.g. all staff before use and regular intervals, upon hiring, annual
refreshers and as needed if there are changes.
41 Toolkit Page 87-90
PSRS Awareness Tool Appendix I PSRS Awareness Fast Fact
• What is a PSRS and why is it important
• Definitions
• Roles and responsibilities of employers, supervisors/managers, workers, JHSC/HSR
• Link to the tool at www.pshsa.ca /workplace-violence/
• Can be used to create awareness to all workplace parties and JHSC/HSR
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PSRS Plan-Do-Check-Act Summary
Toolkit page 41
Role of the JHSC • Gather evidence to support a new PSR system (e.g., during inspections,
investigations of accidents, near misses, during code white debriefs etc.)
• Review accident illness report to identify when a PSRS may have assisted in preventing injury/illness
• Use workplace inspections to identify if a PSRS is in place that does, when activated, summon immediate assistance when violence is likely to occur and/or does occur
• Caucus with worker members of the JHSC to develop a draft recommendation
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Role of the JHSC Cont. • Make written recommendations to employer to:
Conduct a comprehensive organizational risk assessment using all elements of the new PSHSA organizational risk assessment tool - to identify all workers who may become exposed to a person with a history of violent behaviour
Implement an appropriate PSRS with written measures, procedures and training that will allow workers at risk to summon immediate assistance when violence occurs or is likely to occur
Until an appropriate system is in place look to the PSHSA VARB tool on PSRS to implement interim measures to summon assistance
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Role of the JHSC Cont. • A single co-chair can submit recommendations to the employer
if it fails to reach consensus with JHSC after attempting to do so in good faith
• Connect with your Labour Relations officer at ONA if you need more assistance and/or to discuss filing a grievance
• Connect with your PSHSA consultant
• If you can’t resolve issues internally, contact the Ministry of Labour
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Questions
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PSHSA.ca
@PSHSAca
Public Services Health & Safety Association on LinkedIn
youtube.com/PSHSA
416-250-2131 (toll free: 1-877-250-7444)
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