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

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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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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

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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

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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

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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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@PSHSAca

Public Services Health & Safety Association on LinkedIn

youtube.com/PSHSA

416-250-2131 (toll free: 1-877-250-7444)

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