Managing occupational health and safety at Toronto’s Hospital for Sick Children (SickKids) is no walk in the park. Making sure everyone in the organization is properly trained and keeping health and safety top of mind is a challenge for any health-care institution, but with approximately 6,500 employees, up to a thousand students and another thousand or so volunteers onsite, SickKids’ Occupational Health and Safety Services department has its hands full.SickKids took pride in having a well-established occupational health and safety program, but didn’t have a formal health and safety management system to identify gaps, assess performance and strive for continuous improvement. “We were looking at the CSA’s Z1000 standard a few years ago when The Ontario Safety Association for Community & Healthcare (OSACH) invited us to pilot its Health and Safety Management System,” recalls Fiona Dalziel, SickKids’ Manager of Occupational Hygiene and Safety. “OSACH took the Z1000 standard and adapted it to meet the needs of a hospital environment, so we saw it as a real advantage for us.” SickKids was the largest of six health-care institutions in Ontario to participate in the pilot. “The management system provided us with a more stringent, systematic approach to help shape our priorities,” says Joy McGuire, Director of SickKids’ Occupational Health and Safety Services department. “We are a relatively small team, given the size of the hospital, and health and safety never stops. So having some rigour as to how we decide on our priorities is important.” The pilot kicked off in January 2008 with a hospital-wide audit aimed at assessing performance and identifying gaps. A series of focus groups solicited input from front-line staff and data on health and safety indicators was compiled and reviewed. “By mapping it out and following the process,” says Cheryl Craven, Vice President, Human Resources, “our Occupational Health and Safety Services team was able go out and solicit feedback from areas of the hospital that they may not have thought of approaching before.” Among the indicators looked at were Workplace Safety and Insurance Board (WSIB) injury frequency and severity rates, action taken on health and safety committee recommendations, sick days, voluntary attrition, patient safety incidents and staff satisfaction surveys. SickKids has an enviable health and safety record, typically experiencing half the health-care average for lost-time injuries and earning rebates from the WSIB, but there are always health and safety challenges and opportunities for improvement. The challenge is usually that there are more potential projects and initiatives than time and resources to carry them out, so priorities have to be set. “We can’t do everything,” says Dalziel. “Having the structure of the health and safety management system allowed us to prioritize what we’re going to do.” SickKids decided to focus on two priorities: the revitalization of its health and safety training strategy and the introduction of safety engineered medical sharps. The health and safety training strategy hinges on the introduction of a hospital-wide, online-learning management system that will allow health and safety staff to deliver training more efficiently and track compliance. “It’s challenging today for our occupational health and safety team to keep track of everything,” says Craven. With more computer-based training, staff can be scheduled to complete a series of training sessions in a single block of time rather than being repeatedly pulled away from their work to attend multiple training sessions. “It will help to ensure that people are properly trained and allow us to backfill to free them up,” says Craven. The OSACH health and safety management system also served as a catalyst for keeping senior management in the loop. In addition to its paper-based monthly reports, the department has committed to a formal presentation to senior management once a year. “This is new,” says McGuire. “We get to report on what we did and what worked. Then we tell them what we’re planning to do. Before, it wasn’t on an established cycle.” It’s difficult to link the introduction of the health and safety management system to any improvement in hospital statistics in such a short period, but SickKids’ health and safety team agrees on its value and plans to entrench it as a means of driving continuous improvement. “The whole process of systematically reviewing occupational health and safety performance, deciding on priorities, implementing programs and going back and reassessing them is excellent no matter what size hospital you are,” notes Dalziel.