AOHP 2015 National Conference

State-of-the-art information in the field of occupational and environmental health and safety; Comprehensive workbook/resource manuals and classroom materials; Test-taking techniques and strategies for examination preparation; Written tests prior, during and at conclusion of seminar; Participative lectures. Registration fee includes updated Occupational Health & Safety Principles and Nursing Certification Review Course Manual and FREE admission to attend Workshop W014 (3:15 pm to 4:15 pm on September 9.)  LUNCH NOT INCLUDED.

Topic Overview: Healthcare facilities are potentially dangerous work environments, and while proper training, engineering controls and administrative precautions can help to effectively manage risk, employee accidents can and do happen. Accidents are inevitable in today’s healthcare workplace. Even with the best loss control program, employees still can be hurried or distracted. Employee accidents, while unfortunate, present an opportunity to improve the performance of a healthcare facility’s safety program. Properly conducted accident investigations provide solutions to many workplace hazards. Participants will learn a simple methodology for determining the root cause of workplace accidents and utilize a six-step process for an effective employee accident investigation program that will help to identify root causes, prescribe appropriate corrective measures and implement performance metrics to ensure a safer workplace. Accident investigation analysis will include investigation strategy, witness questioning, evidence gathering, critical decision points and effective legal documentation.

Objectives:

1. Describe a six-step process for an effective employee accident investigation program to ensure a safer workplace. 
2. Explain the components of an effective facility safety program.
3. Discuss the root cause analysis to conduct thorough investigations of employee accidents.
4. Describe a six-step process for an effective employee accident investigation program.

Topic Overview: The Affordable Care Act will now focus on quality and reimbursements to organizations based on outcomes for patients as opposed to volumes. New quality and compliance requirements will be the focus on transitioning all organizations to becoming Accountable Care Organizations as the nation's healthcare delivery system moves from the hospital clinic to the home, workplace and school. Occupational health nurses need to recognize now how their roles may change due to this shift in focus that will affect their worker population.

Objectives:

1. List two attributes the occupational health nurse must portray when setting healthcare reform goals for the occupational health team.
2. Describe the role of the occupational health nurse when dealing with healthcare reform and the effects it will have on employees.
3. Explain the importance of the occupational health nurse’s understanding of healthcare benefits during this era of healthcare reform.

Topic Overview: This workshop will offer recommendations and advice from individuals who have experience with implementing and sustaining a safe patient handling program (SPH,) from start-ups to seasoned programs at single locations as well as multi-facility systems. The presentation will be targeted to those who have a management role for SPH in an acute care environment who want to start a SPH program from the beginning or to build upon a program that is well established but needs updating. Practical examples and tools will be presented that will be useful in a clinical setting. The workshop will be a combination of lecture, group interaction and exercises, including a review of case studies and assessment tools. Attendees will be encouraged to bring their tough SPH problems to the workshop for discussion.

Objectives:

1. Identify strategies for planning, implementing and sustaining a Safe Patient Handling (SPH) program.
2. Identify key elements to include in SPH policy and procedure.
3. Explain how to conduct reliable and valid risk assessments and control selections.
4. Identify practical next steps to existing SPH challenges.

*The Association of Safe Patient Handling Professionals (ASPHP) proudly acknowledges its relationship with AOHP and recognizes the contact hours for this course in meeting continuing education requirements for its professional certification process.

Topic Overview: This comprehensive, informative presentation is designed for the occupational health professional new to the field. The eight-hour didactic course was developed from the Getting Started manual, which is updated every two years by the AOHP organization. Course content includes valuable resources, encourages interactive discussion and is presented by a team of knowledgeable experts. All participants will receive the 2014 edition of the Getting Started resource manual in CD format.

Objectives:

1. Describe how the occupational health professional interacts in the healthcare facility’s organizational structure.
2. Discuss areas of medical/legal confidentiality in occupational health.
3. Identify federal, state and local regulatory requirements as related to job placement, physical hazards, and biological and chemical exposures.
4. Review current infection prevention and control practices related to infectious diseases.
5. Describe strategies to utilize health teaching in infection prevention and control, and safety.
6. Discuss the effectiveness of case management in loss control.
7. Explain how to communicate the value of the occupational health professional’s service and continuous performance improvement. 

Topic Overview: Leadership attributes are critical in today’s ever changing healthcare processes. Occupational health professionals need to understand the characteristics of our culture in today’s workplace. The understanding of an organization’s mission and vision are essential in leading any organization today. This presentation will demonstrate for participants how to be Change Agents for their organizations by connecting the cultural aspects of their organizations into daily work tasks to achieve increased functionality in their Occupational Health Departments.

Objectives:

1. Discuss two essential characteristics of a culture of ownership.
2. Explain why mission/vision/ values are essential in leadership today.
3. Describe three attributes on why building a culture of ownership is important.
4. Interpret the leadership function in the operations of Occupational Health Services.

Topic Overview: On November 7, 2013, the Occupational Safety and Health Administration (OSHA) issued a proposed rule it claims will improve workplace safety and health through improved tracking of workplace injuries and illnesses. The proposal will amend OSHA’s recordkeeping regulations to require the electronic submission of injury and illness information employers are already required to keep under OSHA's regulations for recording and reporting occupational injuries and illnesses. The proposed rule amends the regulation on the annual OSHA injury and illness survey of 10 or more employees to add three new electronic reporting requirements and aims to use data to prevent work-related injuries and illnesses by encouraging employers to identify and abate hazards in their workplaces before workers get hurt and without OSHA making an inspection. 

OSHA intends to make all injury and illness data publicly available through a searchable database. Only information protected by the Freedom of Information Act, the Privacy Act, certain provisions of the Recordkeeping Rule (which protect the privacy of cases involving mental illness, certain illnesses or sexual assault,) and the injured employees’ names will be kept private. The increased availability of data will also enable employers and employees to compare their injury rates with others in the same industry. While OSHA emphasizes that the proposed regulation will not alter employers’ basic recordkeeping duties, it will dramatically change the way that OSHA uses injury and illness data to select employers for inspections, and it will provide unions, community activists, plaintiffs’ lawyers and competitors with easy access to that data as well.

Objectives:

1. Review major changes to the OSHA recordkeeping standard.
2. Explain how the proposed rule would be phased in, starting with high hazard facilities having a days away from work, restricted work activity, or job transfer (DART) rate of 2.0 or above.
3. Discuss the basics of recordkeeping and how to determine if an injury/illness is reportable. 
4. Discuss why many trade groups are against the proposed changes through analysis of the Top Five Impacts to Industry.

Topic Overview: The “Beyond Getting Started” Business Skill program has been developed for the occupational health professional who has some experience in the field of occupational health and is ready to move “Beyond Getting Started.” Attendees will gain confidence by formulating how to write a plan, present it to leadership and evaluate results. This program will identify tools needed to demonstrate cost savings, cost avoidance, and practices to justify program expense, growth and/or change. Learn how to leverage leadership to implement best practices and become the subject matter expert for occupational health.

Objectives:

1. Identify components of defining a problem related to occupational health.
2. Review the steps in identifying the customer(s) and their needs.
3. Describe the business plan, including the importance of appropriate data collection and presentation.
4. Review the steps of an effective measurement plan.
5. Explain the importance of best practices in occupational health. 

Topic Overview: The record-breaking OSHA fines currently in the news are eye-popping. The Occupational Safety and Health Act has been in effect for 45 years, and no employer is given the benefit of the doubt if an interpretation of the OSHA requirements is questioned. With OSHA’s spotlight focusing on aggressive enforcement, occupational health professionals need to know and understand their rights and obligations before OSHA shows up at the door. Be prepared to face them with aggressive compliance.

If you work for one of the many healthcare facilities that grew somewhat lax about employee safety during the Bush Administration, now is the time to buckle down and evaluate your current regulatory compliance policies and practices. Would you be prepared if you opened the door today to find an OSHA Compliance Safety Health Officer (CSHO) ready to inspect your facility? Do you know the step-by-step approach to an OSHA inspection? Do you know your legal rights? Your failure to plan may constitute an emergency that will put unnecessary stress - human and financial - on your organization.  In this workshop, we will: discuss solid defenses to defend citations; review the top 25 violations written in hospitals; and offer helpful tips on ways to minimize exposure to costly OSHA penalties and negative public relations.

Objectives:

1. Describe the step-by-step process of an OSHA inspection.
2. Identify a plan to prepare for an OSHA inspection.
3. Describe the types of OSHA violations, penalty structures and potentially costly penalty factors.
4. Identify affirmative defense strategies to possibly avoid the issuance of citations and minimize the financial impact of violations.
5. Review OSHA’s new penalty structure and method for calculating fines.

Topic Overview: Do you know how to evaluate an ergonomic chair for best fit and comfort? Do you know how to identify proper workstation set-ups for all ranges of users, including standing stations? Are you self-taught in ergonomics and think you know how to evaluate someone at work? This presentation will show participants the best way to evaluate healthy office workers at a computer workstation using an easy five-step methodology, and to identify if the ergonomic chair is a good fit and competent for ongoing use. By using a valid methodology based on anthropometrics and sound ergonomics science, attendees will gain consistency and confidence in conducting an office ergonomic and chair evaluation for preventive purposes to help healthy workers stay healthy. 

Objectives:

1. Discuss the science of sitting and standing using anthropometrics.
2. Describe an easy five-step methodology to evaluate a seated office workstation.
3. Describe a chair fitting to determine optimal chair fit and comfort.

Topic Overview: Today, stress, poor fitness and increased weight all present challenges for the health and safety of workers, especially in the prevention of strains, sprains and other musculoskeletal disorders (MSDs.) In this session, we will discuss the link between an employee’s overall health and these types of injuries. We will also give examples of changes to consider to better prevent these injuries, including, but not limited to, ergonomic equipment solutions.

 Objectives:

1. Describe how stress contributes to musculoskeletal disorders.
2.  Explain how an obese worker may be at increased risk for musculoskeletal disorders.    
3. List two environmental concerns that should be considered in an effort to improve safety for the obese worker.
4. Review two organizational level solutions to prevent musculoskeletal disorders.

Topic Overview: New evidence continues to provide us with more information to assist patients and other providers in choosing appropriate treatment for specific patients. This session will review the latest changes to recommended treatment of knee, low back and shoulder injuries, as well as use of platelet rich plasma and other biologics. Motivational interviewing techniques can add to our armamentarium and assist us in changing treatment patterns. All of these issues will be covered in this session using case examples.

Objectives:

1. Describe evidence-based recommendations for common low back conditions.
2. Describe the evidence-based recommendations for common shoulder conditions.
3. Describe the evidence-based recommendations for common knee conditions.
4. Review the value of motivational interviewing to assist in decision making. 

Topic Overview: It's time to step up to the plate in dealing with blood and body fluid exposures! This presentation will cover all the bases, from identifying a blood and body fluid exposure, collecting the details, and obtaining information on who was involved, as well as the how, what, where and when of the exposure. Consents and risk review will also be discussed.

First Base: Identify steps for HIV testing for the source and the exposed person, and follow-up needed. Discuss prophylaxis and when it should be used. Review recent research that shows occupationally acquired HIV is now rare. 

Second Base: Identify steps for Hepatitis B testing for the source and exposed person. Highlight immunization and discuss non-responders to Hepatitis B. 

Third Base: Identify steps for Hepatitis C testing for the source and exposed person, including use of the PCR, RNA test.

Home Run: No Conversions! 

Case studies featuring actual exposures with HIV positive sources, Hepatitis B sources and Hepatitis C sources, in addition to double exposures, will be reviewed. Resources from the CDC and the National HIV/AIDS Clinicians’ Consultation Center will also be available for participants. 

Objectives:

1. Recognize blood and body fluid exposures, and how to conduct appropriate follow-up.
2. Describe techniques to manage HIV positive exposures.
3. Identify how to manage Hepatitis B positive exposures.
4. Identify skills to manage Hepatitis C positive exposures.
5. List resources available to assist with management of blood/ body fluid exposures.

Topic Overview: Employees who are stressed have difficulty concentrating and may be unable to complete a task safely. What can your organization do to create an environment that is less stressful while still getting the job done? How do your fitness level, nutrition and overall health contribute to your stress level? This session provides practical tips for reducing the stress in your workplace and information to take back to your employees on the role of nutrition and exercise in stress management.

 Objectives:

1. Describe one organizational strategy designed to reduce workplace stress.
2. Review one environmental strategy that could reduce employee stress.
3. Explain one personal strategy that could be employed to reduce stress.

Topic Overview: Most working people are not engaged in their health, their safety or their job. Why? We are going to take a look at this question from three viewpoints: economics; psychology; and public health. To solve this riddle, we will collaborate to identify some of the barriers and possible solutions for the “engagement problem.” Two significant parts of the solution are interconnected: our sense of happiness; and our health. We will consider who cares about your health, your safety and your productivity. We will also consider how our personal values and the values of our organizations may converge or collide… and what each of us can do to improve our own sense of engagement while we promote the health, safety and well-being of workers in our roles as occupational health and safety professionals.

Objectives:

1. Review emerging trends in business and economics that impact worker health, safety, wellness and engagement.
2. Interpret how the field of psychology can impact occupational health, safety and wellness.
3. Recognize recent trends in public health, and in occupational health and safety that impact individual contributions to health, happiness and productivity.

Topic Overview: This presentation will provide an insider's perspective of the Ebola experience at Emory Healthcare, the largest health system in Georgia. General background information about the Emory University Hospital Serious Communicable Disease Unit  (SCDU,) including the Ebola experience from the nurse’s perspective, will be shared, as will details of the occupational health monitoring of the Ebola Virus Disease (EVD) healthcare provider. The evolution of the monitoring system, including case management, will be discussed, highlighted by a live demonstration of the EVD monitoring tool. The presenters will review The Centers for Disease Control and Prevention's Exposure Risk Categories and will offer advice on how to most effectively manage EVD exposures and provide guidance to staff returning from travel to West Africa.

Objectives:

1. Identify the mission and role of Occupational Health as it pertains to caring for a patent with Ebola Virus Disease (EVD).
2. Discuss the Serious Communicable Disease Unit (SCDU), standard operating procedure (SOP) and BBP OSHA standard.
   Review CDC Exposure Risk Categories and managing exposures to EVD.
3. Explain follow up to staff returning from West African travel. 

Topic Overview: Emerging safety hazards, a tighter labor supply, razor-thin profit margins, a sluggish global economy, rising healthcare costs, an aging workforce, and high levels of workplace stress and chronic disease represent real hazards facing today’s businesses and workers. Will your organization weather the coming changes and navigate these challenges successfully? Keeping your employees safe, healthy and productively engaged in this environment demands a determined strategy and a willingness to adapt quickly. This presentation will examine the coming threats and offer new insights on the integrated approach to workplace health, safety and well-being. Learn the latest research on worker protection, health promotion and prevention resources from the National Institute for Occupational Safety and Health (NIOSH,) the Centers for Disease Control and Prevention (CDC) and other credible sources, designed to help you grow a strong, people-centered culture and maximize individual and organizational opportunities for health and productivity.   
Objectives:

1. Describe the leading challenges facing workers and workplaces.
2. Explain a framework for integrated health protection and health promotion interventions.
3. Identify sources for credible, ongoing information on the latest Total Worker Health science, research findings and intervention.

Topic Overview: You have implemented safe needles, personal protective equipment, patient lifts and other injury prevention controls, but staff are still getting hurt, recovery from those injuries is slow and patient safety is not where it should be. What’s left to do? Learn how fatigue, stress, what we eat and drink, and our level of fitness contribute to our ability to do a job safely for ourselves and our patients, as well as the impact on the time it takes to heal and bring our injured workers back to the bedside. This session introduces attendees to ideas for small changes to our working environments that make it easier for an employee to make a healthy choice. Specific examples demonstrate how wellness and injury prevention can be applied together to improve team well-being. 

Objectives:

1. Define Total Worker Health.
2. Explain how wellness and health promotion may influence injury prevention and workers' compensation performance.
3. Review how safety and health protection may influence health and health plan performance.

Topic Overview: This presentation will describe immunization and immunity recommendations for U.S. healthcare personnel (HCP.) It is important for occupational health professionals to ensure that HCP are immune to vaccine-preventable diseases – both for the protection of HCP and to prevent them from infecting patients, staff and visitors. In addition, it is important for occupational health professionals to know how to follow up on employee exposures to vaccine-preventable diseases. 

Objectives

1. List the vaccines recommended for healthcare personnel.
2. Describe acceptable evidence of immunity to vaccine-preventable diseases.
3. Discuss follow-up of employees exposed to vaccine-preventable diseases.

Topic Overview: In 14 years, one in five persons will be over the age of 65. The probability that our aging workers will be diagnosed with new diseases that affect their ability to produce and function will increase. This might include workers diagnosed with low vision, fibromyalgia, arthritis, Crohn’s Disease, diabetes, ALS, etc. Inclusion Ergonomics aims to retain the wealth of knowledge possessed by an aging and differently-abled workforce by ergonomically accommodating these individuals. In using inclusive ergonomics, you will be able to attract and retain the best workforce, and design work environments to mitigate or reduce disability, not only within today's workplace, but also in tomorrow's.

Purpose:

1. Recognize the importance of creating an adjustable work area.
2. Identify how to accommodate differently-abled workers.
3. Explain how to reduce barriers to focus on productivity.

Topic Overview: The goal of this presentation is to educate occupational health professionals on the various tuberculosis (TB) tests available, and the operational and financial considerations for switching from one TB testing method to another. Specifically, the program will include an educational review of the Tuberculin Skin Test (TST) and Interferon-Gamma Release Assays (IGRAs,) including what they are, how they work and how they are used to screen for latent tuberculosis infection.

The presenters will discuss TB prevalence in the United States now and in the past, and they will introduce current diagnostic and treatment options for latent TB infection, focusing on the newer, blood-based IGRAs, some procedural considerations for screening programs and the importance of perspective and quantitative result interpretation. Current CDC screening recommendations and guidelines will be reviewed. Examples of screening programs in hospital, public health and Veterans Health Administration settings will be discussed, particularly in comparison with the previous standard of TST use. A toolkit with samples of policies and procedures will be shared.

The program will conclude with information about how participants can complete a financial assessment of the total cost of switching from one TB testing method to another at their institutions, with suggestions on how to present that information to other administrators and medical staff involved in the decision-making process.

Objectives:

1. Describe the scientific and technical differences for the three tuberculosis screening tests available.
2. Identify advantages and disadvantages of different tuberculosis testing methods in various clinical settings.
3. Review the epidemiology of tuberculosis infection in the United States and worldwide.
4. Explain the comparison of interferon-gamma release assays to the tuberculin skin test.
5. Name interferon-gamma release assays, and their advantages and disadvantages.
6. Review the CDC 2010 “Updated Guidelines for Using Interferon-Gamma Release Assays to Detect M. tuberculosis Infection.”
7. Discuss practical considerations when running a tuberculosis screening program.
8. Describe result interpretation and treatment options.

Topic Overview: Fatigue management is an emerging area of healthcare. It directly relates to patient safety and employee burnout. Recent discoveries have been made regarding the effects of sleep deprivation on employee health, decision making errors, and most importantly, interventions to reduce fatigue risk.

Fascinating new findings in the neuroscience of fatigue include the newly named Glymphatic system. This waste removal system clears the toxin Beta Amyloid, but only while asleep. A night shift nurse, driving home at dawn, will have trouble getting to sleep due to the blue light of dawn. This effect of dawn on the SCN and brain chemistry will be discussed.  Based on new fatigue science, novel new counter measures to fatigue have emerged.  “Anchor sleep,” blue blocking sunglasses and the color of the computer screen can alter fatigue. The proven risks of fatigue include elevated cortisol levels, higher risk of stroke, hypertension and breast cancer. Fatigue management is required in the FAA, the military and commercial trucking. Given the effect of fatigue on patient safety and nursing burn out, this is an emerging area of healthcare that deserves more attention.

Objectives:

1. Recognize recent discoveries of sleep and why sleep is critical for life.
2. Review scientifically proven counter measures for fatigue.
3. Explain proven risks of sleep deprivation.
4. Review fatigue management regulations.

Topic Overview: Keeping employees healthy and safe on the job demands new ways to engage individuals through good communication. In today’s ever-evolving work environments, we face challenges including off-site workers, generation gaps, widely different expectations and attitudes, and time itself. How do you manage it all? How do you communicate to promote worker health and well-being? This presentation will focus on developing a communication plan that leverages your existing tools, cuts across traditional and innovative methods, and incorporates best practices and solutions to overcoming your biggest barriers. Learn how to effectively identify your target audience, build key messages and create compelling content to create healthy behavior change and promote employee health and safety.

Objectives:

1. Identify ways to engage workers through existing communication channels.
2. Identify a communication plan to promote healthy and safe behaviors.
3. Explain how different age groups communicate.
4. Discuss ways to tailor messaging and methods to reach all workers.

Topic Overview: This presentation addresses the needs of employers who want to optimize employee health and productivity, including: making the business case to senior leadership; mapping data and measurement needs; and working effectively with vendors.

To optimize employee health and productivity, Kaiser Permanente (KP) enhanced its integrated disability management (IDM) focus by integrating with key functional areas such as EAP, Wellness, Workplace Safety, Occupational Health and clinicians so that IDM could help overcome KP’s disability absence and related health and productivity challenges. This model utilizes creative methods of sharing ideas and resources, measuring predictors and outcomes, and working together to demonstrate that only through collaboration and integration can we optimize the health and productivity of our most valuable resources - our employees!

This project has been very successful at KP, a highly complex organization. The core principles could be applied to any size employer, and we welcome the opportunity to share and inspire others with these innovative solutions.

Objectives:

1. Explain why IDM is most effective when integrated with other total workforce health programs.
2. Identify creative techniques and strategies for gaining leadership support for IDM/health and productivity programs.
3. Compare innovative models for cross-functional engagement.

Topic Overview: In the ever-changing world of healthcare, it is important to shed light on the hazards that can be exposed to those working in a potentially risky environment. This educational session will successfully describe how healthcare workers and patient safety are closely woven together and why they should be understood in a converging manner. Awareness of potential risks to both patients and staff allows an organization to create a stronger safety culture for all.

Although many examples of overlap between workers and patient safety can be discussed, this session will focus on falls, fatigue and infections. Healthcare organizations may vary by their type of setting, but it is important to recognize common safety risks so that prevention methods can be integrated into any organization. Staff injuries related to patient falls are a frequently identified safety concern among healthcare organizations; there are a wide range of factors that can contribute to this concern. In addition, the increased risk of infectious disease transmission among healthcare staff and patients demonstrates how both staff and patients’ safety can be compromised. Extended shifts have been linked to worker fatigue and sleep deprivation, increasing the likelihood of errors that harm both patients and staff. It is critical that healthcare organizations identify these risk factors and develop interventions so that a safe environment can be sustained for everyone.

As organizations work toward a greater safety culture, The Joint Commission provides numerous resources to its customers to help reduce harm and improve safety. The core values of The Joint Commission’s accreditation include that quality care and safety is foundational. Proactive risk reduction and a greater safety culture are critical to improving both worker and patient safety as we work toward making healthcare a safer environment for all.

Objectives:

1. Describe the connection between worker and patient safety.
2. Identify ways to improve safety related to fatigue, falls and infection prevention.
3. Identify resources to assist in creating a greater culture of safety.
4. Identify myths surrounding TJC accreditation. 

Topic Overview: This presentation will feature the evolution of recent major legislative changes to workers’ compensation practice, laws and guidelines in California and how these changes have affected care for work-related injuries, payment for services and disability prevention. The session will include a discussion of various programs that fall under the purview of the California Division of Workers’ Compensation’s Medical Unit, with an emphasis on utilization review, independent medical review, independent bill review and medical treatment guidelines.

Objectives:

1. Identify major changes to the California workers' compensation system as a result of SB 863.
2. Describe the method by which medical treatment decisions will be made in the workers' compensation system.
3. Explain best practices that comply with new regulations and provide optimal care to injured workers.

Topic Overview: In this presentation, we will review the National Patient Safety Foundation (NPSF) report Through the Eyes of the Workforce: Creating Joy, Meaning and Safer Healthcare and make the argument that worker safety is a fundamental precondition to patient safety. We will describe the epidemiology of physical and psychological harms that healthcare workers face, as well as organizational strategies to bring a higher priority to this issue. Key recommendations from the report will be discussed, with an emphasis on takeaways that participants can bring back to their organizations. In particular, the need to tighten the linkage between occupational health and patient safety will be highlighted. Please see this link for the full report and recommendations: http://c.ymcdn.com/sites/www.npsf.org/resource/resmgr/LLI/Through-Eyes-of-the-Workforc.pdf.

Objectives:

1. Describe the main types of physical harm experienced by the healthcare workforce.
2. Describe the main types of physical harm experienced by the healthcare workforce
3. Identify potential organizational strategies for prevention that can be implemented in organizations.     
4. Recognize the linkage between workforce safety and patient safety.

Topic Overview: Needle stick injuries from various sources are a significant problem in healthcare institutions. These needle stick injuries have various causes, including improper use of devices, incorrect suturing and poorly equipped procedure trays. These problems are compounded by the lack of compliance from the healthcare worker, improper reporting and inappropriate treatment of needle stick injuries. Employers can reduce the incidence of exposure from needle sticks. This presentation will discuss means to reduce the incidence of needle sticks, the latest treatment of needle stick injuries, effective monitoring and improved staff education on needle stick injuries. A case-based educational approach will be used to emphasize the key concepts. Some of the innovations from the Sinai Health System will be presented. 

 Objectives:

1. Describe the incidence of needle stick injuries.
2. Explain the techniques to reduce needle stick injuries.
3. Review proper suture procedure.
4. Discuss the proper treatment of needle stick injuries. 

Topic Overview: It is well known that patient movement-related injuries plague many healthcare institutions. This presentation provides a framework for establishing an individualized safe patient handling and movement program driven by the process of quality improvement and root cause analysis. Prior to the commencement of Madonna’s safe patient handling and movement (mobility) program, the cost of patient movement-related injuries (i.e., transfers and repositioning) totaled over $1 million, including injuries involving patient transfers that amounted to $782,761. Following the development, implementation and sustainability of the comprehensive safe patient handling and movement program at Madonna, the cost of patient transfer-related injuries declined by nearly 97% in six years, and the overall injury rate dropped by 52%. As the program continues to change and grow, the numbers continue to be monitored and show improvement. 

Objectives:

1. Describe why a positive relationship between disciplines ends in a sustainable safe patient handling program.
2. Identify successful safe patient handling program components.
3. Describe the methods to sustain a successful safe patient handling program. 

Topic Overview: Research has shown that stress among healthcare professionals is associated with many important problems (e.g. burnout, employee injury, jeopardized patient safety.) Memorial Sloan Kettering Cancer Center (MSKCC) recognizes that our employees may be subject to very stressful and exhausting work. Building Resilience is an institution-wide program supporting our medical center staff in their efforts to manage stress in healthy ways. 

The presenter will describe the services offered to the more than 13,000 staff of MSKCC, including: tailored team workshops; educational seminars focusing on self-care; and “Building Resilience through the Arts” (i.e. a creative series providing a restorative lunch hour via music, visual arts, poetry, dance, etc.) How and why the programs were developed will be explained, as will the process followed to identify and tailor to particular needs of staff within different departments including, but not limited to, nurses, housekeeping and administrative support. Finally, participation and evaluation data will be reported, along with a discussion of costs and benefits of this work. 

Objectives:

1. Discuss how stress management is a relevant component of a medical center occupational health and wellness program.
2. Describe the components of the Memorial Sloan Kettering Cancer Center Building Resilience Program.
3. Review steps to implement novel stress management programs.

Topic Overview: From Blackberries to iPads to Windows-based tablets, mobile technology is an ever more common feature in America’s homes and offices. We see them everywhere, from planes to trains to preschool classrooms. In our modern world, the quest for interconnectedness through mobile technology is at an all-time high, but at what personal price? Texting thumb? iPad neck? Cell phone shoulder? Instant communication by text message, whether through iPhones, iPads, Xboxes or laptops, has changed our culture and expectations while creating a civilization that screams iHurt! This session will discuss the ergonomics around the use of modern technology to avoid the personal toll that technology takes on our body. 

Objectives:

1. Describe the toll technology takes on the human body and the trade- offs from technology use.
2. Describe hearing concerns from iPods and earbuds, as well as dangers of excessive sitting.
3. Discuss focus issues, compulsive checking of devices and addiction to technology.

Topic Overview: Protecting workers from exposure to all types of respiratory hazards is an important issue for all hospital staff, yet often does not receive the attention it deserves. Studies following the H1N1 outbreak identified several opportunities for improvement in respiratory protection programs (RPP.) To address this need, The Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) National Personal Protective Technology Laboratory (NPPTL) spearheaded a cluster of research activities around respiratory protection programs. 

CDC/NIOSH/NPPTL recently developed a national toolkit, Hospital Respiratory Protection Program Toolkit: Resources for Respirator Program Administrators (National Toolkit,) to assist hospital respirator program administrators in the implementation of a comprehensive respiratory protection program that will meet the requirements as set forth in the OSHA standard (29 CFR 1910.134.) The toolkit provides authoritative guidance on indications for isolation precautions, the essential elements of a RPP, types of respiratory protection devices and sample program evaluation checklists.

In addition, The Joint Commission collaborated with CDC/NIOSH/NPPTL to develop an educational monograph designed to assist hospitals in addressing common challenges and barriers in the implementation of respiratory protection programs. The monograph, Implementing Hospital Respiratory Protection Programs: Strategies from the Field, features case study examples, strategies, new resources and a variety of approaches which were solicited from the field and vetted through an eight-member Technical Expert Panel, with expertise in occupational health, environmental medicine, emergency preparedness, infectious diseases and industrial hygiene. It is designed to be a companion document to the CDC/NIOSH/NPPTL toolkit.

This presentation will illustrate the processes for developing the two resources, highlight the features and key points in each, and show how they can be used to improve respiratory protection programs. 

Objectives:

1. Describe processes for development of new respiratory protection resources.
2. Review key points of the National Toolkit for respiratory program administrators.
3. Explain key points of The Joint Commission educational monograph.

Topic Overview: Substance abuse, and ultimately impairment while at work, is a significant problem for healthcare employers. Many institutions have implemented pre-employment and/or random drug testing programs in an effort to combat this problem. Unfortunately, even the most stringent testing programs don’t seem to be able to completely eliminate the problem of an employee coming to work impaired or becoming impaired while at work. This is especially concerning when a clinician is impaired and providing care to patients. Massachusetts General Hospital, a 900+ bed acute care hospital, has taken a multi-disciplinary approach to deciphering impairment versus poor practice, investigating potential diversions and determining the best course of action once a conclusion has been made. The role of the occupational health professional is paramount to this process. Occupational Health needs to be involved with the development of hospital policy, the selection of the drug testing method and panel development, and potentially development of a return to work and monitoring plan. This includes reporting to and working with the clinicians licensing board.

Objectives:

1. Discuss tools available to decipher poor practice from impairment.
2. List at least three methods of substance abuse testing.
3. Review the legal requirements for reporting impairment and/or diversion of medication.
4. Identify three components of a successful return to work plan for a rehabilitated clinician.
5. Describe the value of Occupational Health as part of the team.

Topic Overview: Independent Medical Examinations (IME) are a useful clinical tool in occupational medicine. This discussion will touch on the circumstances in which an IME can be helpful, as well as the concepts of disability and impairment. Advice on how to find a good IME physician will be given. The presentation will also feature the financial aspects of IMEs, including how they can save money. 

Objectives:

1. Define an IME.
2. Describe situations in which IMEs can be useful.
3. Review how IMEs can save money.

Topic Overview: Today, we’re facing increasing changes and national attention to promote the health and well-being of women returning to work after having children. In 2013, 69% of all mothers with children under age 18 were employed. Among mothers with infants, 57% are working. While new mothers have always been a focus of employee health, changing roles at work and at home beg the question, what tools do working mothers need? What worksite accommodations and policies should be integrated as part of a worksite wellness program to support new mothers?

This presentation will address health promotion programs at work that build healthy environments for keeping working mothers healthy on the job and to retain them as employees.  Discussion will include the top health concerns facing new mothers, including stress, weight management, physical activity and work-life issues. Learn what policies and best practices are encouraged to manage maternal leave, return to work and health promotion before and after childbirth.

Objectives:

1. Recognize the renewed focus of women in the workplace.
2. Explain policies and best practices for new mothers in the workplace.
3. Explain major health concerns of new mothers in the workplace.
4. Discuss ways to integrate these practices into your worksite wellness program.

Topic Overview: This presentation will walk participants through the difficult process of developing a user-friendly and practical safe patient handling policy. Attendees will learn what key tools to incorporate into a successful policy that will drive compliance and positive outcomes. From writing roles and responsibilities of all management levels to dependency definitions and proper algorithms, this presentation will cover all of the basic components of a quality policy. Participants will be encouraged to bring examples and discuss aspects of their current policies so they can return with real and beneficial solutions. 

Objectives:

1. Describe the key components of a clear, concise and consistent safe patient handling policy.
2. Identify the appropriate use of dependency descriptors.
3. Explain the basic rules of developing usable patient handling algorithms.
4. Describe the role and proper application of activity, compliance and outcome measures.

Topic Overview: Every specialty has its procedure that makes it unique. In occupational medicine, our special skill is in disability management, and the product is an accurate, concise and clear work status report in the form of work restrictions. And yet, there is virtually no science behind the determination of what restrictions are appropriate for a certain worker. Each case stands on its own merits, but there are general principles that can be applied to the return-to-work process. In Part 1 of this series, Dr. Buchta will discuss the foundational principles of disability and presenteesim and how medical providers can foster (or hinder) the process of returning workers back to the workplace at the right time with the right restrictions, if any.

Objectives:

1. Describe the existing literature supporting medical restrictions in the workplace.
2. Clarify differences between the major constructs in disability management.
3. Contrast two different models of disability management.

Topic Overview: Respiratory protection, when used correctly, is one way to help protect healthcare workers from disease caused by inhaling infectious aerosols. In recent years, in response to diseases such as tuberculosis and pandemic H1N1 influenza, hospitals have invested substantial resources in implementing comprehensive respiratory protection programs (RPPs.) This presenter has participated in several projects from 2009-2015 focused on assessing hospital RPPs, identifying common problems and best practices, and then producing and compiling educational resources designed to assist anyone who is responsible for administering a hospital RPP. This work, funded by the National Institute for Occupational Safety and Health’s National Personal Protective Technology Laboratory (NIOSH NPPTL,) has been conducted in collaboration with numerous healthcare stakeholders. The effort has culminated in the 2015 release of the co-branded NIOSH-OSHA web-based document Hospital Respiratory Protection Toolkit: Resources for Program Administrators.

Objectives:

1. Review respirator use in healthcare.
2. Explain the findings of field projects assessing hospital respirator programs.
3. Describe new NIOSH-OSHA resources for hospital respirator program administrators.

Topic Overview: Healthcare and social assistance accounts for the highest number of private industry non-fatal occupational injuries among all sectors, representing 20.7% of all occupational injuries reported to the Bureau of Labor Statistics (BLS) in 2013. The Occupational Health Safety Network (OHSN) is a voluntary surveillance system developed by the National Institute for Occupational Safety and Health (NIOSH,) part of CDC, and collaborating partners in 2011 to enable near real-time tracking of occupational injuries among healthcare personnel (HCP,) including injury event type, occupation of the injured worker, injury location and injury risk factors. From January 2012 to October 2014, 112 hospitals in 19 states and Washington D.C. used OHSN to track: slips, trips and falls (STF;) musculoskeletal disorders due to patient handling (PHM;) and workplace violence (WPV) among their HCP. A total of 13,798 injuries were reported to OHSN. More than 76% of these injuries met Occupational Safety and Health Administration (OSHA) recordability criteria. Nurses (38%,) nursing assistants (19%) and radiology technicians (4%) accounted for 61% of injuries.

OHSN empowers participating hospitals to identify, promote and measure the impact of practical interventions to reduce injuries among HCP in hospital settings. OHSN data suggest that readily available hospital resources such as lifting equipment can significantly reduce the number of patient handling injuries.

Objectives:

1. Identify observed trends in injury rates from aggregate OHSN data.
2. Explain how to join and participate in OHSN.
3. Describe how to use reports and prevention resources in OHSN.
4. Review the new OHSN Exposure Module.

Topic Overview: INTRODUCTION: Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among U.S. workers from various industries. This analysis examined the associations between workplace physical, psychosocial factors and incidence of dominant-hand CTS, adjusting for personal risk factors.

METHODS: 2,474 participants were followed up to 6.5 years (5102 person-years.) Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted-averaging (TWA) to estimate job level exposures. CTS case-criteria was based on symptoms and results of electrophysiological testing. Information on occupational psychosocial factors was collected with scales from the Job Content Questionnaire (JCQ.) 

RESULTS: After adjustment for covariates, analyst (HR=2.17; 95% CI: 1.38-3.43) and worker (HR=2.08; 95% CI: 1.31-3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI: 1.19-2.86) and percent time spent (e.g., duty cycle) in forceful hand exertions (HR=2.05; 95% CI: 1.34-3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, percent duration all hand exertions, or wrist posture and incident CTS. Psychological demand (HR=1.31; 95%CI: 0.88-1.96) was not confounded by biomechanical exposures, yet decision latitude was confounded by the HAL Scale (HR=0.84; 95%CI: 0.54-1.31). There was evidence of effect modification of the association between decision latitude and CTS by forceful repetition rate among the lower half (HR=0.64; 95%CI=0.34-1.20) and upper half (HR=1.78; 95%CI=0.83-3.81) and various physical exposure measures. 

DISCUSSION:  In this prospective multi-center study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. When work psychosocial factors were assessed for effect modification by biomechanical exposure, a trend supported a protective association between high decision latitude and incidence of CTS only among those with low biomechanical exposure.

Objectives:

1. Discuss the hypothesized relationship among physical, psychosocial factors & CTS using a directed acyclic graph.
2. Describe how different measures of force are associated with incident CTS.
3. Recognize how psychosocial factors are independently related to CTS.
4. Identify how physical risk factors modify the relationship between psychosocial risk factors and CTS.

Topic Overview: Violence in the Workplace. We hear about it every once in a while, yet it seems like it's happening more often. And, for every incident that we hear or read about in the news, many other smaller incidents occur across the country each day that we don't hear about. Employers have both legal and ethical responsibilities to maintain a safe work environment – for the patients, but also for the staff. Well over half of the employers in this country have no program or policy addressing workplace violence, and among those who have a policy, less than half address domestic violence. Workplace violence probably wouldn't or couldn't happen at your healthcare facility - right? Or could it? Workplace violence has remained among the top four causes of death at work for over 15 years, and it impacts thousands of workers and their families annually. Employers can be held liable for workplace violence when it can be shown that there was negligent hiring, negligent retention, negligent security and/or inadequate safeguards to provide a “safe and healthful workplace.” As an occupational health professional, how can you help to minimize the potential for violence in employees?

Hospitals may face liability for workplace violence events. You want to be prepared! OSHA has issued the Compliance Directive “Enforcement Procedures for Investigating or Inspecting Incidents of Workplace Violence.” This comprehensive seminar will explore the statistics, the legal issues surrounding employment practices and what OSHA is doing to try to make your workplace safer for employees.

Objectives:

1. Review the comprehensive list of best practices outlined in OSHA’s Compliance Directive C PL 02-01-052 for Investigating Reports of Violence in the Workplace.
2. Explain the importance of quality screening of potential employees by Human Resources to minimize future violent incidents.
3. Demonstrate the importance of supervisory training for a frontline awareness of personality changes in employees which may predict violent behaviors.
4. Discuss how to initiate legal strategies to address issues of disruptive behavior at any level, including a workable process to address disruptive behavior among staff members.

Topic Overview: Occupational exposure to waste anesthetic gases (WAG) poses serious and long-term health risks for employees and their families. The Occupational Safety and Health Administration (OSHA) estimates that more than 250,000 U.S. healthcare professionals working in hospitals, operating rooms, dental offices and veterinary clinics are exposed to waste anesthetic gases every year. Laws and recommendations regarding WAG exposures are outdated and vague. In 2014, Legacy Health was awarded a $180K grant to upgrade its program for preventing, reducing and educating on exposures to anesthetic waste gases.

The presentation provides an overview of the approach used by Legacy Health to revamp and expand its program regarding WAG monitoring, risk notification and exposure prevention among its five medical centers and a large research facility. The new WAG program focused on three areas: 1) reduce exposure to anesthetic gases using an innovative and inexpensive device which can easily be adopted at other facilities;  2) educate employees, managers  and contractors on the risks of WAG exposure and how to reduce their own risk, and 3) develop and implement a WAG monitoring program across multiple departments.

The presentation will discuss a study investigating the efficiency of a Disposal of Gas (DoG) control device to reduce the amount of waste anesthetic gases present in the breathing area of staff. The device is intended to be used in conjunction with a system-wide monitoring program and educational materials that help reduce potential exposure to airborne WAG concentrations generated from the mask during surgical procedures. The study concluded that DoG device implementation in addition to work practice modifications may be highly effective control measures that reduce occupational exposure to gases. Examples of policy, educational materials, monitoring programs and an outline for how to create a DoG device will be provided to attendees.

Objectives:

1. Recognize risks of Waste Anesthetic Gases (WAG) in occupational settings.
2. Describe the best practices to reduce WAG exposures.
3. Identify the tool to develop an effective WAG monitoring program.

Topic Overview: Fitness for duty may be due to a multitude of factors; not only physical conditions or functional impairment, but also possibly substance abuse and/or mental health conditions. The occupational health (OH) clinician is expected to apply clinical expertise and judgment to determine if the employee’s behavior and/or performance issues are related to a medical condition rendering them unfit to work in a safe and healthy manner. 

Once an employee has been identified as potentially being unfit, the OH clinician serves as the liaison between management, the employee, the employee’s provider and potentially an independent medical examiner. It is essential for the OH clinician to have a good understanding of the various regulatory standards that guide this interactive process,  including the OSHA General Duty Clause, the Family and Medical Leave Act (FMLA,) the Americans with Disabilities Act (ADA) and HIPAA.

To ensure the best outcome for both the employee and the institution, the OH clinician must have a firm understanding of the regulatory, operational and safety issues in the workplace involving the employee. In addition, the OH clinician needs to understand the importance of measuring fitness objectively and, in most cases, of having an independent determination of fitness that is acceptable to both the employee and employer.

Objectives:

1. Explain the differences among physical, mental health, and substance abuse fitness for duty issues.
2. Explain the legal issues surrounding fitness for duty issues.
3. Recognize the role of the Independent Medical Examiner (IME) and the value of the Functional Capacity Exam (FCE.)
4. Describe the role of the occupational health clinician throughout the fitness determination process.

Topic Overview: In healthcare, employee safety often becomes one of many competing priorities. With this, regulatory compliance measures such as OSHA and Joint Commission standards tend to become benchmarks for success, while accident and injury rates persist to the outdated mantra of "the cost of doing business." However, by utilizing High-Reliability principles to account for the comprehensive and systemic identification, assessment, and control of hazards among environmental conditions and behaviors, components and relations, and managerial oversight to promote reliability of behaviors and validity of metrics, workplace safety can become a matter of continual improvement, and accident and injury reduction can become a reality.

This presentation discusses the differences between a true High-Reliability Organization that requires workplace safety as a pre-requisite to success in any operation (let alone a device to avoid catastrophic failure,) and a culture of baseline, minimal compliance. It discusses High-Reliability concepts, starting with Enterprise Risk Management, illustrates how reliability and validity of data are required through program participation and managerial oversight before any progress can be considered real, and systemically and scientifically delineates a workplace safety program into integrated components that are executable in an organization of any size. Ultimately, true to High-Reliability concepts, these components allow for the positive reinforcement of safe behaviors, maintenance of safe conditions, and the interaction between the two to account for a total culture change.

Objectives:

1. Identify the principles and concepts of a High-Reliability Organization.
2. Discuss the correlation of High-Reliability principles with hazard identification, assessment and control.
3. Define workplace safety program components leading to the implementation of High-Reliability principles.

Topic Overview: Every specialty has its procedure that makes it unique. In occupational medicine, our special skill is in disability management, and the product is an accurate, concise and clear work status report in the form of work restrictions. In Part 1, the concepts of disability management were discussed. Part 2 provides further exploration of the steps recommended for crafting work restrictions, presents “pearls” from an experienced provider and includes case study discussion.

Objectives:

1. Develop a framework to consistently write appropriate work restrictions.
2. Apply principles of proper work restrictions to select cases.
3. Demonstrate a variety of methods to communicate the same work status.

Topic Overview: LASER is an acronym which stands for Light Amplification by Stimulated Emission of Radiation. The laser produces an intense, highly directional beam of light. The most common cause of laser-induced tissue damage is thermal in nature, where the tissue proteins are denatured due to the temperature rise following absorption of laser energy.

The human body is vulnerable to the output of certain lasers, and under certain circumstances, exposure can result in damage to the eye and skin. Research relating to injury thresholds of the eye and skin has been carried out to understand the biological hazards of laser radiation. It is now widely accepted that the human eye is almost always more vulnerable to injury than human skin. Workers unprotected from laser exposure can suffer serious eye and skin injuries, including permanent blindness and tissue damage, in addition to respiratory hazards from surgical smoke.

Objectives:

1. Describe the range of tissue interactions that can be achieved with the use of lasers.
2. List four safety standards regarding laser use according to the American National Standards Institute (ANSI,) AORN and the American Society for Lasers in Medicine and Surgery.
3. Explain the essential steps that must be in place to ensure safety for patients and healthcare personnel during laser use.
4. Review potential employee-related laser incidents.

Topic Overview: 

Occupational health plays a pivotal role in the ongoing safety of the work environment.  As members of the management team, it is essential for occupational health professionals to know and understand the potential changes in the regulatory environment caused by the passage of newly introduced legislation. This session will review the pertinent and germane bills introduced in the first session of the 114th Congress and give insights into the reasons behind the issues. We will examine the bills which have passed and the bills which have been introduced – both shed light on where we are heading in the ever-changing – and evolving – regulatory arena of occupational health.

We will also review new initiatives presented by various federal agencies. Since 2008, OSHA has once again become an enforcement agency and, in its fall 2014 regulatory agenda, OSHA has included initiatives for a new infectious disease standard and regulations which may result in changes to the Recordkeeping Standard. This section of the legislative review will discuss the proposed regulations introduced by the Department of Labor and Health and Human Services and give details of the potential outcomes and impacts on occupational health professionals.

Objectives:

1. Identify which new legislation introduced into the 114th Congress may impact occupational health.
2. Describe the issues behind newly introduced legislation and the potential for passage.
3. Identify strategies to address departmental changes brought on by the newly introduced legislation.
4. Review OSHA’s and HHS's upcoming regulatory agenda for 2015 andinitiatives which may impact the Occupational Health Department.

Topic Overview: "All rise" as AOHP Court is called to order! AOHP Court will take four real, litigated cases, and members will debate each case. The audience will vote, and our judge will reveal actual decisions.

Objectives:

1. Explain an improved understanding of drug testing.
2. Examine reasonable accommodation.
3. Underline the importance of wellness exams.
4. Identify increased awareness of wrongful termination.

Topic Overview: OSHA recently announced an initiative to protect temporary employees from workplace hazards. OSHA has become increasingly concerned that some employers may be using temporary workers to duck their compliance obligations. Knowing that a worker is – or is not – an employee can be tricky. The federal courts use an “economic realities” test to determine whether an individual is an employee or a temporary employee. Depending on the state in which a hospital is located, state courts may use a similar test or a “right-to-control” test to determine whether an individual is an employee or a temporary employee under the applicable state labor (OSHA,) wage and hour laws. OSHA is directing field inspectors to assess whether employers who use temporary workers are complying with their responsibilities. Inspectors will evaluate whether temporary workers are exposed to safety and health violations, and they will assess whether temporary workers received required training in a language and vocabulary they could understand. To assist employers in addressing the temporary worker issue, on August 25, 2014, OSHA and NIOSH released recommended practices for staffing agencies and host employers to better protect temporary workers from hazards on the job.  Proper recordkeeping and reporting is also critical so responsibilities can be clearly defined. The guidance clarifies that illness and injury recordkeeping for temporary employees should be accounted for on only one employer’s 300 log. 

According to Dr. David Michaels, Assistant Secretary of Labor for Occupational Safety and Health, "Host employers need to treat temporary workers as they treat existing employees. Temporary staffing agencies and host employers share control over the employee and are therefore jointly responsible for the temp employee's safety and health. It is essential that both employers comply with all relevant OSHA requirements."

Objectives:

1. Explain OSHA’s new emphasis on the safety of temporary workers and what hospitals should do to evaluate relationships with staffing agencies.
2. Describe methodologies to jointly review all worksites to which temporary workers might be sent, task assignments and job hazard analyses to identify and eliminate potential safety and health hazards and identify necessary training and protections for each worker.
3. Review the basics of recordkeeping in multi-employer settings and how to determine if an injury/illness is reportable.  

Topic Overview: Bloodborne pathogen exposures continue to occur among healthcare workers, despite years of attention and a variety of efforts to eliminate them. The AOHP-sponsored Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) benchmarking research study (which has collected data since 2011) continues to provide new insights into this issue. This team-taught presentation will demonstrate to conference participants how research and evidence-based practice can inform their management of this crucial concern. The session will include updates on sharps and muco-cutaneous exposure incidence, expand on best practices in exposure prevention and provide a preview report on the most recent findings. This preview will include information gathered from 2013 and 2014 data, encourage continued member support, and demonstrate AOHP’s commitment to the generation of original research and position as a recognized leader in occupational health practice.

 Objectives:

1. Identify current bloodborne pathogen exposure prevention initiatives.
2. Discuss examples of prevention best practice.
3. Discuss findings of the most recent EXPO- S.T.O.P. survey, and encourage continued support. 

Topic Overview: Few threats are as difficult to predict — and prevent — as the eruption of violence.  Hospitals are faced with planning for and combating a variety of violent threats in a 24/7 operational environment. This important session reviews guidelines and regulations, and addresses key components of preparedness and response to violent threats and events in the hospital from a hospital operations basis, not a law enforcement perspective. Focus will be on training and exercise planning, contemporary challenges in preparing the facility for response, and the behavioral health considerations in both planning and recovery. Attendees will learn ways to improve the culture of safety across the organization.

Objectives:

1. Review healthcare specific statistics for incidence of workplace violence and active shooter in the healthcare environment.
2. Discuss legal and regulatory considerations associated with safety in the workplace, and illness and injury prevention plans.
3. Describe workplace security assessments to identify hospital risk factors when developing plans for hospital staff response activities to an active shooter incident.
4. Recognize the role of law enforcement, and anticipate initial response and interactions with hospital staff when preparing staff to respond.
5. Identify issues and needs for employees in the post-incident phase, including incident debriefing and plans for mental health interventions.

Topic Overview: Tuberculosis (TB) transmission can and does occur in hospitals and other healthcare settings. TB investigations in these settings pose unique challenges and opportunities to detect and prevent TB. This presentation will review a large TB outbreak that was identified in a small community in California. Many healthcare workers were exposed and became infected with TB; four healthcare workers developed active TB disease linked to this outbreak. Working together with public health and infection control practitioners, occupational health providers are playing a key role in investigating TB transmission, identifying infected healthcare workers, developing appropriate ongoing plans for TB evaluation, and offering preventive treatment. The outbreak investigation methods, including the role of TB genotyping and whole genome sequencing, will be reviewed. The issue of visitors to healthcare facilities being potential sources of TB will also be discussed.

 Objectives:

1. Describe indications that TB transmission is occurring in a healthcare setting.
2. Discuss methods for investigating and responding to a TB outbreak or other TB transmission events in a healthcare setting and potential data sources.
3. Discuss short-course treatment regimens for TB infection.
4. Describe strategies to enhance healthcare worker adherence to TB infection treatment in a setting of recent TB transmission. 

Topic Overview: Powerful changes are sweeping the worlds of economics, demographics, occupational health and workers' compensation. From bankrupt municipalities (Bakersfield, Detroit, Stockton) to ObamaCare; from aging and obesity to shifting demographics of employee populations; from shifts in work from office to home, employee to contractor, U.S. to foreign workers on visas, and people to machines; Phil Walker gazes into these changes and provides his predictions and warnings for the next 25 years of employee health and workers' compensation. This powerful session will provide attendees the forecasts to plan for the future and the tools and ideas to help prepare for, and anticipate, the changes which are certain to come.

Objectives:

1. Identify future changes in employee health and workers' compensation.
2. Explain economic factors and workplace changes driving the evolution of workers' compensation.
3. Explain practical tools for anticipating and dealing with changes in employee health and workers' compensation.