Occupational injury root cause analysis

The Education and health service sector has the highest occupational injury & illness (OII) rate of any other private industry in the USA. The root cause investigation and analysis process (RCA) is frequently used in the hospital industry by patient safety professionals since being required by The Joint Commission in 2001. However, there is limited information about the prevalence or utility of RCA use for identifying and correcting OII hazards in the healthcare settings.

The Environmental Health & Safety (EH&S) department of an academic teaching hospital in the Northeastern U.S. implemented an RCA process in January 2012. The 5 Whys methodology was used by seven EH&S staff through an electronic form constructed and tracked in Microsoft SharePoint. Risk-based decision criteria for investigation and corrective actions along with standardized communications methods were developed. The goals were to help prevent new OII cases through review of 100% of reported cases, investigation of 100% of OSHA recordable cases, and delivery of recommendations for corrective actions for 100% of all high priority hazards identified.

In 2012, 43% were reviewed, 47% of OSHA Recordables were investigated, and recommendations were issued for 21% of those investigated. EH&S staff invested an estimated 228 hours for investigation and documentation alone. Reported OII rates declined in 2012 from 2011 but many factors are known to contribute to these trends.

RCA can be a useful yet resource intensive tool for identifying and eliminating OII hazards and increasing injured employee's sense of support by hospital employers.