Health Care Program

Overview

Health care inspectors enforce the Occupational Health and Safety Act and applicable regulations at health care workplaces across the province.

The Ministry of Labour’s Health Care Program covers health and community care services in seven settings:

• long-term care homes (homes for nursing care)
• retirement homes (homes for residential care)
• hospitals
• nursing services
• supported group living residences and other facilities (group homes)
• treatment clinics and specialized services
• professional offices and agencies

In 2017-18, health care inspectors focused on falls, noise, workplace violence, infection control and the Internal Responsibility System, along with their general inspection duties and field visits.

Health care health and safety initiatives

Falls (including slips and trips)

Slips, trips and falls are among the leading causes of workplace lost-time injuries (LTIs) in Ontario’s health care sector. For example, in 2017, slips, trips and falls accounted for 1,264 LTIs, which was 18% of all LTIs in health care workplaces across Ontario.

Employers are ultimately responsible for protecting workers from slips, trips and fall hazards in health care workplaces. Some examples of common slips, trips, and fall hazards are:

• poorly maintained or obstructed floors and other work surfaces
• wet and slippery surfaces
• debris and items stored in pedestrian walkways or hallways
• weather conditions (snow, ice and rain)
• clutter and loose cords, hoses, wires and medical tubing

Inspectors conducted a two month falls health and safety initiative on specific safety issues, including:

• maintenance of work surfaces
• same level falls, for example falls caused by slippery and uneven surfaces, tripping hazards and dark and obstructed pathways in hallways and walkways
• housekeeping
• safe ladder use
• safe work practices and working conditions
• training, including training and education on measures and procedures to recognize fall hazards.

During this inspection initiative, there were 47 field visits which resulted in 60 orders.

Initiative activity summary

• field visits—47
• workplaces visited—37
• orders and requirements issued—60
• stop work orders—0
• orders and requirements per field visit—1.28
• orders and requirements per workplace visited—1.62

Resources

• Health and community care
• Public Services Health & Safety Association to identify, prevent and control hazards in health and community workplaces

Provincial health care initiatives

Provincial health care initiative (July 1, 2014 – June 30, 2017)

As part of Safe At Work Ontario, the Ministry of Labour conducted a three-year (July 1, 2014 – June 30, 2017) initiative to promote health and safety in Ontario’s health care sector.

Inspectors checked the internal responsibility system and five of the most serious hazards:

• musculoskeletal disorders
• exposure to hazardous biological, chemical and physical agents
• slips, trips and falls
• worker contact with objects and/or being struck by objects
• workplace violence

Over the three years, inspectors visited all acute care hospitals, along with some long-term care (LTC) homes, retirement homes, group homes and community-based health care services. They reviewed both clinical and non-clinical areas.

Inspectors checked for compliance with:

• the Occupational Health and Safety Act
• the regulation for health care and residential facilities
• regulations on needle safety
• other health and safety regulations, including awareness and training

Inspectors also reviewed the workplaces’ internal responsibility systems. Inspectors referred employers to health and safety associations for compliance support and training.

Enforcement initiatives raise awareness of workplace hazards and help employers and workers comply with health and safety requirements. If needed, inspectors conduct follow-up inspections at a workplace.

During the initiative, there were 2,525 field visits to 908 workplaces.

Initiative activity summary

• field visits—2,525
• workplaces visited—908
• orders and requirements issued—6,051
• stop work orders—62
• orders and requirements per workplace visited—6.66

Orders were issued for violations under the:

• Occupational Health and Safety Act
• Ontario Regulation 67/93: Health Care and Residential Facilities
• Ontario Regulation 474/07: Needle Safety
• other health and safety regulations

This table shows the number of visits by type of health care workplace, and the orders issued between July 1, 2014 and June 30, 2017.

Resources

• Health care sector plan 2017-2018
• Public Services Health & Safety Association
• Health and community care

Noise

The ministry conducted a one-year provincial enforcement initiative on noise hazards in all workplaces across the province, including health care workplaces. The initiative took place between April 1, 2017 and March 31, 2018.

Noise is a serious health hazard and a leading cause of occupational disease in Ontario. If exposure to noise from machinery, processes and equipment is not properly eliminated or controlled, it can cause permanent hearing loss.

In 2017-18, inspectors visited workplaces to check that workers were protected from hazardous sound levels. Inspectors focused on:

• sources of noise
• signs
• engineering controls
• personal protective equipment (hearing protection devices)
• the condition of hearing protection devices
• training on hearing protection devices

The ministry conducted 102 field visits resulting in 62 orders.

Initiative activity summary

• field visits—102
• workplaces visited—80
• orders and requirements issued—62
• stop work orders—0
• orders and requirements per field visit—0.61
• orders and requirements per workplace visited—0.78

Resources

• A guide to the noise regulation (Ontario Regulation 381/15) under the Occupational Health and Safety Act
• Health care sector plan 2017-2018

Health care sector enforcement initiative (September 1, 2017 – March 31, 2018)^{footnote 16[16]}

The Ministry of Labour launched a seven-month health care enforcement initiative at LTC/retirement homes, primary care workplaces (family health teams and community health centres) and hospitals.

Hospitals

For hospitals, ministry inspectors focused on workplace violence prevention, including:

• risk assessments, with measures and procedures to control the risks identified
• summoning immediate help when workplace violence occurs or is likely to occur
• providing information about a risk of workplace violence from a person with a history of violent behaviour
• identifying the steps taken to prevent another incident in the written notification of a workplace injury

Ministry inspectors informed workplaces about the recommendations and the tools from the Workplace Violence Prevention in Health Care Leadership Table.

Inspection activity summary

• field visits—192
• workplaces visited—101
• orders and requirements issued—296
• stop work orders—0
• orders and requirements per field visit—1.54
• orders and requirements per workplace visited—2.93

LTC and retirement homes

In LTC and retirement homes, ministry inspectors focused on the internal responsibility system (IRS). They checked that homes were complying with the law regarding musculoskeletal disorders and exposure/infection control.

Inspection activity summary

• field visits—160
• workplaces visited—124
• orders and requirements issued—224
• stop work orders—3
• orders and requirements per field visit—1.4
• orders and requirements per workplace visited—1.81

Primary care

In primary care workplaces, ministry inspectors checked that they were complying with the regulations on IRS compliance, workplace violence and needle safety.

Inspection activity summary

• field visits—90
• workplaces visited—67
• orders and requirements issued—161
• stop work orders—0
• orders and requirements per field visit—1.79
• orders and requirements per workplace visited—2.40

Resources

• Ministry of Labour’s Health and Community Care web page
• Public Services Health & Safety Association