Overview

From September 18, 2017 to June 30, 2018, the Ministry of Labour (MOL) conducted a 10-month health care enforcement initiative, which focused on hospitals, long-term care and retirement homes and primary care workplaces (family health teams and community health centres).

To help stakeholders prepare for this initiative, the MOL and the Public Services Health & Safety Association (PSHSA) held three joint webinars in June 2017—one was for long-term care homes and retirement homes and two were for primary care workplaces. The MOL focused on the enforcement of the initiative and PSHSA outlined resources available to workplace parties to assist with compliance such as training courses and resource guides.

In September and November, two webinars were held regarding workplace violence prevention and the enforcement initiative, which started in hospitals on September 18, 2017.

Results for hospitals

Between September 18, 2017 and June 30, 2018, ministry inspectors conducted:

  • 256 field visits with 52 activities in a support rolefootnote 1
  • at 122 workplaces

A total of 352 orders and requirements were issued under the Occupational Health and Safety Act (OHSA) and its regulations, which included 4 stop work orders.

Results for long-term care and retirement homes

Between September 1, 2017 and June 30, 2018, inspectors conducted:

  • 226 field visits with 41 activities in a support role
  • at 162 workplaces

A total of 339 orders and requirements were issued under the OHSA and its regulations, which included 4 stop work orders.

Results for the primary care workplaces initiative

Between September 1, 2017 and June 30, 2018, inspectors conducted:

  • 157 field visits with 11 activities in a support role
  • at 113 workplaces

A total of 273 orders and requirements were issued under the OHSA and its regulations. There were no stop work orders.

Initiative focus

1. Hospitals

Ministry inspectors focused on workplace violence prevention in hospitals, including:

  • workplace violence risk assessments, including measures and procedures to control the risks identified in the assessments
  • obtaining immediate assistance when workplace violence occurs or is likely to occur
  • providing information about the risk of workplace violence from a person with a history of violent behaviour and
  • ensuring that the steps taken to prevent recurrence were included in the written notification of a workplace injury

Ministry inspectors supported the recommendations and tools of the Workplace Violence Prevention in Health Care Leadership Table. For example, they used the hazard prevention tools to enhance enforcement and convey the expectations for compliance.

2. Long-term care and retirement homes

Ministry inspectors checked on the internal responsibility system (IRS) by inspecting for compliance with the OHSA with a focus on musculoskeletal disorders and exposure/infection control.

3. Primary care (family health teams and community health centres)

Ministry inspectors focused on IRS compliance, workplace violence and compliance with O. Reg. 474/07: Needle Safety.

Full report

Inspection activity summary

1. Hospitals

Visits to workplaces from September 18, 2017 to June 30, 2018
  • 256 field visits with 52 activities in a support role
  • 122 workplaces visited
  • 352 orders and requirements issued
  • an average of 2.89 orders and requirements issued per workplace visited
  • an average of 1.38 orders and requirements issued per visit
Most frequently issued orders

During the initiative, a total of 232 orders and requirements (66%) were written under the OHSA to health care workplaces. Of these, the most frequently issued orders were:

  • failure to reassess the risks of workplace violence as often as necessary to ensure that the policy and program continue to protect workers [s. 32.0.3(4)]—39 orders
  • failure to provide information, instruction and supervision to a worker to protect his or her health or safety [s. 25(2)(a)]—34 orders
  • failure to assess the risks of workplace violence that may arise from the nature of the workplace, the type of work or the conditions of work [s. 32.0.3(1)]—24 orders

In total, 125 OHSA orders (36% of the total orders and requirements) involved section 32.0 of the act for workplace violence. Of these, 24 orders involved a lack of risk assessment [s. 32.0.3(1)] and 39 involved a lack of reassessment [s. 32.0.3(4)]. Ten OHSA orders were written for failing to provide information regarding the risk of workplace violence from a person with a history of violent behaviour [s. 32.0.5(3)] and 18 orders were written for measures and procedures to summon immediate assistance [s. 32.0.2(2)(b)].

A total of 111 orders (32%) were issued under O. Reg. 67/93: Health Care and Residential Facilities. Of these, the four most commonly issued orders were about measures and procedures:

  • failure to review measures and procedures for the health and safety of workers at least once a year and revise in light of current knowledge and practice [s. 9(2)]—30 orders
  • failure of the employer, in consultation with and in consideration of the recommendation of the joint health and safety committee or health and safety representative, to develop, establish and provide training and educational programs in health and safety measures and procedures for workers that are relevant to his or her work [s. 9(4)]—27 orders
  • failure of the employer to have written measures and procedures for the health and safety of workers [s. 9(1)]—20 orders
  • failure of the employer, in consultation with and in consideration of the recommendation of the joint health and safety committee or health and safety representative, to develop, establish and put into effect measures and procedures for the health and safety of workers [s. 8]—19 orders.
Observations

A total of 36% of the orders were issued under the violence provisions of the OHSA. The most common orders written under O. Reg. 67/93 were under sections 8 and 9, which require measures and procedures, and consultation with the joint health and safety committee in the workplace.

2. Long-term care and retirement homes

Visits to workplaces from September 1, 2017 to June 30, 2018
  • 226 field visits with 33 activities in a support role
  • 162 workplaces visited
  • 339 orders and requirements issued for a number of violations under the OHSA and its regulations
  • 4 stop work orders issued
  • an average of 2.09 orders and requirements issued per workplace visited
  • an average of 1.50 orders and requirements issued per visit
Most frequently issued orders

During the initiative, a total of 208 orders (61%) were written under the OHSA to health care workplaces. Orders for employers not complying with their duties under section 25 of the OSHA accounted for 130 orders (38%) of the total orders/requirements issued. Of these, the three most frequently issued orders were:

  • failure to take every precaution reasonable in the circumstances for the protection of a worker [s. 25(2)(h)]—56 orders
  • failure to ensure equipment, materials and protective devices were maintained in good condition [s. 25(1)(b)]—51 orders
  • failure to provide information, instruction and supervision to a worker to protect his or her health or safety [s. 25(2)(a)]—7 orders

There were 11 orders (3%) requiring that a joint health and safety committee member inspect the physical condition of the workplace at least once a month [s. 9(26)].

A total of 86 orders (25%) were issued under O. Reg. 67/93 (Health Care and Residential Facilities). Of these, the most commonly issued orders were:

  • failure to transport, place or store materials, articles or things so that they will not tip, collapse or fall [s. 103(2)]
  • failure to keep work surfaces free of obstructions and hazards [s. 33(1)(a)]
  • failure to ensure that equipment that had an exposed part that may endanger the safety of any worker was equipped with and guarded by a guard or other device that prevented access to the moving part [s. 45]

There were 45 orders (13%) written under other legislation, including:

Observations

Thirty-eight per cent of the most frequently issued orders for long-term care and retirement homes were for employers’ failure to protect workers from hazards as required by OHSA section 25.

Orders issued under O. Reg. 67/93 indicate workers continue to be exposed to hazards involving material handling, unsafe work surfaces and unguarded equipment.

3. Primary care workplaces

Visits to workplaces from September 1, 2017 to June 30, 2018
  • 157 field visits with 11 activities in a support role
  • 113 workplaces visited
  • 273 orders and requirements issued for a number of violations under the OHSA and its regulations
  • an average of 2.42 orders issued per workplace visited
  • an average of 1.74 orders issued per visit
Most frequently issued orders

A total of 188 orders (69%) were written under the OHSA to health care workplaces. Of these, the most frequently issued orders were:

  • failure to take every precaution reasonable in the circumstances for the protection of a worker [s. 25(2)(h)]—61 orders
  • failure to prepare and review at least annually a written occupational health and safety policy and develop and maintain a program to implement that policy [s. 25(2)(j)]—12 orders
  • failure to review the violence and harassment policies as often as is necessary, but at least annually and/or failure to have a written policy that is posted in a conspicuous place in the workplace

There were 85 orders (31%) written under other legislation, including:

Observations

Many of the orders issued to primary care workplaces were related to the IRS, such as  preparing, reviewing and posting of required policies and worker completion of awareness training. There were also contraventions of O. Reg. 474/07: Needle Safety.

Conclusion and next steps

The MOL is committed to increasing awareness and compliance with the OHSA and its regulations, as part of our enforcement initiatives.

Workplace violence prevention in health care and a strong IRS are priorities in the MOL's 2017-18 SAWO Health Care Sector Plan.

To strengthen workplace health and safety in Ontario’s health care sector, the ministry will continue to work with its health and safety system partners and stakeholders in Ontario’s health care sector.

Help for employers

Contact the Public Services Health & Safety Association (PSHSA) for resources and training on identifying, preventing and controlling workplace hazards in health care and community workplaces.

Visit Workplace-violence.ca for resources and tools to prevent workplace violence.