1. AWARENESS OF HEALTH AND SAFETY IN THE WORKPLACE-A CASE AT AKUH, N Joshua Odero, Zahir Moloo, Zul Premji Department of Pathology, Aga Khan University Hospital, Nairobi

2. Presentation Overview AKU experience in improving safety culture What effect does management commitment have on safety implementation A safety culture as a continuous journey Achieving Improvements in Safety Does it Work?

3. Organizational Characteristics of A Good Safety Culture Strong senior management commitment, leadership and involvement in safety Closer contact and better communications between all organizational levels Greater hazard control and better housekeeping A mature, stable workforce Good personnel selection, job placement and promotion procedures Good induction and follow-up safety training Ongoing safety schemes reinforcing the importance of safety, including “near miss reporting”

4. What is Safety Culture? Safety culture is the extent to which safety is emphasized, both formally and informally, by an organization and its members.

5. Safety culture indicators Indicators Behaviour Indicators: Unsafe behaviour by the workers Management commitment to safety Statements about safety Structural conditions Formal safety policies and objectives Safety standard of equipment and machines Formal safety meetings The composition of the HSC Accident registration and analysis The inclusion of safety on the agenda of meetings Measures Interview Inspection reports Minutes of meetings Direct observation Inspection by health and safety team Inspection by environment authorities

6. Safety culture indicators Contd… Documents Visible safety information Safety signposting Inspection reports Monthly meetings of HSC

7. AKU experience in improving safety culture Low safety commitment for workers and management, as there was no communication on notice boards/ minutes Behaviour was generally unsafe No objectives for safety performance or formal safety policies nor systematic preventive efforts Inefficient or lacking safety signposting No records of safety training No incident/ accident records No safety rules and procedures No planned maintenance of equipment  Baseline assessment :

8. AKU experience in improving safety culture  Undertaken interventions: Hazard assessment and engineering controls Health and safety policies and procedures; An effective management structure with appointment of Safety Officer, safety representatives Setting Health and safety committee (HSC) Inspections carried out by the safety committees every week Safety orientation,training and communication Enforcing proper utilization of PPEs Systems to track Hazard correction Preventive Maintenance Systems Emergency preparedness Medical programs

9. Process with safety representatives Safety representatives were urged by management to be proactive and take the initiative to safety activities Employees report concerns at meeting, to H & S reps Safety regular agenda item at management meetings Senior leadership in the laboratory together with the safety reps conduct workplace inspections once/ week

10. Measuring Performance  Active self-monitoring / Inspections: reveals how effectively the health and safety management system is functioning  Main objective indicators of safety culture: Annual rate of problems with repeated root cause Annual rate of safety significant errors Ratio of corrective to preventive maintenance of safety  Improvement in the indicators: CAPA data show a significant improvement in violations by workers Improvement in Top management commitment to safety, issues addressed a lot more by management

11. Measuring Performance Contd....  Improvement in the indicators: HSC performance: at baseline, no minutes were available, from HSC minutes of meeting recommended safety issues, frequent meetings Inspection reports that showed gaps at baseline regarding equipment (PPM) not being up to date had all been resolved HSC composition and number of formal meetings increased Different types of documents, safety information was available through notice boards and signposting were visible Accident analysis and registration were used to guide preventive efforts

12. THANK YOU