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SAFETY AND SECURITY GUIDELINES FOR REMOTE AND ISOLATED HEALTH

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Page 1: SAFETY AND SECURITY GUIDELINES FOR REMOTE AND ISOLATED … · Safety and Security Guidelines for Remote and Isolated Health the peak professional body for the remote and isolated

SAFETY AND SECURITY GUIDELINES FOR REMOTE

AND ISOLATED HEALTH

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INTRODUCTION 02

HOW TO USE THE GUIDELINES 04

GUIDELINES SUMMARY 05

GUIDELINES, AIMS AND ACTIVITIES 06

1AlwaysBeingAccompanied(NotAlone) 06

2BeingPreparedforRemoteHealthPractice 07

3EnsuringStaffResilienceandManagingFatigue 08

4CreatingaStableWorkforce 09

5TheEssentialNatureofCommunication 10andConnectivity

6TheAbilitytoPreventandDe-escalate 11

7IdentifyingHazardsandManagingRisks 12

STAKEHOLDER ROLES AND CONTRIBUTION 13

CONTENT

Safety and Security Guidelines for Remote and Isolated Health

the peak professional body for the remote and isolated health workforce | www.crana.org.au 1

CRANAplusacknowledgestheAboriginalandTorresStraitIslanderpeoplesasthetraditionalcustodiansofAustralia,manyofwhomliveinremoteareas,andwepayourrespecttotheirEldersbothpastandpresent.CRANApluscontributessignificantlytoimprovingthehealthofAboriginalandTorresStraitIslanderpeoplesbybuildingthestrengthoftheremoteandisolatedhealthworkforce.

CRANAplusSafetyandSecurityGuidelinesforRemoteandIsolatedHealth,2017,©CRANAplus,CairnsQLD.

Copyrightprotectsthispublication.ExceptforpurposespermittedbytheCopyrightAct1968,reproduction,adaptation,electronicstorage,andcommunicationtothepublicisprohibitedwithoutpriorwrittenpermission.EnquiresshouldbeaddressedtoCRANAplusPOBox7410,Cairns,[email protected]

TheprojecttodevelopthispublicationwasfundedbytheAustralianGovernmentDepartmentofHealth.

www.crana.org.au

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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 2

INTRODUCTION

Workplace violence in remote health is an ongoing and escalating concern that presents unique challenges not faced in urban areas.

ThedrivetoimprovethesafetyandsecurityoftheremotehealthworkforcebecameanindustrywidepriorityfollowingthetragicmurderofremoteareanurseGayleWoodfordin2016.Thiscausedtheremotehealthindustrytocriticallyreflectonlongheldpracticesandchallengeitsacceptanceoftherisksthatwereroutinelyconsidered‘justpartofthejob’.

Inthe2016–2017financialyear,CRANAplusreceivedfundingbytheCommonwealthDepartmentofHealthtoundertakearemotehealthworkforcesafetyandsecurityproject.

Adiverserepresentativeexpertadvisorygroupinformedtheentireproject.Themembersofthisgroupincluded:

Christopher CliffeCEOCRANAplus,VIC;(Chairperson)

Geri MaloneDirectorProfessionalServices,(DeputyChairperson)CRANAplus,SA

Marie Baxter ExecutiveDirectorNursingandMidwifery,CountryHealthService,WA

Julianne Bryce SeniorFederalProfessionalOfficerANMF

Michelle GarnerExecutiveDirectorNursingandMidwifery,MountIsaQLD

Heather KeighleyActingChiefNursingandMidwiferyOfficer,NT

Assoc. Prof Sue LenthallCentreforRemoteHealth,NT

Dr. Jennifer MayDepartmentofRuralHealth,TamworthNSW

Rod MenereProfessionalOfficer,CRANAplus,NSW(ProjectOfficer)

Johanna NevilleRemoteAreaNurse/MidwifeApunipimaCapeYork,QLD

Lesley PearsonDirectorofClinicalOperations,SilverChainWA

Bobbi SawyerSocialWorker,TeamManager,CAMHS,SA

Rob StarlingChiefInformationOfficer,NACCHO,ACT

Tony VaughanChiefOperatingOfficer,RFDS,SA

ThecompletionofphaseoneoftheprojectsawthereleaseoftheNationalRemoteHealthWorkforceSafetyandSecurityReport:LiteratureReview,Consultation,andSurveyResults,inJanuary2017.ThereportincludedaliteraturereviewbuildingontheworkoftheWorkingSafeinRuralandRemoteAustraliaProject.Additionally,utilisingworkshops,surveysandsocialmedia,CRANAplusundertooka‘nationalconversation’withremotehealthstakeholders.

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Safety and Security Guidelines for Remote and Isolated Health

the peak professional body for the remote and isolated health workforce | www.crana.org.au 3

Thisprovidedanopportunitytoseektheviewsoftheworkforce,employers,andotherstakeholders,andtestexistingassumptionsontherealandperceivedissuesaroundsafetyandsecurity.

Thereportidentifiedseveralsignificantissues:

• Theneedforemployersandstafftoconducthazardidentificationandriskassessment,eventreporting,andworkplacereviewofsignificanteventsandnear-misses;

• Theneedforstafftobeaccompaniedon-call,andatothertimeswhenrisksareidentified;

• Theneedformorecomprehensiveandtimelyorientationofnewstaff;

• Theneedtopromoteindividualresilienceandmanagetheriskoffatigue;

• Theneedtoaddresshighworkforceturnoverandissuesrelatingtobullyingandharassment;

• Theneedforreliable,accessibletransportandemergencyafterhourscommunicationsystems,includingmonitoring,supportedbystafftraininginequipmentuse;

• Theneedtoprovideaccesstopatientinformationanddatainstaffaccommodation;

• Theneedforstafftrainingandpracticeincommunicationandde-escalationtechniques,tomitigatetheriskofconflictleadingtoviolence.

ThefullreportcanbeaccessedontheCRANApluswebsitewww.crana.org.au.

Recognisingthatthesafetyofstaffandservicesareessentialfortheeffectiveprovisionofhealthservices,theguidelinescontributetosupportingtwosignificantgovernmentinitiatives:TheCommonwealthWorkHealthandSafetyAct;andtheNationalSafetyandQualityHealthServiceStandards(StandardOne:GovernanceforSafetyandQualityinHealthServiceOrganisations).

Thegoaloftheseguidelinesistoprovidebroadstatementswithexamplesofactivities,whichcanbeimplementedbyemployers,serviceproviders,communities,clinicians,andotherstakeholderstoestablishandmaintainsafeandeffectiveoperatingsystemsinremotehealthservices.

Theguidelinesidentifysevensafetyandsecuritypriorityareas,eachofwhichistobeconsideredthroughthelenseoftheindividual,theteam,theemployer,theinfrastructure,theenvironmentandthecultureandcommunity.

Theseguidelinesprovideastructuredpathwaytoidentifyriskandprioritiseareasforimprovement.Ultimately,itwillbehighlyvaluabletodevelopagreednationalstandardsforremotehealthworkforcesafetyandsecurity.Standardswillprovideclear,measurableexpectationsonsafetyandsecurityissues,providinggreaterimpetustodrivereform.

Althoughdevelopedprimarilyforsmallremotetownsandcommunities,theseguidelinescanbecontextualisedtoanyareaorindustrythatrequireshealthserviceprovisioninanisolatedsetting.

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Safety and Security Guidelines for Remote and Isolated Health © CRANAplus 2017 4

1. Theinfographicprovidesasummaryoverviewoftheguidelinesandlenses.

2. Thesummarytableassiststoidentifythecomplexityofissues,rolesandresponsibilitiescontributingtoremotehealthworkforcesafetyandsecurity.

3. Moredetailedinformation,isprovidedundertheheadingofGuidelines,AimsandActivities.Thisinformationisprovidedasaguideonly.Activitiesshouldbedevelopedaccordingtothecontextofindividualservicesandcommunities,andwiththecontributionoflocalstakeholders.

4. Thefinalcomponentofthisdocumentprovidesactivitiesonhowdifferentremotehealthstakeholderscancontributetosafetyandsecurityissues.

Improved Safety and

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Guidelines for Remote and Isolated HealthIndividual

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Team

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Employer

Culture &Community

Workforce Stability Communication & Connectivity Prevention & De-escalation

Hazard Iden

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Alw

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HOW TO USE THE GUIDELINES

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Safety and Security Guidelines for Remote and Isolated Health

the peak professional body for the remote and isolated health workforce | www.crana.org.au 5

GUIDELINESLENSES

Individual Team Employer Infrastructure Environment Culture and community

Always accompanied (not alone)

Adheretoworkplacesafetyguidelines.

Clinicpracticespreventexcessiveon-call.

On-callguidelinesreflect‘alwaysaccompanied’fullcomplementofskilledstaff.

Transportandcommunication.Reliablecommun-icationwithon-callsupportworker.

Zerotoleranceofviolence

Communitypartnershipsandsupport.Afterhoursserviceforemergencyonly.

Preparation for remote practice

Bepreparedfortheworkplace,undertakeorientation.

Providelocalorientation.Earlyhazardidentificationandprevention.

Comprehensiveorientationtobeprovided.Embedacultureofsafetyandreporting.

Securebuildings,adequatelighting,andpreventivemainte-nance.Monitoringandreviewofsystems.

Hazardandriskassessmenttraining.Workhealthandsafetyhierarchyofresponses.Industrycultureofsafety.

Orientation.Culturalsafetyeducation.Communityemergencyplan.

Staff resilience and fatigue management

Engageinclinicalsupervision,mentoringandself-carepractices.

Equitabledistributionofworkload.Proactiveresponsetocriticalevents.

Managementtraining.Supportivestaffsupervision.Proactiveresponsetofatigueandwellbeingissues.Servicefullystaffed.

Fitforpurposeandwellmaintainedequipmentandinfrastructure.

Serviceresponsetomanageclimateandmajorevents.Limitedworkandtravelhours.Manageteamtensions.

Improvecommunities’healthliteracyandcapacitytoreduceburdenonafterhoursservices.

Workforce stability

Careergoalsandplans.Communityparticipation.

Supportiveworkplaceculture.Shareworkloadandclinicalinterests.

Professionaldevelopment.Remotestaffrecreation.Exitinterviews,supportandcounselling.Leaveentitlements.

Safe,secure,adequatelyequippedandmaintainedaccommodation.Goodinternetaccess.Vehicleuseforrecreationalactivities.

Supportiveorganisationalculture.Proactiveresponsetobullying.

Communityeducationandprocessestoattractstaffandlimitattrition.Exitinterviewfeedback.

Communication and connectivity

Logallon-callworkandlocation.Establishandmaintainowncommunicationnetworks.

Teamdevelopmentandsupport.On-callstaffmovementsmonitoredbyobjectiveprovider.

Businesshoursandafterhourscommunicationsystems.Proactiveresponsetopossiblehazards.

Voice,datacommunicationwithinandoutsidecommunity.Powerbackupsystem.Clinicandmobile/emergencycommuni-cationandtransport.

Emergencycommunicationandtransportplan.

Healthserviceandcommunitymeetings.Problemresolutionprocess.

Prevention and de-escalation

Communicationandde-escalationskillsandexperience.

In-servicetraining.Alertsystemforhighriskpatients.Monitoringandreviewevents.Peersupport.

Maintainsafetypriorities.Supportcommunicationandde-escalationforstaff.

Abilitytocontrolclinicaccess.Goodaccessandegress.Saferoom.Noserviceprovisionatstaffaccommodation.

Culturalsafetyeducation.Positivecommunityandstaffrelations.

Localemployedstaff.Communityandhealthservicepartnerships.Communitytoalertstafftohazards.

Hazard identification and risk management

Orientation.Safetyprioritised.WorkplaceSafetyGuidelines.Auditandriskassessmenttools.

Ongoinghazardidentificationandresponse.Teamresponsetosafetyandsecurityissues.

Workhealthandsafetyrequirements.Workplacesafetyguidelinesdeveloped,resourced,monitoredandreviewed.

Programmedmaintenance.Infrastructureandequipmentaudit.Prioritisedresponseprocessforacutehazards.

Reduceimpactofisolation.Emergencyresponseplans.

Localculturalsafetyeducation.Communityalertstaffabouthazardsandparticipateinresponse.

GUIDELINES SUMMARY

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1. Always Being Accompanied (Not Alone)

AIM

Cliniciansarenottobealonewhenattendingcall-outsafterhours,orduringbusinesshoursiftheyareattendinganunknowneventorhaveconcernsfortheirsafety.

ACTIVITIES

Individual• WorkwithintherequirementsandexpectationsofWorkplaceHealthandSafety

ActsandRegulations.

• SupportandadheretoWorkplaceSafetyGuidelines.

• Nottoworkunaccompaniedorinisolationuntilsafetyconcernshavebeenresolved.

Team• On-callrostersareapprovedandreleasedinadvance.

• On-callallocatedequitably,withnewstafforientedbeforebeingrosteredon-call.

• Thecareofacutelyill/returningpatientsisclinicallyconsideredtoreduceanyafterhoursburden.

Employer• UpholdWorkplaceHealthandSafetylegislativeobligations.

• Resourcingrequirementstomeetremotehealthservicesafetyguidelinesrecognisedinfunding.

• Develop,resource,implement,monitorandevaluatesafetyprocessesinallhealthcentres.

• Recruitandmaintainafullcomplementofadequatelyskilledstaff.

• Staffarenotrequiredtoworkunaccompaniedifsafetyconcernsareidentified.

Infrastructure• Fitforpurposetransportandcommunicationresourceswillalwaysbeavailable.

• Clinicianswillhaveaccesstoreliablecommunicationwithon-callsupportworkers.

Environment• Conflictresolutionprocessdevelopedtoresolveanyproblemsorcomplaints.

• Services,clinicians,patientsandcommunitiessupportzerotolerancetoviolence.

Culture and Community

• Communityandhealthservicespartnershipsdevelop,manage,andresourceafterhours(alwaysaccompanied)guidelines.

• Afterhourshealthserviceattendancelimitedtoemergenciesandcriticaleventsonly.

• Acultureofsafetyintheworkplaceispromotedandencouraged.

GUIDELINES, AIMS AND ACTIVITIES

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the peak professional body for the remote and isolated health workforce | www.crana.org.au 7

2. Being Prepared for Remote Health Practice

AIM

Thehealthworkforcewillhaveundertakenthenecessaryeducationtobebothprofessionallyandpersonallypreparedfortheirroleinremoteandisolatedpractice.

ACTIVITIES

Individual• Prospectivestaffwillresearchremotehealthsafetyandsecurityissues,includingpathwaystoremote

practice,priortoseekingremotehealthemployment.

• Staffwillcompletepersonalpreparations(educational,financial,nutrition,emotional,andsocial)priortocommencingworkinremoteorisolatedsettings.

• Staffwillparticipateinworkplace/communityorientationpriortoplacementandonarrival,engageinmentoringpartnerships.

Team• Localorientationofnewstaff.

• Hazardanticipation,riskassessmentandpreventionundertakenroutinelyintheworkplace.

• Teammeetingsrespondtosignificanteventsandnearmisses.

Employer• Recruitmentagenciesandemployersshouldsupplypre-employmentinformation/preparationfor

applicantswhoaregoingtonewareasorcommunities.

• Initialemployerorientationshouldbecompletedpriortocommencingwork,withlocalorientationandcommunityculturaleducationoccurringonarrivalattheworkplaceandpriortocommencementofservicedelivery.

• Healthservicesshouldresourceandmonitorworkplacesafetystrategies.

Infrastructure• Securebuildings,vehicleparking,adequatelighting,maintenance,monitoringand

evaluationofsystems.

Environment• Hazardandriskassessmentincorporatedintomanagementschedules,withclinicstaffassessingand

respondingtoemergenthazardsandrisks.

• Workplacehealthandsafetyhierarchyofresponsesusedtoguideinterventions.

Culture and Community• Communitiesshouldcontributetoworkplaceorientationandculturalsafetyeducationpromotinga

communitypartnershipapproach.

• Communities,healthservicesandclinicstaffdevelopandpracticeemergencyresponses.

GUIDELINES, AIMS AND ACTIVITIES

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3. Ensuring Staff Resilience and Managing Fatigue

AIM

Staffarepersonallyandprofessionallyabletorespondtothechallengesofremotepractice.Theriskoffatigueisminimisedthroughworkloadmanagement,supportivesupervision,timelyuseofleaveopportunities,andprioritisingofself-care.

ACTIVITIES

Individual• Accessclinicalsupervisionandmentoring.

• Monitorandprioritiseself-care,healthandwellbeing.

Team• Shareclinicroles/clinicalinterestsandon-callresponsibilitiesandparticipateinpeersupport.

• De-briefaftercriticaleventsandnear-misses.

• Pro-activeresponsewhensignificantissuesaffectingteammembersareidentified.

• Educatethecommunityontheroleofafterhoursservicesandthatcliniciansworkinglonghourson-callimpactonthefunctionoftheservicethenextday.

Employer• Ensureremotehealthmanagershaveinterpersonalandmanagementskillsand

trainingopportunities.

• Allocateprogrammeandon-callworkloadsequitably.

• Workwithcliniciansandcommunitiestolimitafterhoursserviceexpectations.

• Supportivesupervisionofclinicstaffwiththeopportunityfor‘timeout’followingcriticalincidents.

• Schedulestaffleave,limitingcapacitytodeferorclusterleaveentitlements.

• Monitor,identifyandrespondtoissuescreatingstafffatigueandchallengingwellbeing.

• Planandrecruittoensureafullcomplementofappropriatelyskilledstaff.

Infrastructure• Accommodationandclinicbuildings:designedandbuiltfitforpurpose;cycloneratedinnorthern

Australia;adequatelyequippedandmaintained.

Environment• Flexibilityofworkhourstoaccommodateclimateextremesorsportingandculturalactivities.

• Identifyworkrelatedtravelaspartoftheworkingday.

• CliniciansandManagersproactivelyrespondtotensionswithinteams.

Culture and Community• Buildcommunityhealthliteracytoself-manageminorailmentsafterhours.

• Limitafterhourshealthserviceexpectationstocriticalcareandemergencies.

GUIDELINES, AIMS AND ACTIVITIES

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4. Creating a Stable Workforce

AIM

Maintainaregularandreliableworkforce,alongwithareduction/managementofstaffturnoverandchurntopromotesafe,qualityandreliableremoteserviceprovision.

ACTIVITIES

Individual• Developamedium-termcareerplan.

• Engagewithcommunityresidentsandothers–participateinsocialactivities.

• Identifypersonalneedsandhowyoucanachievethesewhileworkinginremotehealth.

Team• Shareworkloadandclinicalinterests.Adjustrolestoincludetheinterestsofincomingstaff.

• Worktogethertocreateandsustainasupportiveteamenvironment.

Employer• Structuredrecruitmentandorientationprocessestopreparestaffforplacement.

• Supportivestaffsupervisiontoensuremanagersintervenebeforestaffburnout,andtoreducethepotentialforbullyingwithinteams.

• Plancliniciancoversostaffcanscheduleleaveentitlements.

• Managersareeducatedandpreparedfortheirroles,includingstaffwellbeingandcreationofworkforcebenchmarkstomonitorsuccess.

• Structuredexitinterviewwithresultsconsideredindividuallyandcollatedforreviewbymanagementandcommunities.

• Respondtorecognisedstafffrustrationsincluding:accommodationsafety;excessiveon-calldemands;andlackoflocaltransportforstaff.

Infrastructure• Safe,secure,adequatelyequipped,cleanandwellmaintainedaccommodation.

• Internet/datalinkandphoneconnectioninstaffaccommodationwithcostsco-shared.

• Healthservices,communitiesandcliniciansconsiderinnovativewaystomakeafterhourstransportaccessavailableforstaffwhohavenolocaltransport.

Environment• Supportiveclinicalandhumanresourcemanagementculture.

• Pro-activemanagementresponsetobullyingandotherissuesaffectingstaffwellbeing.

Culture and Community• Communityeducationaboutlimitingstaffattrition,includingexitinterviewfeedback.

GUIDELINES, AIMS AND ACTIVITIES

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5. The Essential Nature of Communication and Connectivity

AIM

Ensurethatreliableandeffectivecommunicationandtransportsystemsareavailabletomitigateriskstotheremotehealthworkforce.

ACTIVITIES

Individual• Developandmaintainsocialcontactswithinandoutsidethecommunity.Utilisingsocialmedia,

participationinprofessionalorganisationsandpersonalsocialmediacontacts.

• Trainingforsafeandeffectiveuseofhealthservicetransportandcommunicationequipment.

Team• Orientincomingstafftosafe,effectiveuseoftransportandcommunicationequipment.

• Scheduledauditandtestoftransportandcommunicationequipment,includingmaintenance,repair,safetyandsurvivalequipment.

• Scheduledteammeetingstoidentifyissues,reviewsignificanteventsandnearmisses.

Employer• Developandimplementanon-callcommunicationsystemthatmonitorsandrecordslocationofstaff

anddurationofcall-out,includingrealtimemonitoring24/7.

• Ensurethatremotehealthserviceshavereliable,effectivephoneanddatacommunication,includinginallvehiclesandaccommodation.

• ArobustmaintenanceschedulewithauditedcomplianceagainstKPIsforrespondingtofaults.

• Ensurethatstaffaretrainedandexperiencedinusingallequipment,includingtrouble-shootingproblemswithsatellitephonereception.

• Fitforpurpose,adequatelymaintainedvehiclessuppliedtoremotehealthfacilities,withstafftrainedintheiruse.

• Trainingandexperienceindistancetravelonbushroadsinvaryingconditionsdayandnight.

Infrastructure• Reliable,effectivevoiceanddatacommunicationwithinandoutsidethecommunity.

• Emergencypowerback-upsystemforcommunicationsequipment.

• Mobilecommunications,monitoringand/oremergencyassistequipmentavailable.

Environment• Emergencytransportandcommunicationsplantomanageseasonalextremesand

environmentalrisks.

Culture and Community• Regularmeetingswithhealthservicestaff,managersandcommunityrepresentatives,including

policeandeducation.

GUIDELINES, AIMS AND ACTIVITIES

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GUIDELINES, AIMS AND ACTIVITIES

6. The Ability to Prevent and De-escalate

AIM

Theremotehealthworkforceisequippedwitheffectiveinter-personalcommunication,preventionandde-escalationskillstomanagebullyingandharassment,andreducetheincidenceofeventsescalatingtoviolence.

ACTIVITIES

Individual• Includecommunication,de-escalationandsafetyinprofessionaldevelopmentpriorities.

• Practiceandreflectoncommunicationandde-escalationstrategies,includingself-awarenessandyourroleinescalatingorsettlingpotentialconflict.

• Researchyourrightsandresponsibilitiesinrelationtobullyingandharassment.

• Processexperiencesandeventsthroughclinicalsupervision,mentoring,communityengagementand/orcontactwithBushSupportServices.

Team• Ongoinghazardidentificationandresponse,includinghi-riskclientregister/alertsystem.

• Promotesupportiveteamculturetomanage/reviewsignificanteventsandnearmisses.

Employer• Workplacehealthandsafetyrequirementsfulfilled.

• Allafterhourscaretobeprovidedintheclinic,notatstaffaccommodation.

• Monitorandreviewepisodesofworkplaceviolence,respondingtohazardsandrisks.

• Educationandtrainingoncommunication,de-escalationandemergencyresponsestrategiestodevelopstaffcapacitytodefuseescalatingsituationsandprioritisetheirownsafety.

• Supportivestaffsupervision,engagingandrespondingearlytoemergingevidenceofdeterioratingstaffwellbeingorindicationsofbullyingandharassment.

• Supportive,rapidresponseforstaffwhohaveexperiencedtraumaticevents.

Infrastructure• Saferoominclinicwithdualaccessandinternalcommunicationlink(phone/radio).

• Clearviewofclinicentrances,withaccessabletoberestricted/controlled.

• Clinicandaccommodationalarmsystemswithinternal(community)alarmsandexternalmonitoring.

Culture and Community• Localcommunityprovidesculturalsafetyeducation.

• Communityalertstaffaboutemerginghazardsandcooperateindevelopingandimplementingasaferesponse.

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7. Identifying Hazards and Managing Risks

AIM

Aproactivescheduleofmonitoring,evaluationandworkplaceauditstoidentifyandrespondtohazardsandrisks.

ACTIVITIES

Individual• Developskillsusingworkplacesafetyguidelinesandriskassessmenttools.

Team• Hazardidentificationandriskmanagementanagendaiteminteammeetings.

• Reviewandrespondtoallnear-missesandsignificantevents.

Employer• WorkHealthandSafetyobligationsfulfilled.

• Workplacesafetyguidelinesresourced,implemented,monitoredandreviewed.

• EmployerWorkHealthandSafetyreviewsscheduled.

• Reviewandrespondtoallsignificanteventsandnearmisses.

• Eventsandnear-missesreported,datacollatedandusedinqualityimprovementactivities.

• On-callandbusinesshourssafetyplanimplemented.

• Orientationincludesuseofworkplacesafetyguidelinesandriskassessmenttools.

Infrastructure• Safe,secure,well-litclinic,accommodationandvehiclestorage.

• Bi-annualinfrastructureandequipmentauditcompleted.

• Alertsystemsinplaceforrespondingtoimmediatehazardsthroughanemergencymaintenancesystem.

• Aplanforstaffsafetyifinfrastructureistemporarilyinsecure.

Environment• WorkplaceHealthandSafetyGuidelinesreduceimpactofisolationandenvironmenton

staffandservices.

• Emergencyresponseplansdeveloped,resourced,andpracticed.

Culture and Community• Culturalsafetyeducationdevelopedandprovidedbylocalcommunity.

• Communityalerthealthstaffabouttransienthazards,andparticipateinresponse.

GUIDELINES, AIMS AND ACTIVITIES

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STAKEHOLDER ROLES AND CONTRIBUTION

Employers

Role Contribution

Developandimplementtheadministrativeandclinicalservicesrequiredtoprovideasafeandsecureworkenvironmentfortheremotehealthworkforce.

Ensuresafeworkplace,accommodation,communicationandtransportfacilitiesandequipmenttoachieveNationalmodelOHSrequirementsandenableclinicianstoimplementsafetyprotocols.

FulfillegislatedOHSrequirementsie:workplacesafetycommitteeandworkplacesafetyrepresentatives.

Conductfacetofacemeetingswithcommunitymanagementandcouncilrepresentativestoensurecommunitiesareawareandsupportiveofsafetyprotocols.

Providetrainingandsupporttoensurecommunitiesareabletocontributeasrequiredtoimplementeffectivesafetyprotocols.

Informcommunityifspecificservicessuchason-callarebeingsuspended,orstaffarebeingevacuatedatanytimeduetocriticaleventsorsafetyguidelinesnotbeingabletobeimplemented.

Develop,resourceandimplementstandardoperatingprocedures/safetyguidelinestopromoteandfacilitatecliniciansafetyatwork,inemployerprovidedaccommodation,andwhileoncall.

Providetimelyorientationfornewstaffthatidentifiesworkplacesafetyandsecurityguidelines,andpracticalexperienceinuseoffacilitiesandequipment.

Incorporateinformationandtrainingaboutculturalsafetytraining,safety,security,andriskassessmentintostafforientation.

Ensurearapidandsupportiveresponsetostaffwhohaveexperiencedsafetyandsecurityproblems.

Thefollowingisalistofsignificantstakeholderswhocontributetothesafetyandsecurityoftheremotehealthworkforce.Farfrombeinganoverwhelmingandseeminglyintractableissue,therearemanyinterventionsabletobeimplementedthatwillcontributetoimprovingworkforcesafetyandsecurity.

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STAKEHOLDER ROLES AND CONTRIBUTION

Workforce Agencies

Role Contribution

Promotethesafetyandsecurityofclinicians/employeesrecruitedtoremoteareahealthservicesthroughendorsementandimplementationoftheNationalGuidelines.

Agenciesseekwrittenworkplacesafetyguidelinesandconfirmationofimplementationfromemployersseekingtorecruitstaff.

Agenciesinformprospectiveapplicantsofbasicsafetyandsecurityguidelines,andacuteeventsplacingstaffatincreasedrisk.

Suspendrecruitmenttospecificserviceproviderpendingissueresolutionifstaffcontractedthroughyouragencyhaveidentifiedthatprotocolsarenotdocumentedorimplemented.

Collectivelydevelopsafetyandsecuritystandardsforthenurseagencyindustry.

New and Incoming Remote Area Staff

Prepareyourselfprofessionally,clinicallyandpersonallyforyourremoteareaworkforceexperience.

Beinformedabouttheprospectivejob,locationandprofessionaltransition.

Initialinternetandsocialmediasearchandfollowupidentifiedorganisationsandtopics.

ReadNationalSafetyandSecurityGuidelinesandenquirewithemployer/agencyregardingactiveuseofworkplacesafetyguidelines.

Askforacopyofworkplacesafetyguidelines,includingon-callprotocols.

Applytoworkwithemployersandrecruitmentagenciesthatsupportidentificationanduseofsafetyandsecurityguidelines.

Considerseekingfeedbackfromotherstaffwhohaveworkedinthelocationyouareconsidering.Keepinmindthatexperiencescanvary.

Seekinformationandadvicefrompeakprofessionalorganisations.

The Existing Remote Workforce

Engagewithallrelevantstakeholderstopromoteimplementationandasrequired,developmentoforrefinementtoworkplacesafetyguidelinesbasedonan‘alwaysaccompanied’approach.

Contributeto,andworkaccordingtoworkplacesafetyguidelines.

Informandsupportincoming/newstafftoworkaccordingtosafetyguidelines.

Donotofferclinicalserviceorotherwiseplaceyourselfatriskuntilsafetyguidelinesaremet.

Ensureinformationaboutsafetyguidelinesisavailableinthehealthcentreandelsewhere.Opportunisticallydiscussguidelineswithotherstaffandcommunitymembers.

Promotecommunitycooperationin‘alwaysaccompanied’strategies.

Informemployerandcommunityrepresentatives,withasmuchnoticeaspossible,ifspecificservicessuchason-callavailabilityarebeingrestrictedduetoriskissues.

ContacttheBushSupportServices,CRANAplusoryourunionifsupportisneeded.

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STAKEHOLDER ROLES AND CONTRIBUTION

Communities

Role Contribution

SupportlocalcliniciansintheprovisionofviableandeffectiveremoteareaPrimaryHealthCareServices.

Discussrequirementsofsafetyprotocolsandidentifyhowcommunitycontributioncanbeachieved.

Participateindiscussionsandnegotiationswithhealthservicemanagementaboutsafetyandsecurityissues.

Contributetoeffectiveimplementationofsafetyandsecurityguidelines.

Promoteresidentadherencetosafetyguidelines.

Agreeonandimplementbackupoptionsasneededtoensuresafetyprotocolsareabletobeimplemented.

CRANAplus – the professional body for remote and isolated health

Industryadvocacy,professionalsupport,andeducation.

Lead(andchampion)ImplementationofNationalremoteareasafetyandsecurityproject.

Industryinformationaccessthroughwebsite,magazineandprintresources.

Trainingthroughexistingandproposedcoursespromotingsafetyandsecurityaspartof,andinadditiontoclinicalroles.

Developmentofprofession(notworkplace)orientationforincomingclinicians.

Continuingadvocacyonsafetyandsecurityissues.

Participateinresearchinitiativesanddevelopmentofpublicationscontributingtobodyofworkonsafetyandsecurityinremoteandisolatedhealthsettings.

CRANAplus Bush Support Services

24-hourprovisionofpersonalsupport,counselling,andreferraloptionsfortheremoteareaworkforceandfamilymembers.

CounsellingService

PrintandOnlineResources

BullyingApp

ResearchandAdvocacy

Police

Protectionoflifeandproperty. Negotiateandliaisewithhealthservicesregardingco-operativesafetyandsecurity,planningandresponse.

Staffinremotesitesparticipateinacollaborativeresponsetoandmanagingsafetyandsecurityissues.

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STAKEHOLDER ROLES AND CONTRIBUTION

Researchers and Educators

Role Contribution

Educationandtrainingofprospectiveandexistingclinicians.

Prioritisingandconductingresearch,supervisingpostgraduateresearch.

InclusionofworkforcesafetyandsecurityinformationandNationalguidelinesincoreunitsofallprogramsacrossthesectorsinvolvedineducationprogramsfocusingonremoteandisolatedhealthincludingtransitionprograms.

Clinicaleducationincludesassessmentofstaffsafetyandsecurityinrelevantunits.

Newresearchproposalstoconsiderexistingandemergentsafetyandsecuritypriorities.

Industrial Organisations

Professionaladvocacy,industrialinformationandadviceformembers.

Documentinformationaboutsafetyandsecurityrisksandinterventionsonwebsiteandjournaltoempowerclinicianstopromotetheirownwellbeingandprovidesafe,effectivehealthservicesinremotecommunities.

Respondtospecificindustrialeventsorrequestsforassistancefrommembers.

Professional and Peak Bodies

Varyingrolesrepresentingandadvocatingformembershipissues,orspecificinterestgroupswithinmembership.

Advocacygroupssupportingdevelopmentofsafetyandsecurity,policyandbestpracticebymembership.

Sectoraladvocacy,policyandresearchsupport.

Worksafe Australia

Policy(Nationally)implementationandmonitoringoflegislated/regulatedworkplacesafetyandsecurityguidelines(StateandTerritory).

Remoteworkforcesafetyandsecurityissuesinformationandadvice,respondingtoproblemandpriorityimprovementnotices.

Provideadvicetoorganisationsandindividualsaboutrightsandresponses.

AllocateaPriorityImprovementNotice(PIN)toalocationorserviceproviderifsignificantsafetyrisksareidentified.

Regulatory Authorities

Role Contribution

ClinicianRegulationandprotectionofthepublic.

ImplementPractitionerComplaintsSystem.

Acknowledgecontextandseekexpertcontributioninmanagementandassessmentofcliniciannotification.

Governments

Legislationandpolicydevelopmentandreview.

ReviewofWorksafeguidelines(COAG)toconsiderhowWHSregulationscanbeimplementedandrespondedtoinatimelymannerinveryremoteareas.

Developmentofmandatedstandardsandincludeintherequirementsforfindingserviceproviders.

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www.crana.org.au

CRANAplus DIRECTORYCAIRNS HEAD OFFICEADDRESSSuite2WallamurraTowers189–191AbbottStreetCairns,QLD4870

Tel 0740476400Fax 0740412661

POSTALPOBox7410Cairns,QLD4870

Connect with us on social media

Facebook.com/CRANAplus

Twitter.com/CRANAplus

Flickr.com/CRANAplus

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