SAFETY AND SECURITY GUIDELINES FOR REMOTE AND … · surveys and social media, CRANAplus undertook...

SAFETY AND SECURITY GUIDELINES FOR REMOTE

AND ISOLATED HEALTH

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

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.



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.


1. Theinfographicprovidesasummaryoverviewoftheguidelinesandlenses.

2. Thesummarytableassiststoidentifythecomplexityofissues,rolesandresponsibilitiescontributingtoremotehealthworkforcesafetyandsecurity.

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

4. Thefinalcomponentofthisdocumentprovidesactivitiesonhowdifferentremotehealthstakeholderscancontributetosafetyandsecurityissues.

Improved Safety and

Security

Safe

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Guidelines for Remote and Isolated HealthIndividual

Environment

Team

Infrastructure

Employer

Culture &Community

Workforce Stability Communication & Connectivity Prevention & De-escalation

Hazard Iden

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Risk

Man

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Alw

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lone) Preparation for Remote Practice Sta� Resilience & Fatigue Management

HOW TO USE THE GUIDELINES



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


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



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.



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.




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.



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.





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.


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.




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.



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.




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.



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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