During the COVID-19 pandemic, U.S. hospitals and health systems have focused on protocols to keep workers safe. Now, new federal COVID-19 workplace safety rules have set a protection standard industrywide.
Alison Kerr, chief administrative officer of clinical operations at Palo Alto, Calif.-based Stanford Health Care, and Stephanie Gryboski, associate vice president of employee health and emergency management at Danville, Pa.-based Geisinger, told Becker's they support rules protecting workers. They discussed how their organizations are ensuring the safety of employees, as well as obstacles they may encounter related to the pandemic and rules.
The rules
On June 10, the U.S. Labor Department's Occupational Safety and Health Administration released the rules, including a requirement that healthcare employers provide workers with paid time off to get vaccinated and to recover from side effects.
The emergency temporary standard applies to healthcare settings where suspected or confirmed coronavirus patients are treated. This includes hospitals, nursing homes and assisted living facilities, as well as home healthcare and ambulatory care settings.
OSHA is providing some exemptions for healthcare providers that screen out potentially infected patients.
"I support any intervention, whether it be masking, social distancing, to ensure our healthcare workers are safe as we continue to learn and as new information becomes available," said Ms. Kerr, with Stanford. "This virus, as we know, has varied and mutated over time, and we need to continue to inform ourselves with the best science and the best data to continue to adapt and learn new things and then continue to apply that learning. Safety of workers is foremost, because if we don't have a strong infrastructure around our healthcare, things rapidly fall apart."
Under OSHA's emergency temporary standard, nonexempt facilities are required to conduct a hazard assessment and have a written plan to mitigate the spread of COVID-19. The rules also require healthcare employers to provide and ensure workers wear face masks "when indoors and when occupying a vehicle with other people for work purposes"; provide and ensure workers use respirators and other personal protective equipment for exposure to people with suspected or confirmed coronavirus; and ensure social distancing between workers, or place physical barriers between employees in nonpatient care areas where employees are not socially distanced, according to an OSHA fact sheet.
Additionally, the rules call on healthcare employers to provide workers with paid time off to get inoculated and to recover from side effects. Healthcare employees who are infected or may be contagious must work remotely or otherwise be separated from other workers, if possible, or be given paid time off up to $1,400 weekly, said OSHA. The federal government said tax credits in the American Rescue Plan may be paid back through these provisions for most businesses with fewer than 500 employees.
Preparing for the rules and workplace safety challenges
Hospitals and health systems have already implemented many measures cited in the workplace safety rules, per guidance from the CDC and their local public health entities. Still, they must continue to ensure compliance with the rules and adapt protocols based on new information.
Geisinger is offering PPE for more staff than it traditionally would, given new knowledge revealed during the pandemic, according to Ms. Gryboski.
"Not all employees previously required respirators, but now knowing you could have illnesses like COVID that would potentially expose more employees, we have revisited our respiratory protection program, and are planning to continue to offer that protection to all staff who want it and need it in the future," she said.
The health system has also worked with vendors to increase its allotment of supplies, she said.
Moving forward with the new OSHA rules, part of the challenge is that a lot of vaccinated people in U.S. communities have taken off masks in many public places when outside of a healthcare setting, according to Ms. Kerr.
"You can walk into a restaurant or a store without a mask if you've been vaccinated," she said, referring to locations in California. "We are not at that place for a hospital, so continuing to educate our patients, our providers, the community to let them know hospitals, like airports, have different standards" may be challenging, she said.
At Stanford, Ms. Kerr said visitor policies remain restrictive, and the health system continues to screen people when they come in. All visitors, patients and workers must wear a mask provided by the health system regardless of vaccination status.
Ms. Gryboski said she doesn't expect the physical barrier part of the OSHA rules to be an issue for hospitals and health systems since many bought these barriers during the pandemic. But she said the screening and visitor management component of the federal standard may be more challenging, because screening for symptomatic employees, patients and visitors and those who are exposed, requires a lot of manpower.
Regarding the rules overall, Ms. Kerr said they "provide great clarity around how we keep our workers safe." She also stressed the importance of flexibility, as well as continuing efforts to boost inoculation in general among healthcare workers. As of July 13, about 78 percent of Stanford Health Care's 14,000 employees were fully vaccinated, and about 70 percent of Geisinger's more than 24,000 employees were fully vaccinated.
"Remaining flexible and adaptable is important because if we're not well, we can't take care of patients," said Ms. Kerr. "And our patients in our communities have relied on us during this pandemic, whether it be for testing or new innovations for tackling this disease. We have to do everything at our disposal to ensure we keep our workers safe and protected."
Ms. Gryboski echoed Ms. Kerr:
"We're excited about the new regulations from OSHA. We were in compliance with them already, as were many other healthcare entities. I think it helps with the consistency across all healthcare, to make sure all facilities are abiding by the same rules, which makes our staff safer as well, so we're not caring for people who may not have been following those same rules. I think it makes healthcare as a whole safer."
Next steps
On July 8, OSHA said it is extending the comment period for its emergency workplace safety standards to Aug. 20, so providers have more time to weigh in.
Most of the provisions had to be in effect within 14 days of the standard's June 21 publication in the federal register, with remaining provisions being in effect within 30 days.
OSHA said it will continue to monitor and assess the need for changes.