We'd like to provide you with a survey of the safety profession in the world of healthcare in 2001. A highly regulated, specialized set of forces and regulations make it both interesting and challenging. In 1998 health care surpassed the nuclear power industry as the most regulated type of business in the U.S. And the regulations have continued to multiply since then - the Safe Needle legislation, first enacted in California; the many initiatives underway associated with patient safety, and one of the most complex to manage, patient confidentiality. Since healthcare is a very process-driven, interactive business, the safety professional is draw into all these issues and more. It s a fascinating, evolving, complex, and intriguing specialty within safety. We'd like to share some of it with you today.

There are a host of regulations and standards that many of you deal with regularly - California's Illness and Injury Prevention Program, confined spaces, hazard communication, disaster planning and ergonomics to cite a few. Healthcare safety professionals deal with those and a whole additional set of standards contained in many State regulations and the Joint Commission on Accreditation of Healthcare Organizations - known as JCAHO. We'll review with you some of the forces pushing and pulling safety professionals in healthcare today.

Integration Within and Across a Specialty

Increasing demands, more regulations, less budget, more stress. Sound familiar? Healthcare, as an industry, is going though a huge change process. For too many years, business as usual continued, costs escalated and rates were raised without too much resistance. Now there is enormous competition in most markets. Yet prices keep rising - for instance, in San Diego we expect to spend more this year to operate our pharmacy than to operate a 350 bed hospital. As the economic pie shrinks, the three major stakeholders - hospitals (and nurses), physicians, and health plans - have turned on each other, with the patient often the unwitting victim. The effect on our profession has been significant. Safety and health staffs must be seen as value added. Otherwise, you re overhead, then history in the next round of budget cutting, reorganizations, or buy-outs. Today's professional must contribute in meaningful ways, in collaboration with many entities, and be seen as a resource not a hindrance.

Communications, cooperation, and coordination are the watchwords today. Economics, licensing, and regulations increasingly focus on outcomes and processes, systems integration and statistical control methods. It is simply too complex for any one individual or department to succeed on its own. What I know about ergonomics and what you know about biohazardous waste disposal, for example, need to mesh seamlessly. Within Kaiser Permanente, for example, Directors from all California areas meet bi-monthly to share solutions to new regulations and leverage skills across the organization.

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