A Culture of Safety Transparency- Three Reasons Why

Gena was working in the microbiology lab when she failed to notice a possible N. meningitidis from a cerebrospinal fluid culture. Not thinking there was any danger, she prepped the organism for identification on the analyzer, but she used a vortexer that was not in the biological safety cabinet and did not cap the tube. The next day when she saw the organism identification, she realized she had created an aerosol the previous day in the open lab when co-workers were nearby. She was afraid of getting in trouble, so she did not report the incident. Three days later, Gena was in the hospital and not expected to recover. Two other co-workers had also fallen ill with minor symptoms. After the investigation, the manager did not relay the details of the incident to all of the staff fearing that the department would get in trouble with hospital administrators. One lab employee decided to call OSHA and report what she felt were unsafe working conditions.

There are at least three reasons it is important to create a safety culture in the laboratory where all staff members feel comfortable discussing potential safety issues, incidents, and near-misses. The first reason is so that every single safety incident in the department will be reported. Even something as minor as a paper cut that occurs within the walls of the lab should be reported. A tiny wound can quickly become an infection if skin is broken while working in an area where bloodborne pathogens are present. Staff should understand why reporting is essential, and they should be aware of the follow-up procedures that are put in place by the organization. To get lab employees to realize near-miss situations may be more difficult- there needs to be education about unsafe practices and potential consequences. For example, an employee might successfully retrieve a lost specimen from a sharps container without injury, but they and others should understand the high potential consequence of that action, and it should be reported. That is a tie to discuss unknown source exposures and potential impacts.

A second reason for a culture of transparency in the lab is to help the staff know the organization s working to keep them safe and to make them comfortable enough to talk to leadership about incidents and questions they may have about them. Sometimes, if employees feel leadership is not doing a good job of this, they will report to agencies outside of the workplace. It is easy for an employee to report incidents to OSHA, and if that happens, the lab will need to do much more work for the response. When an incident occurs, being open and honest about the details, the response, and the follow up to ensure it does not happen again can go a long way toward comforting staff. Hiding information just helps to generate rumors and a feeling by some that they are not working in a place that is doing all it can to keep their employees safe. It can be difficult after certain events to tell the story. While names may not be mentioned, it is likely in many situations that staff will know who the involved parties are. That is still better than hiding information. When OSHA responds to a safety report, even if the response is written and no inspectors come on site, the incident report and the written response from the organization must be posted in the department per regulation. The employees are going to know what happened either way. It is always best to be up front about incidents and to make staff aware that their safety is important and monitored, and that issues have swift follow-up.

Safety transparency also has a third benefit- it generates an overall better safety culture for the laboratory. When staff are comfortable reporting issues without punishment or pushback, and when they see they can work with leadership to continually correct issues, safety becomes a natural part of the job. Openly reporting incidents in staff huddles, discussing routine safety fixes and improvements, and educating about near-misses are all normal in a department where the safety culture is strong. A strong safety culture means fewer incidents and fewer injuries and exposures, a goal for which all labs should strive. Once Gena realized her mistakes in the microbiology lab, she should have felt comfortable enough to report them for her safety and for the safety of others in the department. Even if she were new to the field or to the department, her leadership should have conveyed to her how vital it is to report safety incidents or potential safety issues. When staff understand that their organization cares about them and will work to protect them, even when something goes wrong, they will feel confident they work in an environment where safety transparency is the norm, and where the safety culture is strong.

–Dan Scungio, MT(ASCP), SLS, CQA (ASQ) has over 25 years experience as a certified medical technologist. Today he is the Laboratory Safety Officer for Sentara Healthcare, a system of seven hospitals and over 20 laboratories and draw sites in the Tidewater area of Virginia. He is also known as Dan the Lab Safety Man, a lab safety consultant, educator, and trainer.