Page 217 - Hospital Authority Convention 2018

Service Enhancement Presentations

F7.3 Committed and Happy Staff 13:15 Room 421

Adopting a Scientific Basis to Tackle Slip, Trip and Fall in HKWC – Improving Safety of Staff, Patients and Visitors
Leung KK, Lam C
Occupational Safety and Health, Quality and Safety Division, Queen Mary Hospital, Hong Kong
Introduction HOSPITAL AUTHORITY CONVENTION 2018
The slip, trip and fall (STF) hazard has been causing a substantial number of safety, causing personal injury, loss in
productivity, staff compensation, and civil liability. All staff, patients and visitors are at equal risk. In fact, the Hospital
Authority (HA) injury-on-duty (IOD) report indicates that both IOD rate and sick leave rate of STF have been increasing since
2015. On average, the number of sick leave days per 100 FTE is 22, which is the second highest among all IOD types. The
issue is of particular concern in historical buildings of HA such as Queen Mary Hospital (QMH). In QMH, the STF Prevention
Programme has been managed by the Patient Journey Working Group since 2016. It is collaborated with the Hong Kong West
Cluster (HKWC) Occupational Safety and Health (OSH) Team that has driven a scientific basis in strategy that is piloted in
QMH.
ObjectiveTo improve the safety of staff, patients and visitors by eliminating slip, trip and fall hazard in HKWC.

Methodology
Risk Assessment
Previous injuries and near misses related to falls were reviewed and analysed. Wet floor surface of lobbies and corridors
was identified as the significant contributing factor. Site inspection was conducted to rule out environmental factors such as
adequacy of lighting, and to assess the specific quality of flooring surfaces of lobbies, e.g., evenness, polished or glazed,
potential to slip when wet, and also the trembling walking movement of staff and visitors. The degree of slip resistance was
measured under both dry and wet conditions by American Slip Meter 825A and expressed as the Coefficient of Friction (COF).
An obvious difference of COF between dry and wet surface was observed.

Control Measures
The success of administrative control is variable. Engineering means such as applying anti-slip treatment to increase slip
resistance should be the preferred measure to fix the problem. Traditional non-slip coating, however, is not suitable in the
healthcare setting as it may wear off easily and hazardous chemical vapour is generated during application. After extensive
sourcing in the market, a hospital grade acid “etching” agent was found. After applying this agent onto the floor surfaces by
simple mopping, the surface of the tile will be transformed into microscopic pores and turned rougher, thus greatly increasing
the level of friction. When the floor gets wet, it will then activate and instantly transform the millions of tiny pores into suction
cups, gripping the bottom of shoes and increasing traction.

Results
The COF of the untreated floor surfaces on dry and wet conditions were 0.6 and 0.3 respectively. Only COF measured on
dry floors complied with the relevant international standards such as American National Standards Institute (ANSI) A137.1
and National Floor Safety Institute (NFSI) B101.1, which recommend 0.5 on dry floor and 0.6 or above on wet floor. Although
the COF of dry floors showed only 5% increase to 0.63, the COF of the wet floors showed a significant improvement to 0.87.
All readings obtained from the treated floor surface met with international standards. Serial reassessments at three-month
intervals were conducted from 2016 to 2017 to examine the durability of anti-slip effect. COF of the treated floor surfaces
were shown to be of ‘High-traction’ over the period. The effectiveness of the treatment was also reflected in the decreasing
trend of STF IOD rate from 0.82 in 2012 to 0.59 in 2017. Tuesday, 8 May 2018

To design an effective STF injury prevention strategy, concerted effort from multiple stakeholders is required and a systematic
multi-prong approach should be adopted. This non-slip enhancement measure has been extended to other HKWC hospitals.
Other Clusters and private hospitals are also keen to adopt this. To maximise the benefit, coverage areas will be extended to
tactile guide paths, patient toilet areas, etc. It is expected that safety of staff, patients and visitors can be much improved.

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