“Risk Management”
Eldercare Inc SA adopted the following approach to risk management across nine sites, as part of a continuous improvement and Occupational Health & Safety initiative:
• each site identified hazards and associated risks
• all staff were involved across care, lifestyle and environmental service positions • risks were prioritized as either high, medium or low
• a hazard register was established
• a hazard status log was established for each site • controls were put in place for each risk
• 3 monthly review commenced to ensure controls are working
• developed additional safe work practices at each site, which are now being amalgamated into a generic set.
Issues identified from previous building projects led to:
• Design of air handling systems in new kitchens to avoid moisture build up on the floors and possible risk of
slips/falls
• Fall arrest system for working at heights (eg cleaning windows and gutters)
• Development of checklist to identify any Occupational Health and Safety risks that may occur during the planning,
implementation and commissioning stages of any new/renovating projects. To assist with the control of these phases Action Plans are developed prior to commencement of, and if required, during, each phase.
• Development of register to identify any OHS hazards/ risks at existing sites to eliminate at the design stage for any
new buildings/ upgrades.
• Development of a Working Party for development/redevelopments involving Architects, Project Managers,
Executive Directors, OHS Coordinator and staff from all areas to discuss OHS related issues commencing from the planning stage to implementation
Eldercare engaged a risk management consultant to assist the organisation in the process.
Refer to the obligations under the OHSW Regulations 1995 (S.A.) 1.3.2 and 1.3.3 to conduct ‘hazard identification and risk assessment’, and implement ‘control of risk’. This requirement encompasses the ‘life cycle’ impact to all persons associated with a facility; and the subsequent and ongoing requirement to create and maintain a risk register.
Photo 4 Roof anchor bolt Photo 5 Anchor bolt used for attaching a harness
to clean external windows.
PRINCIPLES OF SAFE DESIGN
3.4 DEVELOPMENT /REFURBISHMENT OF AGED CARE FACILITIES: A SEVEN STEP
GUIDE TO SAFE DESIGN
When embarking on a building, product development program we often look to what is to be done and overlook the review of what is currently being done. As part of the development program organisations should look at what policies and procedures they currently have in place to ensure that safe and health of employees and persons in their care. Will these suit the needs of the new facility or are you going to be introducing poor practice into a new site? How can the changes to the building or introduction of a ne w product improve the practices for health and safety and have these been reflected in the policies and procedures. What training for staff will be required to ensure that they are aware of the changes to practice or policy?
The success of any project or facility is reliant on foresight, good planning and attention to detail. Failing to plan is planning to fail. The following steps are a guide to help achieve the desired outcome. No one step stands alone but all are reliant on each other and will be found to overlap in some instances:
Step 1: Concept
Step 2: Outline Brief, organisation Step 3: Feasibility, research
Step 4: Identification, Detailed brief Step 5: Design, documentation Step 6: Construction
Step 7: Commissioning
Step 1: Concept
The first step in any endeavour is the idea, the vision of what will be.
This requires an individual or group of individuals with foresight and commitment to put the procedures into place to bring the vision into existence.
Communicate to members of your organisation the intent to build, refurbish or design. Invite interested persons to participate in the project. Identify what it is you want to achieve and why. Break the project into smaller components and establish focus groups. Utilise the skills, knowledge, experience and expertise of employees who are the users of the end product, or building. Have these groups identify all the key considerations for the project? Invite external specialists or experts to sit on the focus groups or to provide input into outcomes from these groups. Liaise with other organisations that have or are going through similar projects. Share difficulties together to achieve acceptable
outcomes.
Develop a framework for the vision.
Step 2: Outline brief, organisation
• The broad picture of what the aims of the facility or product will be. • Where the facility or product will be located or used.
• When the expected commencement and completion of the project will be.
Collating all the information, identified needs, ‘wish lists’ and vision outcomes that have been gathered through the consultative process with all end users and f ocus groups.
At this stage consultants should be engaged. Architects are able to draw up sketch plans and colour perspectives utilising their information gathered and input from across the organisation and other persons involved in Step one.
Step 3: Feasibility, research
It is at this stage where quantity surveyors need to be engaged to initially assess the feasibility of the original idea. Can the conceptual idea work or is it too expensive?
It is at this point where budgets and costs need to be put together and take into consideration the usage and running costs.
PRINCIPLES OF SAFE DESIGN
Research should be undertaken for a market analysis of:
• Current demographics • Projected populations • Demographic trends • User needs
• Private and public sector involvement or competition • Operating personnel
• Suitable sites
• Potential user groups • Future trends and needs • Operation of similar facilities
Only when all information is available and research complete should the owner decide whether to proceed with the project, or not. The sole intention should not be to cut costs; it is important to accommodate future needs and avoid creating unsafe or substandard environments, which may lead to additional costs in the long term. It is good business sense and more cost effective to accept the costs early in the design stage rather than to make expensive changes later.
Step 4: Identification, detailed brief
Identify the market groups the facility is aimed at. Look at the future needs – changes within the Aged Care Industry and the impact of Ageing in Place.
Identify the size and number of rooms and usage specific rooms or areas. Consult with the persons that will be using the areas. Consider space requirements for equipment that needs to be used within the rooms and furniture that residents may wish to have within their rooms.
More detailed specification of building and operating requirements
Develop a list of desirable features to include and avoid. This is where the work done by the focus groups in identifying safe operating needs and requirements can be utilised.
Refine details as required through further discussions with consultants and the focus groups or end users.
Step 5: Design, Documentation
Formal architectural plans and specifications Working drawings
Engineering details Final consultations with:
• representatives of user and wider community groups • government bodies
• interior designers • suppliers.
Detailed description of functional specifications in order for the facility to fulfil goals of the project such as:
• size and internal relationships
• special requirements, temperature, lighting, usage adaptability • other special needs
Positive design changes may be required to meet changing needs of the community thus updated forecasting is required to meet these design changes.
PRINCIPLES OF SAFE DESIGN
Step 6: Construction
Determine suitable form of contract
Engage Project manager to monitor project
Go to tender and engage builder and or subcontractors experiences with type and size of facility Commence site works
Have a detailed progress schedule of works and expected completion and update it monthly Order specialised commodities, furnishings, fit outs early
Plan cash flow to avoid interest charges in line with expected work schedule and completion dates.
Step 7: Commissioning
• Set a realistic opening date after consulting with builder and architect and then allow a buffer of three weeks. • Develop a budget sufficient to launch the facility
• Selection and hiring of personnel should have been completed during construction thus allowing for manager, key
staff and maintenance supervisor to be on site before completion
• Furniture, equipment etc should be ready for delivery
• Ensure suppliers provide detailed operating manual on commissioning of equipment • Finalise selection and training of staff
• Address defects and rectify any problem areas • Make sure facility does what it is intended to do.
These seven steps are a basic starting point to guide one from the start through to the completion of any facility. They are not meant to be conclusive and allow for room and scope for the addition of specific requirements depending on the type of facility and its use.
Once commissioning has taken place ongoing maintenance operational checks must be put into practice as well as adequate training. It is important that consultation occurs throughout all stages and steps of the development of the program and that post implementation an evaluation and monitoring program is established.
Modification may be required with time as the needs of the community change. Further consultation with experts in various fields may this be required. Feedback from users, the general community and personnel is also important in order to keep the facility running efficiently.
Most importantly we must not lose sight of the reasons for building the facility, the needs it must meet and the quality of care it must provide.
PRINCIPLES OF SAFE DESIGN
3.5 BUSINESS EFFICIENCY
Safe design processes are virtually identical to other risk management processes such as value management and asset management in that risks in various areas of a business are recognised and mitigated. In their analysis of costs of owning and using buildings(3), Evans et al identified that, in the overall life cycle costs of buildings, significant business operating cost reductions can be achieved through greater investment in the design and construction process, resulting in greater business efficiency.
Example No. 3 (from Evans et al)
For a commercial building) the whole of life cost ratios were found to be: Design and construction costs 1
Maintenance and building operating costs 5
Business operating costs 200
During the life of a building, usage, technology and operational aspects change. Complex pressures and problems arise when attempting to improve the productivity within a given building.
A design review, in one factory, to examine factors such as noise, temperature fluctuation, lighting and glare, layout and control of the layout by the occupants, resulted productivity improvements of up to 1 7%.
Construction costs for a building are significant and an outcome of the safe design review can be construction cost reductions. Modularisation, standardisation and prefabrication, not only improve health a nd safety performance in construction by reducing exposure to falls and musculo-skeletal injury, but may also speed up construction, minimising construction time and costs.
Loose fit design of plant and equipment in a building can reduce operating costs through simplified maintenance and provide a more flexible re-use of the structure in future.
3.6 SUSTAINABILITY
A major worldwide trend is sustainability. Managing resources and business activity to minimise global impacts of energy usage, greenhouse effects and materials usage through re-use are becoming standard societal demands. Ethical investment is a new cornerstone of business development and sustainability is an economic issue(4). Safe design supports sustainability. Many of the safe design solutions in use improve sustainable developments:
• minimising the use of volatile organic compounds not only improves the general health of workers but also
supports greenhouse initiatives,
• using prefabricated building modules not only reduces construction workers’ exposure to falls from heights and
musculoskeletal injury, but also reduces materials waste in manufacture and promotes recycling of building components through deconstruction instead of demolition
• maximising the use of natural lighting and natural ventilation has health and safety benefits for workers through an
improved work environment as well as minimising energy consumption and greenhouse effects.
(3)
Evans R. et al The Long Term Costs of owning and using Buildings. The Royal Academy of Engineering, London November 1998. Viewed 24 November 2006 www.raeng.org.uk/news/publications/list/default.htm?TypeID=2
(4)
Property council of Australia. Sustainable Development Guide: A roadmap for the Commercial Property Industry. Property Council of Australia 2001
PRINCIPLES OF SAFE DESIGN