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What Can Your Hospital Learn from a Hole in the Ground?

John Commins, for HealthLeaders Media, May 3, 2010

What can your hospital learn about safety from a coal mine? Quite a bit, actually.

The New York Times recently ran an in-depth piece comparing the allegedly checkered safety record and procedures at the now-infamous Upper Big Branch Mine—the Massey Energy Co. coal mine in Montcoal, WV, where 29 men lost their lives following an April 5 explosion—against the E3-1 coal mine in Hazard, KY, that is run by TECO Coal Corp., a company with an impressive safety record. Both mines are nonunion, but the Times report suggests that that is nearly all they have in common.

Despite emitting 25% more methane gas than the Upper Big Branch Mine, for example, E3-1 hasn't had a fatality since it opened in July 2004, the Times reports, nor has it accumulated anywhere near the dozens of safety citations the Upper Big Branch has received. TECO, the Times reports, routinely surpasses minimum state and federal safety standards in critical safety areas like mineshaft ventilation and air quality, and worker emergency training.

Safety inspections are constant at E3-1, especially around shift changes. Workers are encouraged to speak out against safety hazards, and managers and foremen are held accountable for ensuring that equipment is working and safety procedures are followed. If there is a breakdown in safety procedures, someone gets fired.

TECO miners and managers spoke openly and on the record with the Times and said they were satisfied with their training and the safety precautions taken on their part. TECO said it rewards miners who report safety issues, and also provides an 800 number for anonymous complaints.

Massey declined to comment in the Times piece, but the Richmond, VA-based energy company disputed the allegations after the article ran.

"Clearly, something went wrong at Upper Big Branch. But we simply don't yet know what it was," Massey's statement read in part. "If there was improper conduct regarding operations and safety, there will be accountability. What we do know is this: accusations that Massey Energy is indifferent to safety could not be more wrong. Our company puts the safety of its members first—and always first."

Nice slogan: Safety First! Who could argue with that! Sadly, with 29 lives lost, it's no longer about slogans or safety. It's damage control.

Of course, the goal of a good safety program is measureable outcomes, not catchy phrases. In coal mines, safety is measured by quantifiable numbers such as a lack of fatalities, or a reduction in workplace injuries and job-related chronic diseases such as black lung. In hospitals, safety is measured in the reduction of hospital-acquired infections, medication errors, and other preventable mistakes that the Institute of Medicine once said needlessly kill about 100,000 patients each year.

Good hospitals, like good coal mines, have a deeply imbued culture of safety that goes beyond mere words. Safety culture never rests. It always strives to protect workers–and patients—from dangerous conditions. It empowers employees to speak out against hazardous conditions or practices without fear of retribution. Good managers at coal mines—and hospitals—understand that lives are at stake.


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John Commins is a senior editor with HealthLeaders Media.

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