The Facility Safety Manual is a crucial document that outlines procedures for protecting staff, patients, and visitors in the event of emergencies or unsafe situations. It ensures the facility remains compliant with federal, state/provincial, local, and international safety regulations.
QUAD A Standard 3-B-1 requires that the facility review and update the facility safety manual annually, and that the manual is in accordance with all other federal/national, provincial, state, and local regulations. The safety manual can be compiled into one separate binder, or there can be individual safety-related policies that are contained within the facility’s policy and procedure manual. Either method is acceptable, but they must contain all the required safety elements, be easily accessible to all staff, and be readily available upon survey.
Depending upon your program, your manual may need to include policies and procedures for each of the following safety topics:
- Hazard Communications
- Bloodborne Pathogens
- Standard Precautions
- Ionizing Radiation (if x-ray is present at the facility)
- Exit Routes
- Electrical Standards
- Emergency Actions Plan Standards in the event of office or other emergencies
- Exposure Control Plans
- Fire Safety
- Medical and First Aid dependent upon workplace circumstances
- Personal Protective Equipment (PPE)
- Ergonomic Hazards
- Workplace Violence
- Slips, Trips, and Falls
- Influenza
- Tuberculosis
- Emergency Response
- Chemical Hazards
- Other hazards such as Compressed Gas, Laser Hazards, Latex Allergy
In conclusion, your facility’s safety manual or safety policies and procedures must include safety procedures and guidelines to follow during emergencies or unsafe situations to prevent injury, and illness of staff, patients and visitors. These policies and procedures must be in accordance with the services provided at the facility along with industry standards, federal/national, provincial, state and local regulations. If updates or changes are made to the safety manual, staff must be educated.
To keep Patients First, Always, staff must be knowledgeable of what to do when a safety situation is present and where to locate these policies and procedures.
1. Know where the Facility Safety Manual or safety policies are located
2. Review it regularly — especially during the annual update period
3. Complete your annual safety training upon hire and then annually
4. Ensure your training record is up to date
5. Speak up if you identify a hazard or have a question
Thank you for your continued dedication to safety and excellence. Should you have any questions about the facility safety manual, please email standards@quada.org.
Since 1980, QUAD A (a non-profit, physician-founded and led global accreditation organization) has worked with thousands of healthcare facilities to standardize and improve the quality of healthcare they provide – believing that patient safety should always come first.
