• Preventing water damage in your business

    Damage to a building caused by water coming from within the building is possibly not a risk that is top of mind for many businesses. However, at Guild Insurance we have seen these types of claims steadily rising over the past few years, causing more damage and more disruption than business owners expected.

    How does this occur?

    Water inundating the premises can be caused by several factors, usually related to faulty or damaged plumbing. The most common culprits are water pipes and flexi hoses either inferior design, becoming old or damaged and consequently bursting with large volumes of water flooding the premises, while another cause, blockages in sinks, also result in water overflow. Ultimately these failures or issues create water havoc and cause significant damage to premises.

    These types of incidents can happen in any business or home, though those businesses with a high number of basins and toilets, such as early learning businesses, face greater risk simply due to the number of pipes, hoses and sinks.

    What’s the business impact?

    Sometimes businesses are not immediately aware that a pipe has burst, particularly if it’s happened over the weekend or on holidays. Unfortunately, that means a lot of water has flowed into the premises before any action taken and more often than not, it means a lot of damage has occurred.

    It takes time to completely dry an area that has been inundated with water, often requiring industrial driers which are quite loud to operate. As a result of the noise and disruption, businesses often need to close while the drying out process occurs. As well, high volumes of water can lead to mould issues, forcing businesses to temporarily close while they work to resolve these due to the health & safety risks.

    On top of the drying process, there will most likely be furniture and equipment which needs to be repaired or replaced, particularly flooring, which requires clear access to complete.

    Risk mitigation

    While Guild Insurance prides itself on settling these matters as quickly and stress free
    as is possible, insurance can’t mitigate the timing issues described above, which is why at Guild Insurance we believe that prevention is the key and can be achieved by any business with a few simple changes.

    All businesses should have a maintenance program that includes routine inspections of the plumbing so that problems can be detected and repaired before an incident occurs. These inspections should be carried out by staff and supported by regular inspections by a licensed plumber.

    Businesses should also consider installing automated devices which can protect against water leaks. Some of these devices will shut off the water supply when a leak
    is detected, preventing the inundation of water, while others will also notify the
    property owner when a leak is detected, meaning the incident can be acted on much
    sooner. Business owners are advised to speak to their plumber about what will work
    best for their business.

    How you can save

    By making these simple changes you may be eligible for a discount on your premium,
    so talk to your Guild Account Manager today to see how you can save.

    business
  • Understanding your return to work requirements

    The State Insurance Regulatory Authority (SIRA) is the New South Wales (NSW) government organisation that regulates the state’s workers compensation system. It’s a requirement of SIRA that all NSW employers have a return to work (RTW) program in place within 12 months of starting the business. However some employers aren’t complying with this; either they’re not aware of this requirement or they may not understand what they need to do to meet it. This article has been created to assist employers understand what it is they need to do, why it’s important and how to best meet this requirement.

    Please note this information must be read in conjunction with that provided by SIRA, it does not replace it. SIRA’s website (www.sira.nsw.gov.au) contains detailed and valuable information which employers should make themselves familiar with.

    What is a RTW program?

    A return to work program is the formal policy that outlines your general procedures for handling work-related injury or illness. It represents your commitment to the health, safety and recovery of workers following an incident. It sounds quite simple, however unfortunately it’s not always the case. And when not done well it can have a detrimental impact on the employee and employer.

    The program is required to be in place irrespective of whether an employee has been injured. It’s about having the plan in place for when it may be needed.

    Why it’s important to have a return to work program

    While creating a RTW program is something you must do, it’s important to understand why it’s a must and how it benefits your business. A RTW program provides clarity and a clear process for the business in the event of a workplace injury. Supporting an injured worker return to work can be a challenging and sometimes stressful situation; this will be compounded if you haven’t previously thought about how you’ll do it. Creating a program means you’ve planned for the situation before it occurs.

    Having a program means the business has agreed who’s responsible for assisting the different aspects of an injured worker returning to the workplace. The person appointed is responsible for recovery at work. If your business reaches a certain size, a return to work coordinator needs to be appointed.

    Helping your worker to recover at work may reduce the financial impact on your business and enables you to:

    • maintain the skills and knowledge of an experienced worker
    • reduce the cost of training a replacement worker
    • demonstrate to all workers that they are valued employees
    • maintain good employer-employee relationships
    • reduce the length of time your workers are away from work
    • avoid the cost of hiring new staff
    • help to comply with your legislative obligations.

    In addition to the workplace benefits, businesses need to know that SIRA is taking compliance breaches seriously. SIRA can issue fines of up to $2,000 to businesses found to not have the required program in place.

    Resources to assist the process

    Before the requirements of a RTW program are explained, it should be acknowledged that some businesses have found it a bit challenging to fully understand what they need to do. Therefore it’s important to know there are resources and supports available to you.

    Guild Insurance (Guild) offers personalised support and guidance for those businesses who hold a workers compensation policy with Guild or Guild Early Learning. Our Injury Management Specialist, Julia Lock, will walk you through the process of creating a RTW program specific for your individual business. If you would like to take advantage of this invaluable offer of support, please contact Julia directly at jlock@guildinsurance.com.au. And further to this, when a business lodges a claim, Guild’s case managers will have a discussion with the business to be sure the RTW program is in place and created for the correct business category (as described below). If it isn’t, the case manager will refer them to Julia for assistance.

    In addition to this, the SIRA website has a great deal of information about creating a return to work program, as well as various supporting documents to assist this process. The majority of the information needed can be found in their Guidelines for workplace return to work programs document, found here.

    What’s required in the program?

    The information below can be found in more detail in SIRA’s guidelines mentioned above.

    There are two types of requirements depending on the size of your business. These are separated into 2 categories; Category 1 employers and Category 2 employers. The table below defines which category a business fits into.

    Category Criteria
    Category 1 · Basic tariff premium over $50,000 a year or
    · Self-insured or
    · Insured by a specialised insurer and has over 20 employees.
    Category 2 (any employers not in category 1) · Basic tariff premium of $50,000 a year or less.
    · Insured by a specialised insurer and has under 20 employees.

     

    Category 1 requirements

    For Category 1 employers there are four parts to implementing a RTW program, and these are:

    1. Appoint a RTW coordinator – this person looks after the tasks required under the RTW program, such as identifying suitable work opportunities and liaising with key people such as doctors and insurers. This person must be able to demonstrate knowledge and skills specific to this role as set out by SIRA.

    2. Develop a RTW program – there are eight key areas which need to be covered in the program and they are:

      a. leadership and commitment

      b. workplace arrangements

      c. rights and obligations

      d. after an incident

      e. support for the worker

      f. recovery at work

      g. dispute prevention and resolution

      h. administration.

      Details on what needs to be done under each of these areas can be found on a checklist for Category 1 employers in the appendix of the SIRA guidelines document mentioned earlier.

    3. Consult workers and unions – this step ensures workers are involved in the development of their RTW program. Effective communication between all parties, in a way which can be understood by all, ensures everyone is able to contribute to the process.

    4. Implement the RTW program – the information gathered during the previous consultation step is used to finalise the program and implement it. Employers must make the workplace aware of the RTW program and review it at least every two years.

    Category 2 requirements

    For Category 2 employers there are three parts to implementing a RTW program, and these are:

    1. Nominate the person responsible for recovery at work – this doesn’t need to be a return to work coordinator as with Category 1, but this person will manage workers compensation and recovery at work activities.

    2. Develop a RTW program – employers can develop their own program or they can customise the Standard return to work program for Category 2 employers; this can be found in the appendix of their guidelines previously mentioned. Employers must consult with their employees when developing this program.

    3. Implement the RTW program– this step requires the employer to inform workers of their rights and obligations under the program. The program should be reviewed at least every two years.

    Download here

  • Ending a therapeutic relationship in Speech Pathology

    There will be occasions when a speech pathologist needs or wants to end the therapeutic relationship with a client. However, this isn’t an easy thing to do. Knowing how to do this in a professional way that doesn’t cause any distress for either the speech pathologist or the client can be quite challenging.

    Why do therapeutic relationships end?

    There can be many reasons why a speech pathologist considers that the therapeutic relationship needs to end. It may be because the needs of the client won’t be met by that speech pathologist and they should be seeing someone else who has the knowledge and expertise they require. It may also occur because the relationship has become strained or difficult and therefore it’s no longer effective. A speech pathologist may inform a client that services are not able to continue if there are concerns relating to safety, or because the client has not complied with their obligations, such as payment of outstanding invoices, or other practice/organisational policies that the speech pathologist has provided to them.

    Speech pathologists need to know they can end a therapeutic relationship. In some cases it may not just be that they’re able to end the relationship, it may be something they must do as it’s in the speech pathologist’s and/or the client’s best interests.

    Provision of speech pathology services within consumer directed models of funding/care can be challenging. A client may have expectations that will never be met by any speech pathologist, they may not have had much contact with any allied health services in the past and have limited understanding of ‘how it works’. A speech pathologist has an ethical obligation to provide all the information a client will need to understand their communication, swallowing or mealtime support difficulties and how speech pathology may be able to assist them to improve their function or support them. This may mean that information needs to be provided in a variety of ways, with frequent checks of the client’s understanding and support to develop a positive therapeutic relationship.

    Communication is key to maintaining positive therapeutic relationships. A speech pathologist has an obligation to ensure they have provided information in a way the client can understand and has discussed any questions or addressed concerns in a professional and respectful manner. Sometimes however, this still does not result in the development of a positive and beneficial relationship and the speech pathologist must consider how to proceed.

    Tips for ending a therapeutic relationship

    • If there’s tension or conflict arising within the therapeutic relationship, discuss these with the client early. Not doing this allows problems to escalate which makes them harder to manage and de-escalate later. Managing these problems early also allows the speech pathologist and the client to potentially improve the relationship, meaning it may not need to end.
    • Records should be made of any discussions with the client (this includes phone calls and emails) about difficulties within the therapeutic relationship and suggestions to end the relationship. Unfortunately, there will be occasions when the client is unhappy with ending the relationship and they may feel they’ve been treated unfairly. The speech pathologist should keep of record of all conversations had as evidence they’ve addressed all concerns respectfully and professionally.
    • Reasons for ending the relationship should be provided to the client so they understand why this action is being taken. Understanding the reason is most likely going to lead to them being accepting of the decision. However, what information is provided is at the discretion of the speech pathologist. For example, if a parent is non-compliant with home practice, the speech pathologist should provide sufficient information for the parent to understand why home practice is important and the lack of progress if none is completed, however, stating that the parent is very difficult to work with may not assist that understanding.
    • Provide the client with information regarding other speech pathology services available in their area, keeping in mind specific requirements or limitations the client may have, e.g. other practices that offer school/home/residential facility visits etc.
    • If a referral to another speech pathologist is made, the specific reasons why this speech pathologist is being recommended should be explained, such as this person has specific skills which would better meet the needs of the client. When recommending that a client see a colleague for their specific knowledge and skill, the speech pathologist must have personal knowledge of the colleague’s expertise. Speech pathologists should refer to information about referrals in Speech Pathology Australia’s (SPA) Policy and Procedure Manual found on the SPA website. Speech pathologists are reminded that they will breach client confidentiality if they share reasons for ending the therapeutic relationship with the new treating speech pathologist. If there are specific concerns regarding the behaviour of a client or family members, speech pathologists should seek independent legal advice about what can or cannot be provided to the next clinician.

    Support and assistance can be sought from Speech Pathology Australia, they can be contacted on 1300 368 835.

    Ending therapeutic relationships in Speech Pathology

  • Is Facebook a risk for your speech pathology practice?

    Facebook has evolved greatly overtime, and so has our use of it. Gone are the days of it simply being used to chat with friends and share holiday photos. Professional use of Facebook has grown to the point where many people expect businesses to have a Facebook presence. With ever evolving algorithms and functions and various accounts settings, it can be difficult to stay on top of best and safe practice. Most concerningly, these changes can bring misunderstanding about the many risks and issues all businesses, including speech pathology practices, need to consider before creating a professional Facebook account.

    Reasons for a Facebook account

    Creating a business Facebook account because many other businesses or practices have one isn’t a good enough reason. As with all other decisions and plans made for your speech pathology business, creating a Facebook account needs to be well thought through with the pros and cons considered carefully. Risk management is especially important as issues can quickly escalate due to the nature of how the platform can easily share and distribute information.

    Your speech pathology practice should have a process and policy for the following in relation to a business Facebook account and its usage:

    • What information will be shared
    • How responses to comments will be managed
    • Who is responsible for managing the account
    • How client permission, if posting information about clients, will be obtained and recorded
    • Who is responsible for ensuring the content is appropriate for advertising speech pathology services

    Did you know?

    Facebook was created in 2004 as a social networking tool for college students. Now, there are over 2 billion Facebook users and almost 1.5 billion daily users[1].

    94% of Australia’s social networking users have a Facebook account.  And these Facebook users have an average of 234 friends each[2]

    Ethics of posting information about clients

    It’s becoming more common to see speech pathology practices sharing information about clients on Facebook. Even when done with the permission of the client, or the client’s parents, it’s important to consider how ethical or professionally appropriate this is. When intending to post information about client progress on Facebook, first consider the following:

    • Could the information be shared without identifying the client? Is there any real benefit in identifying the client?
    • How many people will be able to see the information being posted (consider how many people follow your page and then their ability to share this further)? And who are these people? Is it possible that friends of the client could see the posts?
    • If the client is a child, as they get older how may they feel about their health information being shared publicly?

    Client permission isn’t always enough when sharing confidential health information. The reasons for and implications of this sharing need to be considered.

    Blurring of professional boundaries

    Using Facebook, and any other form of social media, can contribute to professional boundaries starting to blur. Social media encourages an informal means of communication which may be different to how you’d communicate with clients when face to face. This can alter the dynamics of the professional relationships between clients and clinicians. Professional social media use can also lead to clients contacting clinicians on their personal social media accounts. When using social media for work purposes, it’s important to maintain the professional separation and relationship with clients by not altering the way you interact and communicate with them.

    Privacy

    Privacy on Facebook is almost a contradiction. When using Facebook remember:

    • Posts and comments can never be completely deleted, especially if someone has taken a screen shot of them.
    • Privacy within groups can’t be guaranteed. It’s not uncommon to hear of people creating fake accounts to access private groups and share their information.
    • If there’s something you don’t want to be seen by a regulator, client, colleague or competitor, never post it on Facebook.

    Appropriate use of social media for advertising

    Speech Pathology Australia has published a Code of Ethics – Advertising Policy which describes appropriate advertising of speech pathology services. The policy applies to all social media advertising (Facebook included) as well as any other forms of advertising that the speech pathologist has control over. The required level of professional language used and information shared in all advertising is also required when using Facebook.

    Seeking advice

    When using Facebook in a professional setting, consider the appropriateness of the conversations held in that forum, even if it’s a conversation with other speech pathologists in a private or “closed” community.

    While peer support has many benefits, using forums such as Facebook groups to seek and provide specific clinical information can pose a significant risk to speech pathologists. The risks not only relate to confidentiality of sensitive client information, but also provision and use of advice that is suggested without access to adequate information on which to base decisions. In many situations/scenarios, very little information may have been supplied about the case being discussed. Even if a lot of detail is provided, which carries risk for maintenance of confidentiality, the advice you provide to a colleague could potentially be clinically inappropriate or incorrect. Following advice provided via social media groups that may not be appropriate for your client poses a risk for the treating speech pathologist.

    Speech pathologists have an ethical obligation to provide quality and competent professional services which follow evidence-based practice principles. Although general advice provided through a discussion of general clinical scenarios on a social media platform may be appropriate, for a discussion regarding client specific information speech pathologists are advised to consider how they seek professional advice, such as working with a supervisor.

    Facebook risks in Speech Pathology



    [1] Facebook Reports First Quarter 2018 Results

    [2] Sensis Social Media Report 2017

    social-media
  • Record keeping checklist - Veterinarians

    Maintaining appropriate and proper clinical records relies on veterinarians integrating fundamental record keeping practices into their daily routines. Using this checklist will help to evaluate your practice. ‘No’ answers are opportunities for improvement.

    Actions

    Yes

    No

    I keep a separate record for each animal.

    I record sufficient information to allow me or someone else to return to the record at any time and be able to understand what took place and why. 

    Where the most ideal treatment option isn’t consented to by the client, I make a note in the record why this treatment wasn’t provided.

    I obtain and record informed consent for all treatment provided.

    If documents are scanned to the record, such as external reports, the scanning is done to a sufficient quality that retains the legibility and detail of the original document.

    I have consistent processes for recording the details of any further interactions with clients that may occur via telephone, text message, email or other method. 

    My entries are legible, accurate, made in chronological order and clearly dated. 

    My entries are made at the time of the appointment, or as soon thereafter as practicable.

    Any corrections I make to records do not remove the original information, and any corrections or additions are initialled/signed.

    I only use abbreviations that are widely recognised and accepted in my profession or I provide a list of abbreviations in the animal’s file.

    I don’t make subjective or emotive comments; all information is professional. I know that clients have a right to access their records.

    All treatment and entries in the record are made with my regulator’s professional standard in mind.

    I keep an appropriate, consistent standard of records for all animals, not just those with complex needs.

    I know that I cannot delegate responsibility for the accuracy of information recorded to another person.

    My records are stored securely and in a way that ensures they can be promptly retrieved. 

    My records are collected, maintained, transferred and disposed of in accordance with federal privacy laws as well as other relevant state or territory laws, codes and guidelines.

    Download pdf here

    clinical-records
  • The risk of flexi hoses - Early Learning

    Imagine that you’ve closed your centre at about 6pm on a Friday. Unbeknownst to you, later that evening water starts flowing from underneath one of the bathroom sinks. As no one is there to see or stop this, it continues with water inundating the entire building. By the time you’re aware of this on Monday morning, the building has suffered extensive water damage to the floors and furniture and mould has started to form. 

    What is a flexi hose?

    Many business and home owners will have little understanding of a serious risk lurking beneath their sinks. Flexible braided hoses, commonly called flexi hoses, are frequently found underneath bathroom or kitchen sinks right across Australia. A flexi hose is a flexible hose with braided or woven stainless steel which have overtime replaced standard copper pipes. They’ll usually be used to connect water to an appliance, such as a dishwasher, sink or toilet. The flexibility in them makes plumbing connections easier in a range of settings. However, it’s this flexibility that also creates a very real risk of water damaging your property and disrupting your business if the hose fails or bursts. 

    What could go wrong?

    It’s quite simple really. When the stainless steel outer of a flexi hose fails by either corroding or fraying, this allows the inner tubes of the hose to expand to a point of bursting. 

    How will this impact your centre?

    Any building, both commercial and residential, faces the risk of a burst flexi hose. However early learning centres face a higher risk than many other buildings given their high number of toilets and basins, and therefore the high number of flexi hoses. The scenario at the beginning of this article highlights the damage which can occur with water potentially inundating the entire building before it is realised and stopped. However, the impact unfortunately doesn’t end there. Guild Insurance has seen many cases where extensive water damage has led to an early learning centre being closed for a period of time, possibly a week. This may be because of the time it takes for the floors to completely dry. Driers can be used to speed up this process, however these are quite noisy and it’s difficult to operate a centre while these are being used. There is also the issue of mould building up due to the water damage and this creating an unsafe space for both children and the staff. There is an unfortunate potential consequence of an early learning centre being unable to operate for a period of time. Several centres have experienced their children attending other centres during a closure and then not returning once the centre is up and running. While insurance can assist with the cost of repairs and lost revenue during a closure, it can’t assist with valued clients choosing to not return.

    What can you do about this?

    Use a qualified plumber – There may be a temptation for some people to consider installing flexi hoses themselves, however the majority of issues with flexi hoses come about due to poor installation. Therefore, always use a qualified plumber to be sure flexi hoses are correctly installed. 

    Create a maintenance program – flexi hoses should be regularly checked for damage, approximately every 6 months. When undertaking these checks be on the look out for leaks, bulging pipes and fraying or rusting stainless steel. Your plumber may be able to assist you with this process. 

    Only use quality products – While all flexi hoses have a limited lifespan, some will last longer than others. Your qualified plumber should only be using products which adhere to the WaterMark Certification Scheme and carry the recognised WaterMark logo. While a high cost isn’t a guarantee of high quality, be mindful when trying to limit spending as sometimes cheap options will be of a lower quality. 

    Replacement program – quality flexi hoses are generally thought to have a lifespan of about 5-8 years, however this can vary and some have been known to burst within a few months of installation. It’s therefore recommended hoses are replaced approximately every 5 years, unless maintenance checks suggest it should happen sooner. If you’ve moved into a new premises and you aren’t sure of the age of the flexi hoses, consider replacing them all to be on the safe side. This may seem overly cautious, however the time and money spent doing this will be much less than dealing with water damage to your business. 

    Storage of chemicals nearby – it’s very common to store cleaning products in cupboards under sinks, which is where you’re also likely to find flexi hoses. It’s thought that the chemicals in these cleaning products may contribute to the corrosion of flexi hoses. Therefore, find another safe place to store these products away from your flexi hoses

    Download here

    business
  • Damage to veterinary equipment

    It probably goes without saying that as a vet you rely heavily on your equipment to do your job. Yet how often do you think about the impact on your business should something happen to that necessary equipment? Guild Insurance regularly manages claims where veterinary equipment has been severely damaged and needs to be repaired or replaced. While insurance is there to ease the burden when these events occur, it’s also important that those using the equipment think about the role they play in this.

    What can go wrong?

    A lot of the damage which occurs to veterinary equipment happens when the equipment is being transported, taken in and out of vehicles and used in various locations. Some examples of these include:

    • While having an x-ray taken, a horse has kicked and damaged the x-ray machine
    • While being placed back into a car after use, an x-ray machine was damaged
    • During a procedure on a dog, ultrasound equipment was dropped while being moved
    • A laptop was damaged due to ultrasound gel getting into it while being transported in a vehicle

    Could the incident be prevented?

    The first step to managing any risk is to consider if and how it could be prevented from occurring. In some of these cases, the incident is challenging to prevent. Animals are often unpredictable; some cases of horses kicking have occurred even when the horse has been sedated. However, in many cases human error has

    been a factor and something could have been done differently. When dealing with expensive valuable equipment, please remember to always be mindful of how it’s being lifted, carried and where it’s being placed. Also think about what it’s being stored with or near; Guild has seen numerous examples of lube getting into equipment as it wasn’t stored securely away from that valuable equipment. When using equipment regularly, it’s easy to become too familiar and complacent. However it’s important to be aware that this damage does occur regularly, and vets and their staff should consider what can be done so it’s less likely to happen to them.

    The business impact

    Unfortunately we can sometimes develop a casual approach to property damage thinking ‘well that’s what insurance is for’. However, this view disregards the impact on professionals and their business while the claim is being settled. Damaged equipment won’t be repaired or replaced the next day. While Guild does its best to settle these matters as quickly as it can, the business will still be without that equipment for a short period. So, when considering what you can do to reduce the likelihood of damage to your equipment, also think about how you would manage if you didn’t have a piece of equipment for a week or two.

    Minimise the impact

    As you can’t always prevent an incident from occurring, the next best step is to minimise the impact should something go wrong. One way to minimise this impact is to provide as much information as you can to Guild so the insurance claim can be settled as soon as possible.

    If some of your equipment is damaged and needs to be repaired or replaced, document as soon as possible exactly what happened and how. Taking photos of the damage will also assist Guild to understand what’s happened. Then be sure to contact Guild as soon as you can, ready to provide this information.

    Adequate insurance

    Veterinary equipment is expensive. Therefore replacing it when damaged will be costly. We unfortunately see too many cases where an insurance policy doesn’t cover the full cost of the equipment repairs or replacement, meaning the vet or their business must cover the additional amount. Please take the time to determine the value

    of the equipment you own and therefore the cost that may be incurred if it was badly damaged and check your insurance policy to be sure you’re fully covered.

    Vet Equipment Damage

    Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791. This article contains information of a general nature only, and is not intended to constitute the provision of legal advice. Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them.

    accidents
  • Common workplace errors and injuries in early learning centres

    No employee wants to be injured at work. And no employer wants their staff to be injured at work. Guild Insurance knows that employees and employers have the best of intentions when it comes to workplace safety. Unfortunately, despite these good intentions, we see many cases where early learning workers are injured while at work,
    and sometimes quite seriously. And it’s disappointing that many of these injuries could have been easily avoided.

    Guild Insurance sees too many cases where an injury in an early learning centre has
    occurred while the worker was performing a task in an unsafe manner. We know that in many of these cases the staff member would have been taught the right way to do things and therefore would have been aware it was incorrect. So why does this happen? Why do staff risk their physical health and wellbeing by performing tasks in an incorrect and dangerous manner?

    Examples of tasks performed incorrectly

    The following are some of the common actions which lead to injuries in early learning centres:

    > Standing on swivel chairs instead of ladders to reach an item
    > Picking up children rather than lowering to their height
    > Lifting children onto a change table rather than having the child climb up steps
    > Lifting something alone which is too heavy rather than asking a colleague for assistance

    Training

    It’s possible that one of the main reasons people perform tasks in a dangerous way is that they don’t fully appreciate the risk. They may have been taught that it’s wrong,
    however they may not understand why it’s incorrect and what could go wrong. Therefore, when teaching staff about the correct way to perform tasks, it’s important to not just tell  them what to do and what not to do, but also stress the reasons why. They need to appreciate what could happen and what sort of injury they could sustain. They need to understand, for example, that when standing on a swivel chair, it can easily move causing the person to fall off. This often leads to serious arm injuries, such as fractures, as the person has landed on the ground.

    Reminders

    Being told something only a couple of times, maybe during formal education or at induction, isn’t always enough to enforce learning and change behaviour. People often need to be continually reminded. Early learning centres should be regularly talking about and promoting safety and correct techniques in the workplace. This could be a regular agenda item at team meetings. There could be signs around the centre to remind staff of the correct way to do things. Staff could be commended when seen doing the right thing. Don’t make education a once off.

    Rushing

    One of the most common reasons people don’t do things as they should is that they’re rushing and feeling they’re too busy. Too often when staff are busy at a centre, they’ll try to do things quickly and will often look for workarounds to speed up tasks. Unfortunately, this can lead to unsafe practices and injuries. Taking an extra couple of minutes to look for an appropriate ladder or ask a colleague for assistance is surely better than suffering a serious long-term injury which may prevent someone from working for weeks or even months. Similarly, scanning the room for hazards prior to entering may aid in the prevention of a trip or fall.

    Lead by example

    Managers and senior staff need to be sure they’re leading by example. There’s no point
    telling your staff how to do things correctly and then doing it a different way yourself. And if you think you can do it quickly and get away with it, think again as someone will see you. Not only are managers risking injury by doing things the wrong way, they’re also sending the wrong message to their staff. To create a workplace culture that values safety, all staff need to do the things the right way which is the safe way.

    It won’t happen to me

    We’re all guilty at times of knowing what can go wrong but not really thinking it’ll happen
    to us. However, Guild’s claims experience tells us these incidents and injuries happen
    to anyone, including people just like you. Just because you may have cut corners with tasks in the past and nothing went wrong, doesn’t mean you’ll get away with it next time. Taking these risks just isn’t worth it, because it only takes one time where something goes wrong for a serious injury to occur.

    accidents
  • The unpredictability of an early learning centre

    Early learning and childcare centres are dynamic, unpredictable, ever-changing environments.  For some educators, it’s this type of environment which makes it a fantastic place to work.  However, this environment can also make it a hazardous place to work if the risks of an ever-changing environment aren’t identified and managed.

    All early learning centres have processes in place to be sure the centre is tidy and orderly at the beginning of the day with all furniture and equipment where it should be.  However, this rarely lasts long and nor should it.  Through the regular activities undertaken throughout the day, many pieces of equipment can end up being left in areas which may create a hazard and lead to an injury to staff and children.  Also, it’s possible for toys, play equipment and even furniture to become damaged over time and this also creates a hazard.  The solution of course isn’t to stop the children playing and using what’s in the centre.  The solution requires all staff who work in centres to be aware of the risks within their environment and what they can do to manage them.

    Constant vigilance

    Working in an early learning centre requires constant vigilance from all staff.  This means staff are always looking around and scanning for risks and hazards which could lead to injuries. 

    Centres have processes in place where regular inspections are carried out.  While these checks are important, they aren’t enough.  Staff need to be in a habit of being continually on the lookout for risks at all times and in all locations within a centre.

    Risks aren’t always obvious

    There are some risks which will be obvious and that all staff would know to look out for and rectify, such as toys being left in walkways or spilled drinks on the floor.  However, this is not the case with all risks.  Some are harder to spot and may be unexpected, such as a poorly fitted baby gate closing on a staff member.  This further emphasises the need for constant vigilance and not just looking for common risks.  It means staff should be continually asking themselves ‘What could happen?’ and thinking outside the square when answering this. 

    Don’t put it off

    It’s not uncommon for Guild Insurance to hear of an injury occurring in a centre due to a hazard which had previously been identified yet no action had been taken.  This lack of action may be due to other competing priorities, lack of funds or the risk may have not been taken seriously.  When a risk or hazard has been identified it’s important that it’s assessed immediately so the likelihood of an injury and the potential seriousness of that injury are both well understood.  This will assist the centre in developing an action plan for what needs to happen to reduce or eliminate that risk and how urgent this is.  Staff and children do suffer serious injuries in early learning centres which can affect them for a very long time.  Hoping the risk won’t eventuate isn’t sufficient risk management, centres need to take action.

    Risk register

    Creating a risk register is an important process for dealing with identified risks and being sure they don’t get forgotten about.  The risk register should contain important details about each risk including the likelihood of the risk occurring, the potential consequence if it did occur, what actions or steps are required to mitigate or reduced that risk, who is responsible for doing this and by when this action needs to occur.  This register should be made available to all staff and discussed regularly so there is constant monitoring of which risks have been actioned and which still needs actioning.

    Whose job is it?

    In every workplace, everyone has a responsibility to ensure it’s a safe environment for all who attend or visit.  This means that all staff, including the newest and least experienced right up to the most experienced, have a responsibility to continually be on the lookout for hazards and act on them when found.  Leaving this to someone else is not acceptable.  While some staff members may not have the ability to create the change necessary to reduce the risk, for example it’s not their responsibility to book in maintenance staff, all staff have a responsibility to at least report the hazard to someone who can take action.

    To ensure staff do speak up when they see a risk or hazard, it’s important that a culture of speaking up is encouraged.  This means making all staff aware of their responsibility but also listening to and taking on board the concerns raised by staff. 

    Regular safety discussions

    To encourage and support staff to continually think about safety and identify risks, regular safety conversations in the workplace can be very beneficial.  This can be done in a number of ways such as having safety as an agenda item at staff meetings or by including staff in discussions about how identified risks will be actioned.  This continual conversation encourages safe thinking to become how people do their job, not an addition to it.

    Download pdf here

  • Avoiding big problems for little people

    Early learning centres are dynamic, continually changing environments.  This is important so children are stimulated and always learning.  However, this also presents challenges and potential risks for both children and staff which need to be managed.

    Guild Insurance has over 25 years’ experience insuring early learning centres; this means we understand your industry.  The following information provides examples of common incidents, which lead to insurance claims reported to Guild.  Following this are risk mitigation tips for running a safer early learning centre.

    Case examples:

    • A child scaled a 6ft high fence, with the assistance of nearby play equipment, and left the centre.The child was intending to go after his parent who had just dropped him off.The child was found by a member of the public on a busy road about a hundred metres from the centre, fortunately unharmed.
    • A child was climbing up some play equipment when she lost her footing and slipped.As she fell, she bumped her mouth on the equipment, fracturing her tooth and splitting her lip.
    • A child was running outside and tripped over some play equipment.As she landed, she fractured her wrist.
    • A child was closing a door not realising there was a child on the other side of the door.This child’s finger was caught in the closing door and the tip of his finger was amputated.
    • Following complaints about an employee’s unprofessional conduct towards children, the employer investigated the matter and subsequently decided to terminate the employee. The employee then lodged an unfair dismissal claim with Fair Work Australia.

    Tips to mitigate risks

    Identify and act on hazards

    There are many hazards in an early learning centre which could lead to children suffering an injury or experiencing an incident which could lead to harm.  Staff need to be continually vigilant looking for these hazards.  And this applies to all staff, this isn’t a job just for senior staff.  All staff have a responsibility to maintain a safe environment and this means staff should be encouraged to speak up if they see something which concerns them. 

    When hazards are identified, it’s important they’re acted on immediately.  It’s not uncommon for Guild to see cases where identified hazards are put on the back-burner due to a lack of funds or time to address it.  This isn’t ok.  All centres need to have a process for how identified hazards are reported and recorded, with the person responsible for ensuring it’s rectified clearly noted.  This person needs to have an appreciation for what could go wrong if the matter isn’t addressed and ensure the required focus and urgency is applied.  It’s also important to have a maintenance budget to allow the centre to deal with unexpected yet urgent maintenance issues.  Waiting till more money becomes available could be more costly in the long term if there’s a serious incident.

    Ensure there is appropriate supervision

    All centres would be aware of the required levels of supervision and ratios for their centre.  However, supervision is about much more than numbers.  Staff need to understand what they need to be looking at and for when supervising children.  They need to know where to place themselves.  They need to be sure their attention is on the children and not allow themselves to be distracted.

    Adequate supervision assists in several ways.  It means potential risks may be detected before there’s a serious incident.  Take the earlier case of the child using play equipment to climb the fence.  Not only should appropriate supervision have meant the child was seen climbing over the fence, but it’s possible that staff may have seen children attempting this on previous occasions.  This risk could have been dealt with by moving equipment away from the fence.  Appropriate supervision also means that if there’s an incident, such as a child has fallen and injured themselves, staff will be able to respond quickly and provide an accurate report of what occurred.

    Create a safe place of employment

    All staff want to work in an environment where they feel safe and valued.  Unfortunately, Guild sees many varied cases where staff claim they’ve been treated unfairly.  This may be because they’ve not been provided their full entitlements, such as salary or leave, or they may feel they’ve been bullied or not given promotional opportunities.

    Managers and directors within early learning centres need to be sure their focus isn’t solely on the children but also on their staff, remembering that staff play a crucial role in the success of any business.  There needs to be open conversations and clear expectations regarding how staff are to treat and interact with each.  Managers need to also be sure their expectations in terms of behaviour and work performance is clear.

    It’s important to create a workplace where staff feel comfortable speaking with mangers if they have any issues or concerns.  Too often we see cases where the managers are quite surprised a staff member has lodged a formal complaint as they were unaware of how the staff member was feeling.  It’s much easier and quicker to deal with an issue in its early stages.

    Understand employment law

    Employment related disputes are an ongoing theme in early learning claims reported to Guild.  These claims indicate that some employers may not be aware of their obligations and the laws governing them as an employer.  There are laws surrounding salaries and awards, leave entitlements and terminating employment.  Employers can’t simply do as they please, no matter how their employee behaves, which unfortunately it seems they sometimes do. 

    The following two websites contain a great deal of easy to follow information to assist employers, and employees, understand their obligations.

    If you find yourself in a difficult situation regarding an employment matter and you hold a Guild Insurance Early Learning Business Insurance policy, you’re entitled to two (2) hours of free legal advice under the policy.  This advice can assist you to deal with a matter correctly and fairly while it’s still in its early stage which may prevent the situation escalating into a more serious legal matter.

    Don’t think it won’t happen to you

    It’s easy to read cases such as those at the start of this article and think that wouldn’t happen to you and your centre.  However, Guild’s claims suggest these incidents can happen to anyone.  Thinking you don’t face these risks can actually put you at an increased risk.  This is because when risks and hazards aren’t taken seriously, the necessary risk mitigation strategies are likely to not be implemented.  Therefore, acknowledge what could happen, and do what you need to do to prevent this.

    Avoiding big problems for little people

  • Using Telehealth during the pandemic

    Many allied health practitioners across the country are already using telehealth to provide care for their patients during the COVID-19 pandemic. However, there are some additional risks and limitations associated with delivering health services via telehealth which practitioners need to be mindful of.

    Using telehealth to deliver allied health services to patients during the pandemic? AHPRA releases new guidance for all health practitioners.

    As part of the national health response to the COVID-19 pandemic, many registered health practitioners are electing to use ‘telehealth’ to deliver health services to their patients.  The Australian Government has demonstrated support for this initiative by rolling out new temporary Medicare Benefit Scheme (MBS) ‘telehealth’ item numbers, several of which apply to the provision of allied health services (including those which form part of chronic disease management[1]). 

    In an effort to support practitioners who wish to use telehealth to service their patients going forward, AHPRA has recently released new guidance (https://www.ahpra.gov.au/News/COVID-19/Workforce-resources/Telehealth-guidance-for-practitioners.aspx) which sets the expectations for all health practitioners delivering health services using videoconferencing or telephone solutions[2].  The key message is that a service may only be provided by telehealth where it is safe and clinically appropriate to do so.[3]  

    Critically, the limitations around the use of a telehealth consultation to provide a particular health service need to be at the forefront of practitioners’ minds and on a case by case basis.  For example, practitioners ought to consider whether this a consultation which, if conducted face-to-face, would add no further value than if conducted over the telephone?  Or, is this a consultation which requires a physical examination in order to properly diagnose the presenting complaint? If it is the latter, in our view it will not be sufficient to simply tell the patient about the limitations of a telehealth consultation and rely on this disclosure defensively without conducting the necessary examination. If required, further arrangements ought to be made to provide full and appropriate clinical care. This may mean arranging for an in-person consultation/examination for the patient with a colleague if you are unable to conduct it yourself. 

    So how do you perform a consultation via ‘telehealth’? While neither AHPRA nor the Department of Health has been prescriptive about the type of software or technology practitioners need to use to deliver telehealth services, the Department has made clear that videoconferencing services are the preferable substitute for a face-to-face consultation.  AHPRA has said that either videoconferencing or telephone is suitable.  However, both organisations have warned practitioners to ensure that their chosen software meets both their clinical requirements and satisfies privacy laws[4].  The MBS Online website refers providers to the Australian Cyber Security Centre website (https://www.cyber.gov.au/publications/web-conferencing-security) for information on how to select a web conferencing solution.

    Although the Australian Government has provided several new MBS telehealth item numbers for the provision of some allied health services, the items are very specific, and should be reviewed carefully as rebates may not be claimable if the service does not have an equivalent telehealth item number.  In addition, practitioners need to be mindful that the MBS items specify whether they are to be used for videoconferencing or telephone-only services – we recommend reviewing the schedule to ensure the correct number is used for billing purposes. 

    While it is a legislative requirement that some medical practitioners must bulk bill the new telehealth services for certain patients (including those who are more vulnerable to COVID-19), these requirements do not apply to allied health practitioners as of 20 April 2020.   Allied health practitioners may employ their usual billing practices for delivering services via telehealth. That being said, it is expected that practitioners will obtain informed financial consent from patients prior to providing any telehealth service, including providing details about the practitioner’s fees and any out-of-pocket costs. 

    Patient privacy is another key issue that allied health practitioners need to consider when using telehealth to conduct consultations.  AHPRA guides practitioners to confirm the identity of the patient at each consultation, which may be more challenging if telephone is used (as opposed to videoconferencing), or if the patient is a new patient for the practitioner.  Also consider the location and surrounds in which the telehealth consultation is conducted - if it is not at the practitioner’s usual practice site (for example, because the practitioner is conducting consultations from home), consider what measures need to be implemented to protect patient privacy during the consultation.

    Finally, all registered health practitioners who intend to use telehealth to conduct patient consultations ought to ensure that they have appropriate professional indemnity insurance arrangements in place for all aspects of their practice, including telehealth consultations. We encourage practitioners to contact their professional indemnity insurer about their intentions to use telehealth, and confirm that the appropriate coverage is in order.

    This article was written by Principal Kellie Dell’Oro and Associate Anna Martin from Meridian Lawyers. Please contact Kellie (kdelloro@meridianlawyers.com.au) if you have any questions or if we can be of assistance to you.


    [1] MBS Online Medicare Benefits Schedules – COVID-19 Temporary MBS Telehealth Services. (http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-TempBB)

    [2] AHPRA FAQ “Telehealth Guidance for Practitioners” dated 16 April 2020.

    [4] Ibid.

    Download here

  • Transitioning out of COVID-19 restrictions

    Operating a business during the COVID-19 pandemic has presented many challenges. Unfortunately, many businesses closed for a period of time while others worked on reduced hours. And for others, staying open meant finding new ways of doing so, such as by providing virtual services. As the world starts to consider how to move out of pandemic restrictions, it’s important for all business owners to carefully consider the approach they’ll take and the associated risks. The fallout of COVID-19 is likely to be with us for some time, so we all need to be careful to not become complacent and make changes too quickly.

    Government requirements

    Firstly, all business owners need to be sure they’re keeping up to date with and adhering to government requirements and regulations. This can at times be challenging as the federal government is making recommendations, yet all state and territory governments are moving at different paces in terms of lifting restrictions. All business owners need to take responsibility for being sure they understand what they can and can’t yet do regarding their operations. Information about this can be found on the following websites:

    Australian Federal Government - www.australia.gov.au 

    ACT - www.covid19.act.gov.au

    New South Wales - www.nsw.gov.au/covid-19

    Northern Territory - www.coronavirus.nt.gov.au

    Queensland - www.covid19.qld.gov.au

    South Australia - www.covid-19.sa.gov.au

    Tasmania - www.coronavirus.tas.gov.au

    Victoria - www.vic.gov.au/coronavirus-covid-19-restrictions-victoria

    Western Australia - www.wa.gov.au/government/covid-19-coronavirus

    Business owners may also wish to seek guidance and clarification from their professional association.

    Gradual changes

    While it’s understandable that business owners want to get back to how things were pre-pandemic, it’s advisable that changes aren’t made too quickly. Rushing could see changes being made which aren’t allowed or aren’t safe if they haven’t been carefully considered. It could also result in staff not understanding the changes and not adhering to them as they should. It’s important to remember we may not continue transitioning out of restrictions. Unfortunately restrictions could at any time be wound back which is another reason why a planned and measured approach is ideal.

    All changes should be communicated to clients. This means they’ll feel reassured and trust that your business is continuing to operate safely. It also helps your clients understand what you expect from them to maintain this safety. This communication can be done in a variety of ways, such as by simply posting notices around the premises or sending email updates.

    What works for you?

    Not all businesses and business owners are the same and therefore how they provide services during the period of restrictions and how they transition out of these will, and should, differ. You should consider the following when planning to transition out of restrictions:

    > Is the current way of working successful? If the changes you’ve made to the business during the restriction period have worked well for you, you may feel less urgency than others to move away from these.t of

    > Does the service you provide require contact with others? The services provided by some professionals requires them to come into close contact with their clients, whereas other services can be offered from more of a distance. When thinking about making changes to your services, you need to carefully consider how close this will require you to be to your clients and if this is something you think you can do safely.

    > Are your clients high risk in relation to COVID-19? If your clients are at an increased risk, possibly due to their age or health condition, this should be seriously considered when assessing how the business provides its services.

    > Are you, or someone you live with, high risk? It’s not just the health of your clients you need to consider when making decisions about how to run your business. You also need to consider your health and that of those you live with. Remember, this is a highly contagious virus which can have devastating consequences; please don’t risk your or another person’s health.

    Insurance cover

    All business owners and professionals need to be sure they have insurance to cover them for what they do. During the period of restrictions, when some professionals changed the way they were working this led to changes in their insurance cover. Therefore, as you come out of restrictions and again change the way you provide services, you need to be sure your insurance covers those services as well as the hours you’ll be operating and the estimated income.

    Trust your instinct

    There are unfortunately cases of clients pleading with business owners to open when they aren’t ready and even when in breach of government restrictions. This puts unfair pressure on business owners to do the wrong thing to keep their clients happy. Of course one of the core functions of running a business is to keep clients happy and satisfied, after all they keep you in business. However this can’t be done when it’s potentially detrimental to the health of you or others. When making changes to come out of restrictions, ensure these are planned, well thought through and explained to your clients. If they do try to convince you otherwise, reiterate your reasons to them and don’t allow yourself to be convinced to do something you know isn’t appropriate.

    In summary…

    As more and more businesses are coming out of their restrictions and returning to their usual services, it can be very tempting to follow suit. However, please be sure no changes are made without careful consideration and planning, as the risks are too great.

    Download here

    business
  • Property maintenance - could your property cause an injury?

    Guild Insurance sees many insurance claims which have come about due to poor maintenance of a property.  In too many of these cases, the poor state of the building or its grounds is obvious and it’s quite surprising, as well as disappointing, that repairs haven’t been carried out before an incident has occurred.

    What can go wrong?

    There are a range of incidents which can occur due to poor maintenance of a property.  Staff can be injured leading to a worker’s compensation claim as well as staff being absent from work for an extended period.  Visitors to the premises, such as customers, clients or contractors, can also suffer injuries leading to public liability claims.  As well as the insurance claims which need to be managed, there’s the added stress of knowing that someone has been injured while at your premises.  Some of these injuries can be very serious and life changing.  Unfortunately, the hazards which lead to these injuries are often not viewed as seriously as they should be.  Yet with appropriate property maintenance many of these injuries could be avoided.

    Case 1

    A client entered a building and tripped over an edge of carpet which was ripped and curled up.  The client sustained a fractured wrist when they landed.

    Case 2

    An awning out the front of a building was old and worn out.  During heavy winds it broke off from the building and hit a person walking past at the time.

    Case 3

    While walking through the carpark of a premises, a staff member has tripped on a large crack in the asphalt which had caused the surface to be uneven.  They fractured their ankle as they fell.

    Case 4

    Poor maintenance doesn’t just lead to people suffering injuries, it can also lead to further damage to the property.  An old deteriorating roof collapsed when hit by heavy rain as it no longer had the strength to support the weight of this rainfall.  This led to excessive water damage within the building.

    Property maintenance tips

    • Have a documented maintenance program in place.This requires a schedule for regularly checking the property to identify hazards as well as details on what needs to be serviced, repaired or replaced and when.
    • Be aware of the out-of-sight, out-of-mind hazards.Many properties have roofs, guttering and downpipes in poor condition due to a lack of maintenance as no one has thought to get up on the roof and inspect it.Include the less obvious hazards in the maintenance program.
    • Have a maintenance budget.Some maintenance work can be planned, other work will come up unexpectedly when something breaks down.You need to be able to find money to fix hazards when identified.
    • Be sure to use qualified tradespeople to undertaken maintenance work.While it can be tempting to undertake some DIY and save money, the risk of things not being maintained or repaired correctly will not be worth the savings in the long term.
    • If you’re a tenant, be aware of what you’re responsible for maintaining and what’s the responsibility of the landlord.Not all tenancy agreements are the same, so you need to be across the details of your agreement.
    • Don’t wait to undertake maintenance till a more convenient time.There are many cases of injuries occurring due to hazards which had been identified but not yet acted upon, usually due to costs, time or not acknowledging the risk of the hazard.
    • All staff have a responsibility to create and maintain a safe workspace. Some hazards will be identified through regular property inspections, however, you can’t rely solely on these inspections.Therefore, encourage all staff to continually be on the lookout for hazards and to speak up when they see something.
    • Don’t think it won’t happen to you and your property.These incidents are a lot more common that many people realise.

    Property maintenance and injuries

  • Navigating communication and due processes during COVID-19

    At Guild Insurance we thought it was timely to remind you of practices you should adopt to ensure you’re operating your business as safely as you can during the COVID-19 situation. 

    These include: 

    • Staying up to date with regulations 

    • Communicating clearly with customers and staff 

    • Taking actions to reduce the risk of spreading COVID-19 

    • Keeping records of what steps you put in place 

    Stay up to date with regulations 

    Firstly, please be sure you’re keeping up to date and adhering with Federal and State or Territory government requirements. To fully understand these requirements, it's always best to go directly to the source rather than rely on other media channels. The following links will provide you with the necessary, and regularly updated, requirements.   

    ACT 

    Communicate clearly with customers and staff 

    When operating any business, your communication is always incredibly important.  It keeps your clients informed of what they can reasonably expect from your business.  Communication also assists them to understand how the operations of the business and services provided impact them.  As we all deal with the challenges presented by COVID-19, communication from business owners and operators has taken on an increased importance. 

    We have seen an increase in complaints over trivial or minor issues. Some complaints have gone directly to the regulators and in a recent example, the police were involved. We believe this is likely the result of an emotional response to the stresses and anxieties people are experiencing as a result of COVID-19. While these complaints could be considered "over the top", they all require a response and may involve the stress of an inquiry by the regulator.  

    Given the circumstances we all face with COVID-19, we need to regularly remind ourselves that many people are struggling to deal with the current situation.  We recommend business operators be especially mindful of how they speak to and interact with their clients and staff.  Maybe you need to take a little more time than usual to explain business processes.   It might be ideal to provide written information to assist people in understanding the services you can and can’t offer and how you are helping to manage the risks associated with COVID-19.  Taking a bit more time and care to explain business processes and services, particularly if they’ve changed from the usual, will potentially mean your clients will be more understanding if their expectations aren’t met. 

    Take actions to reduce the risk of spreading COVID-19 

    As well as focusing on your communication, all business operators also need to be sure they’re doing all they can, and meeting requirements, regarding distancing and cleaning within their business.  Some processes you may consider, or possibly already have, for your business include: 

    • Restricting the number of clients in your premises at the one time.  Depending on the type of business, this can be done in a few ways such as having staff at the entrance managing who comes in and when and removing some chairs from waiting areas.  It can also be done by spreading out the time between appointments and asking clients to wait outside till called in for their appointment. 

    • Placing markings on the floor reminding people where to stand to ensure there’s the required physical distance between them. 

    • Encouraging cashless payments. 

    • Signage both on the outside and inside of the premises making people aware of your processes and what you expect from them when they enter. 

    • Having hand sanitiser available and in sight for all staff and clients. 

    • Regularly cleaning the premises, particularly high touch areas such as doorknobs.  There should also be cleaning in between clients if they come into contact with items such as treatment tables. 

    While all the above is important, just doing it isn’t enough, especially if you want to be sure your clients feel confident and safe using your business.  Again, communication is vital here.  Your clients deserve to know about the safety process within your business, so be sure you make them aware.  This can be done by emailing all clients about the process you’ve put in place.  You could put notices within and around the premises reminding them of your processes.  You and your colleagues should also be talking about the safety measures with clients, such as reminding them to apply hand sanitiser when they enter. 

    Keep records of what steps you put in place 

    Guild also recommends our insureds keep a record of their safety processes.  Like all record keeping, this serves as evidence in the unlikely, yet possible, event the processes are questioned. If a client or any other person accused you and your business of not adhering to safety requirements and restrictions, having this evidence will make it easier to prove otherwise.  Collecting and storing this evidence doesn’t need to be cumbersome.  It can be done by taking photos of items such as signage, floor markings and available hand sanitiser.  Copies of any written communication to clients, such as emails, should be kept.  You should also make a record of any situation where a client has seemed unhappy with your business.  Noting this down when it happens while it’s fresh in your mind will be useful if the client lodges a complaint. 

    Lastly, remember Guild Insurance is here to support you in the event a client makes a complaint.  Whether this complaint is to you directly or to a regulatory body, whether it’s about your processes during COVID-19 or the service you regularly provide, Guild is here to support you during the difficult and stressful period of managing a complaint.    

    Guild Insurance Limited ABN 55 004 538 863, AFS Licence No. 233 791.  This article contains information of a general nature only, and is not intended to constitute the provision of legal advice.  Guild Insurance supports your Association through the payment of referral fees for certain products or services you take out with them.

    communication
  • Online virtual PT sessions - How to manage and reduce risks

    In recent years, with the continual growth in social media, online fitness options have grown dramatically. And now with restrictions on how and where people can exercise due to COVID-19 this demand is increasing.

    Offering personal training sessions in a virtual online manner is a fantastic idea. It means clients can conveniently keep exercising at a time when people have more limitations. It also means personal trainers can keep their business operating and bringing in an income. However, running a personal training business online isn’t the same as running one where you’re physically present, and this means there are new challenges and risks which need to be managed. While some of what has always been expected of you will stay the same, there will be some additional requirements and considerations.

    Meeting your requirements

    As a personal trainer, there are professional obligations you need to meet, regardless of how you’re operating your business. When running virtual online PT sessions, you need to be sure you’re still complying with Fitness Australia’s Code of Ethics and Scope of Practice for Australian Registered Exercise Professionals. Also, all online virtual training
    needs to adhere to Fitness Australia’s Online Virtual Personal Training recommendations.

    You also need to be sure you’re keeping up to date and complying with the COVID-19 restrictions put in place by Federal, State and Local governments. Restrictions are changing frequently, and each State and Territory may vary, so it’s imperative fitness providers remain aware of their requirements.

    Client selection

    Online personal training sessions won’t suit all clients. Therefore, your process for selecting clients who you’ll train in this manner is very important.

    Firstly, all clients should complete the Australian adult pre-exercise screening system tool which can be accessed via Fitness Australia’s website. Fitness Australia recommends that only those clients who are determined to be low risk should be trained online; the challenges of managing high risk clients remotely is too great. Online training may also not be suitable for clients who are new to personal training and the types of exercises you’ll be prescribing, so you’ll want to find out a bit about their exercise history.

    You need to be sure the client has the equipment and space necessary to undergo online virtual training, beyond the obvious of having the necessary technology to connect and a reliable internet connection. You’ll need to discuss devices with them. The small screen of a phone is most likely not going to be suitable, particularly when you want them to see you demonstrating the correct technique. A laptop or tablet would be more ideal.

    You also need to discuss the location where the client will be using, given many won’t be designed for fitness sessions, and assist them to do a risk assessment of that location to be sure it’s safe and ideal. This requires considering the physical layout of the premises such as furniture and flooring, but also other potential distractions and risks such as children or pets being present. You need to work with each client and their set up to make it as safe as possible. If you don’t think it’s safe, you need to reconsider if you’ll train them in this manner.

    Program development

    As a personal trainer, your program development and exercise selection are always incredibly important to ensure the program is suitable for that individual client and their goals and expectations. When creating an online training program, there are additional factors which need to be considered.

    You need to be sure you’re still having regular conversations with the client to understand what they want to achieve with their training and how they’re progressing with the program over time. Given it will be harder for you to observe how the client is going with their training, you may want to set up additional times to talk.

    When selecting exercises, keep in mind that it’s going to be challenging to demonstrate the correct technique as well as check the technique of the client. Therefore, it’s worth considering selecting exercises which are less challenging from a technique perspective and easier to explain. For inexperienced clients, exercises which have a high injury rate when performed incorrectly, such as deadlifts, might be best to avoid. During a virtual online session, you’ll need to be sure you can see what the client is doing so you can check and correct their technique. So, when setting the exercises, plan how you want the client to be positioned so you’re able to watch them. Also, be prepared to spend more time than usual explaining exercises and you may have to repeat yourself a few times.

    When developing the program, you need to decide what you’ll charge the client; your usual fees may change for an online program. Always be sure you’re upfront and clear with clients regarding fees; having this information in writing will assist this.

    Record keeping

    It’s important that personal trainers keep detailed records of their training sessions with clients, whether they’re done in person or online. These records mean trainers don’t need to rely on their memory to know what the client did in previous sessions and provides evidence of the client’s progression. Unfortunately, Guild’s experience in managing claims against personal trainers has shown that many trainers keep minimal records. Be sure when conducting online training sessions, you’re taking notes which include, but isn’t limited to:

    • Exercises performed (include sets, reps, weights etc)
    • Difficulty the client experienced with the exercises
    • Pain, discomfort or injuries experienced
    • Exercise prescribed for the client to undertake in their own time
    • Referrals, such as to a health or allied health practitioner
    Privacy

    You have a professional obligation to take reasonable and appropriate steps to protect the privacy and confidentiality of your clients. Therefore, when conducting an online training session, be sure it’s done in a private setting where no one in the background can hear or see what’s happening. Many forms of online communication, such as video conferences, have a recording function. Training sessions shouldn’t be recorded simply because they can. They should only be recorded if there’s an identified need for it and if the client has given their consent.

    What to do in the case of an emergency?

    While it may not seem likely, you need to be prepared and have a plan for what you’ll do if your client experiences an incident or emergency during one of your sessions. All incidents, even the small ones, need an incident form completed. This acts as the history and record of what happened and your response to it. You also need to think about how you’ll assess the severity of the incident given you aren’t there. If the client is injured, it’s best to err on the side of caution and recommend they seek medical attention even if they don’t think it’s necessary. If the client is severely injured, you may need to call an ambulance for them. To be able to seek the assistance they may need, you should be sure you know the address of where they’re exercising.

    Download here

    Published in conjunction with Fitness Australia.

    risks
  • Things to consider if you're considering Telehealth

    It might be surprising to know that telehealth has been occurring for about 100 years now; there’s evidence of radios being used in the 1920s to provide clinical advice to people in remote locations. The way telehealth is conducted or provided has changed greatly over the years as the technology which supports it has changed and developed.

    What is telehealth

    Telehealth is providing health services remotely with the use of technology. There are many forms of technology which assist this such as phone calls, teleconference calls and sharing of images and videos.

    There are many reasons why telehealth is used, however, they primarily boil down to the patient and practitioner not able to physically be in the same place. This may be because of geographical remoteness. Age or disability can prevent patients from travelling to their practitioner. And now social distancing requirements to reduce the spread of COVID-19 is making face to face appointments difficult and potentially unsafe. Therefore, telehealth is very beneficial, however it isn’t without risk. And these risks need to be considered and managed before this service is offered.

    Is it right for you?

    All business owners want to stay ahead of their competitors and provide the best service possible to their clients. However, this can mean at times business owners leap into something new too quickly without proper consideration and assessment.

    Telehealth isn’t ideal for all health practitioners. Before you start offering telehealth services, do some research that will help you assess if it’s right for your business, your patients and the services you provide. Consider the pros and cons; think about how it’ll benefit your business but also consider the risks and challenges it’ll create.

    You should consider developing an implementation plan to assist you in working through a range of factors to consider, such as:

    • Which services will suit telehealth, which won’t?
    • Who’ll assist with providing and supporting the technology required?
    • How will this new process be communicated with patients?
    • How will patients be assisted if they have difficulty with the technology, or simply
      don’t want to use it?
    • Will the process be phased in gradually?
    • How will it be evaluated?
    Invest to do it well

    The old saying ‘if something’s worth doing it’s worth doing well’ really does apply to implementing telehealth practices. When technology works well, it’s fantastic, when it doesn’t, it can cause a huge amount of frustration and time wasting. It’s therefore important that health practices don’t rush into implementing telehealth practices. It’s worth taking the time to ensure the tools and technology used are suitable for that individual practice. It’s also recommended that time is spent training all staff to be sure they understand how to use the new technology and what’s required of them with this change. Investing both time and money at the beginning will benefit the practice, practitioners and patients in the long term.

    Some things stay the same

    Much of what you already do, and what you’re required to do, as a health practitioner won’t change when using telehealth.

    • Communication – communication is always incredibly important for all health practitioners. However, it needs additional focus when consulting via telehealth. Practitioners may find they need to spend longer having conversations and should consider what questions they’ll ask the patient to be sure information has been understood.
    • Record keeping – you need to keep detailed and accurate records of all consultations and communications with patients, and this includes when using telehealth. It’s not just about actual consultations, even details about phone conversations with patients need to be recorded. If a consultation takes place via telehealth, make a note of this in the clinical record including the type of technology needed.
    • Informed consent – you need to ensure patients give their informed consent prior to treatment. Providing signed informed consent is a bit harder when consultations take place remotely, yet this can still be done in some cases. However verbal consent is sufficient. But remember, informed consent can only be given when the patient has been informed about the treatment, so sending a form to be signed to a patient before there has been any discussion or consultation isn’t appropriate. Also, verbal informed consent must be noted in the clinical record.
    • Privacy – you have a professional obligation to maintain the privacy and confidentiality of your patients. Therefore, when conducting a telehealth consultation, be sure it’s done in a private setting where no one in the background can hear or see what’s happening. Many forms of online communication, such as teleconferences, have a recording function. Consultations shouldn’t be recorded simply because they can. They should only be recorded if there’s a clear and specific reason for it and if the patient has given their consent.
    • Duty of care – health practitioners have a duty of care to all patients they treat. If a patient is being treated using telehealth and has never met the practitioner prior to this, this doesn’t change anything in terms of the practitioner’s duty of care to that patient.
    • Clinical decision making – Incorrect diagnosis is one of the greatest risks with telehealth, yet telehealth is no excuse for mistakes being made. If you don’t have the information needed to make a diagnosis or provide/recommend treatment, you must to find a way to get this additional information. Practitioners may want to consider if their assessment processes alter when using telehealth. Practitioners should also be sure they don’t allow the patient, or the treatment circumstances, convince them to provide treatment or advice that goes against their better judgement.
    • Practice within scope – when consulting using telehealth, the need to keep within your recognised scope of practice, and refer when the situation is outside of this, is no different.
    • Funding schemes – some funding schemes, such as private health insurers and Medicare, provide cover for telehealth, for some forms of treatment. As the treating practitioner, it’s your responsibility to be sure you’re meeting the requirements of the various funding providers and don’t claim for items which aren’t permitted.
    • Regulatory requirements – in addition to the above, any other requirements set by regulatory bodies need to be adhered to. This includes keeping on top of government advice and restrictions relating to COVID-19

    Download here

    communication
  • Communicating with your clients during COVID-19

    The Coronavirus pandemic has challenged us all personally and professionally, as we live through never before seen challenges. Many professionals and businesses alike are struggling with the ever-changing landscape as they navigate business continuity in a way which is safe for them, their staff and their customers and also complies with changing government restrictions and requirements.

    You don’t have to be powerless through this uncertainty, and the key to continue to thrive as we move into the new normal is robust communication with your customers. Clear, concise and relevant  communication with your customers is vital in the coming weeks and months to ensure continued engagement.

    As Guild Insurance works across multiple industries, our experience of working with thousands of professionals and their customers puts us in the unique position to understand what customers need from you. We have compiled some information to assist you in developing email communication with your customers.

    Please note that this information is generic and should be used as a guide. All businesses are unique and how they’re responding to COVID-19 is also unique. Therefore, you need to create your communication to suit your individual circumstances.

    Start your email with an introduction to the situation

    E.g. We face challenging times ahead as we navigate through a continually changing
    environment caused by the impact of the Coronavirus pandemic. Here at (business
    name)
    ,we are focused on staying healthy and continue to review our health and safety
    processes, so we can keep our doors open to our customers when they need us. A key part of this is to ensure we change our operational practices to maintain compliance
    with evolving government recommendations and restrictions and reduce the risks to our
    staff and visiting customers. We’re therefore contacting you keep you informed of what
    we are doing here at (business name).

    Now inform your clients of what you’re doing to avoid the spread of infection in your business

    E.g. At (business name), the health of our clients and staff is our number one priority.
    Therefore, on top of our usual cleaning and hygiene processes, we’re implemented the
    following steps.

    • All clients will be asked to wash their hands when they enter the premises
    • Hand sanitiser is readily available, and we insist all staff and visitors use it regularly
    • We’re asking all clients to wait outside the building, where there is space to maintain
      the recommended distance, rather than in our waiting room which doesn’t allow for
      social distancing. We’ll call you when you should come in for your appointment.
    • We are regularly cleaning and sanitising all high touch areas such as doorknobs and counters.
    • We will no longer accept cash and will only accept card payments.
    Let your clients know if anything about the service you usually provide has changed
    • Is there a service no longer available, have modifications been made, is there something new you’re now doing?
    • Are you offering services remotely?
    • Have opening and closing hours changed?
    • Will your usual cancellation policy alter to encourage people to not attend if unwell
    • Will you be offering any financial assistance or support to customers who may be experiencing financial hardship?
    • Will you offer refunds if people have paid upfront and are no longer able to participate/attend?

    E.g. Our usual cancellation policy requires 24 hours’ notice or a late cancellation/no show fee of $40 is charged. However, we are currently waiving this notification period until further notice. This fee will not be charged provided you call us to let us know you can’t attend. Therefore, if you feel that on the day of your appointment you have flu like
    symptoms and shouldn’t attend our practice, please give us a call and don’t come in.

    Finish with a reminder asking people to not attend your business if they have any concerns about displaying COVID-19 symptoms

    E.g. We understand everyone wants to get on with life and do the things they are used
    to doing. However, for the time being it may not be possible, and we must do what we can to flatten the curve. At (business name) we’re committed to doing our part to minimise the spread of COVID-19. Therefore, if you are experiencing any flu like symptoms, please consider others and stay home, do not visit our practice. We’re keen to see you again soon, however only when you’re feeling well

    communication
  • Protecting your place of business during a closure

    As we all do our best to minimise the spread of COVID-19, one of the tragic outcomes is that many businesses need to close their doors for a period of time. This is never a decision made lightly as the ramifications are enormous. There are many factors to consider when doing this, such as how staff will be looked after during this time, if services can be provided online and how to communicate the closure with clients.

    Another important consideration should be the protection of the property from which you operate your business. Sadly, vacant buildings can lead to an increase in thefts and burglaries as a lot of crime is opportunistic. Thieves will know that many businesses have closed only temporarily and therefore the buildings may not be empty, there may still be items worth stealing inside.

    The following are some tips to consider if you are temporarily closing the physical premises of your business:

    • While you want to inform your clients about the change to the business, placing a sign on the front of the building may not be the most ideal way, especially if this will be easily visible for those walking past. If you do want to place information on the building about a
      closure, don’t indicate this is potentially long term or indefinite, simply provide details for clients to contact you.
    • Redirect mail to a home or post-office box and place a ‘no junk mail’ sign on the building’s letterbox. A messy overflowing letterbox is a sure sign no one has been frequenting the premises.
    • Use a timer to have the lights turn on and off at certain periods of the day, creating a look of someone being in.
    • Electronic Security Alarms should be kept operational where fitted.
    • Consider which appliances can be turned off as many appliances continue to use power even when they aren’t being used. Items to consider turning off include hot water tanks, televisions, microwaves and computers. However, be sure to think about what you’re turning off before you quickly switch off all power; for example, fridges and freezers, unless empty, should be kept on.
    • It’s important to conduct regular external inspections of your property to check the condition, ensuring that it’s safe and there are no signs of attempted entry or vandalism. Where possible, visit your property fortnightly, however, be sure you’re complying with government COVID-19 restrictions when doing this. Maintain the external appearance by removing any rubbish and mail and keep lawns and gardens trimmed.
    • Clear out your gutters. A build-up of leaves and other debris creates a fire hazard as well as a risk of an overflow of water entering the roof space during a storm.
    • If you have a good relationship with your neighbours, let them know about your closure and be sure they have your contact details. That way if anything goes wrong or they notice anything suspicious, they can let you know.

    Download here

    break-in
  • Cybercrime infographic

    business
  • Evidence based dentistry and clinical guidelines

    What is Evidence Based Practice?

    The best known and most widely accepted definition of Evidence-Based Practice (EBP) was suggested by David Sackett back in the 1990s; ‘Evidence based medicine is the integration of best research evidence with clinical expertise and patient values.

    Similarly, the American Dental Association defines Evidence Base Dentistry (EBD) as: ‘An approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence relating to the patient’s oral and medical condition and history, with the dentist’s clinical expertise and the patient’s treatment needs and preferences.’

    The Australian Dental Association’s policy on Evidence Based Dentistry encourages the concept behind EBD, supports the need for ongoing dental research and emphasises that the need for dental care must be determined by the treating dentist in consultation with the patient.

    Click here for the Australian Dental Association policy.

    There are five steps in the EBD process that the clinician should consider when reviewing a clinical intervention:

    > Ask the Question: Define a clinically relevant and focused question where the evidence may promote the oral health of patients.

    > The Search for Information: Access and acquire available evidence, systematically conduct searches of all studies, grade the strength of the evidence used, and identify gaps in the evidence.

    > The Appraisal: Critically appraise the information accessed, evidence for validity with an understanding of the research methods.

    > The Application: Use the results and act on them to provide treatment in practice. Apply the results of the evidence to patient care or practice in consideration of patients’ preferences, values and circumstances. Ultimately the patient makes the final treatment decision; by using this framework dental professionals can ensure that patients will be provided with treatment options based on sound evidence.

    > The Evaluation: Assess the health care outcomes following the EBD process.

    EBD is not about developing new knowledge or validating existing knowledge. It’s about translating the evidence and applying it to clinical decision-making. The purpose of EBD is to use the best evidence available to make patient-care decisions. Most of the best evidence stems from research, but EBD goes beyond research  use and includes clinical expertise as well as patient preferences and values. The use of EBD takes into consideration that sometimes the best evidence is that of opinion leaders and experts, even though no definitive 6 results from research results exists.

    Applying Evidence Based Practice to everyday clinical situations

    One way of making synthesised evidence usable in practice is to present recommendations for best practice in clinical guidelines.

    Clinical guidelines are systematically developed statements to assist health professional and patient decisions about appropriate health care for specific circumstances. They are used to translate evidence into actionable recommendations that can be applied to clinical situations. The Institute of Medicine defines clinical guidelines as ‘systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances’, and well developed guidelines will have gone through at least the first three stages of the five stage evidence-based process.

    An important consideration is that Clinical Guidelines are fossilised at the time of publication and evidence is rapidly evolving, usually outstripping the rate of updating of guidelines. An example of this is the Therapeutic Guidelines second edition published in 2012 and superseded by version three in December 2019.

    Using research to inform treatment planning can seem daunting for clinicians who have used alternative techniques that have worked adequately throughout their careers. In dentistry, many procedures are accepted and carried-out on patients without having a strong evidence base.

    It has been suggested that these procedures should be called ‘dogmas’ as they are based on beliefs that are accepted as being true even when this has not been supported by evidence. Once formed, ‘dogmas’ can allow clinicians to fall into the routine of carrying out and accepting procedures as a ‘gold standard’ without questioning alternatives which may provide better outcomes for the patient.

    One example of how a dogma has been challenged is the concept of a shortened dental arch. When a shortened dental arch is considered for a patient, the patient’s functional needs and preferences must be taken into account and the patient must be informed of teeth that do not need replacing.

    Another example of dogma is that some orthopaedic surgeons insist that their patients require antibiotic cover when their patients are undergoing dental treatment (particularly extractions) following joint replacement surgery despite there being no evidence to support this and the prescribing of prophylactic antibiotics for patients with pre-existing joint prosthesis is not recommended (Therapeutic guidelines Oral and Dental 2019).

    Unfortunately changes like this take time to be accepted in practice.

    Guidelines are tools, not rules. Clinicians still need to think for themselves and individualise care, not simply follow dogmatic principles and processes in a blinkered fashion.

    Clinicians should support the concept of evidence-based dental care using credible scientific data, in conjunction with the requirement to have patient-centred treatment and base a treatment plan on accepted evidence, with patient input into the plan through a thorough informed consent process.

    Evidence_Graph

    References

    1. Kudray, G, Walmsley A D, -Evidence Based dentistry in Everyday Practice- Dental Update-December 2016.

    2. Innes N.P., Schwendicke F., Lamont T.-How we create, and improve the evidence base-BDJ No 12 -2016.

    3. Evidence Based dentistry: Managing information for Better practice-Derek Richards, Jan Clarkson, Deborah Mathews, Rick Niederman.

    4. Therapeutic Guidelines Oral and Dental Version 3.

    5. ADA Inc Policy statement.

    Download here

    practices

Similar Articles