Sample Slip and Fall Prevention Program

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Slip and Fall Prevention Program United Heartland has developed this sample Slip, Trip and Fall (STF) prevention program to assist our customers as they develop their own program. It shares best practices for an effective program, laying the foundation to help reduce STF injuries and related loss costs. There is no single solution to preventing STF injuries. But with the commitment of management and the use of a multi-faceted and systematic approach, STF injuries can be properly controlled. UnitedHeartland.com 1-800-258-2667 United Heartland is the marketing name for United Wisconsin Insurance Company, a member of AF Group. All policies are underwritten by a licensed insurer subsidiary of AF Group. 17424-5/2016

page 2 of 5 This sample program is a starting point to use as a resource for further development. STF Prevention Program Assessment Slip and Fall Prevention Program The first step in developing an STF prevention program is to perform a self assessment or use our Loss Control representatives to benchmark the difference between the current STF program and the UH best practice guidelines. This process is used to identify strengths and areas of opportunity. If the assessment is led by a United Heartland Loss Control representative, we will partner with management to discuss program components, review related documentation and conduct physical observations in the workplace. This process allows us to create an action plan for working on priority items identified by the assessment. Key Components of a Slip, Trip and Fall Program: STF Best Practices The Best Practices section makes up the largest part of the program and summarizes many of the key components. Although a brief summary of best practices are outlined in the sample below, the full versions of these components are available from your UH Loss Control representative, who can also help you develop each section of your STF prevention program. Roles and Responsibilities The Management and Employee Responsibilities section outlines who will be responsible for implementing, completing and monitoring the key elements outlined in the program. responsibilities have been added to this section to provide a starting point, but should be customized after the best practices section has been finalized. Appendix and Resource Materials An appendix is included in the final part of the program to provide a dedicated space where additional support materials and resources can be added for reference purposes. United Heartland s Loss Control team has access to a library of training and other supplemental materials for the appendix of your program. Customizing Your STF Program We understand each industry and organization has unique STF exposures. This sample program is a starting point to use as a resource for further development. Our STF Program assessment process takes into account your industry and unique operations to fit your particular needs. It has been designed with flexibility so it can be updated on a periodic basis to reflect necessary changes.

STF Prevention Program <Insert Organization Logo> <Insert Organization Name> Adopted: <Insert date policy is adopted> Revised: <Insert date policy is revised> By: <Name of Employee> United Heartland Loss Control Contact Information: Name: <Insert Name> Phone: <Insert Phone Number> Email: <Insert Email> I. Objective As part of the organization s overall safety and health program, a slip, trip and fall (STF) prevention program has been established. The program is designed to proactively identify and eliminate STF exposures to prevent injuries before they occur. This written program outlines the key elements of an effective STF prevention program. II. III. Scope The STF program was implemented to ensure the safety of employees working on the premises or traveling offsite on company business. Managers and supervisors should review the content of the program with employees during orientation, staff meetings and refresher training sessions. Management Support Management is committed to providing a safe and healthy work environment for employees and believes in a proactive approach to safety, with employee participation being key to success. IV. STF Best Practices The following section outlines the best practices of our program. Given the unique challenges of STF injuries, a variety of procedures, safety systems and work practices have been outlined to proactively identify STF exposures, create methods for controlling them and prevent future workers compensation injuries. (Note: comments in parenthesis indicate collateral material to include in program appendix). A. STF Assessment: The first step in developing an STF prevention program is to perform a self assessment or use the assistance of our Loss Control representatives to benchmark the difference between the current STF program and UH best practice guidelines. This process is used to identify where strengths and areas of opportunity exist. If the assessment is led by a United Heartland Loss Control representative, we will partner with management to discuss program components, review related documentation and conduct physical observations in the workplace. This process allows us to create an action plan for working on priority items identified by the assessment. (Insert a copy of the STF Assessment & Action Plan) B. Written Program and Annual Review: This program was formalized to document all of the various procedures, safety systems and work practices that have been put into place to combat STF injuries. On an annual basis, management will review the STF Program with their United Heartland Loss Control representative and appropriate management personnel. (Insert the Written STF Program Annual Review form)

C. Loss Analysis and STF Exposure Analysis: On a periodic basis, management and the STF program administrator will conduct a review of claims with their United Heartland Loss Control representative. The analysis will include sorting the claims by injury source or type to identify STF injuries and further drilling down these losses to identify trends within departments, production lines or job tasks. (Insert the STF Loss Analysis) D. Accident Investigations: All accidents should be reported immediately so the need for medical care can be assessed. An accident investigation will be initiated by the supervisor so facts can be gathered, causes thoroughly documented and preventive measures implemented. A copy of the accident investigation form and STF supplement are attached. (Insert Accident Investigation form and STF Accident Investigation Supplement form) E. Housekeeping Practices: Because contaminants on the floor are a leading cause of STF injuries, good housekeeping practices are an effective means of prevention. A formal housekeeping program has been developed to clean and maintain the facility on a regular basis. (Insert Housekeeping Program) F. Workplace Inspections: Inspections of parking areas, sidewalks and interior of the facility will be conducted on a routine basis to proactively identify potential STF exposures. The inspection process includes a complete tour of the building interior and exterior grounds, parking lots and walkways. (Insert a copy of the inspection checklist) G. Safety Hazard Observations: All employees are encouraged to report any safety concerns, including STF exposures, to their direct supervisor. (Insert a copy of the Slip and Fall Hazard Report) H. Footwear and other Personal Protective Equipment (PPE): Selecting the proper footwear for the job is one of the most critical aspects of STF injury prevention. A PPE assessment has been completed for various job classifications within the company. (Insert a copy of footwear program.) I. Training: New employees will receive information about the STF program during the orientation process. The department manager will then train the employee in the requirements of their specific job and review safety considerations, including potential STF exposures and PPE requirements. (Insert a copy of United Heartland and other training resources.) J. Selection of Flooring Materials: The type of flooring materials used throughout the facility has been carefully selected to offer the appropriate level of slip resistance, optimize the coefficient of friction and reduce the potential for STF injuries. K. Preventive Maintenance (PM) Program: Work orders will be generated for maintenance staff to inspect specific items such as condition and wear of walking surfaces, lighting conditions, stairway treads and handrails, fixed and portable ladders, fall protection harnesses and arrest systems, process equipment with leak potential and various other items. L. Facility, Equipment and Process Changes: Periodic updates are made to the building, equipment, processes and outdoor property. The facility manager and/or maintenance manager will work with the appropriate project engineer to discuss the safety implications of future projects. M. Elevated Work and Fall Protection Program: Elevated work includes any task performed above ground or floor level. It includes simple tasks performed in office areas from stepstools or chairs, up to and including job tasks performed on extension ladders, scissor lifts or maintenance work on the roof of the building. N. Lighting and Illumination: Having the appropriate amount of lighting throughout the facility allows everyone to perform their work more safely. It helps employees view their path of travel and identify potential STF hazards in the way. (Insert copy of illumination study.)

O. Outside Contractors: Maintenance and facilities personnel may occasionally work in conjunction with outside contractors on building and facilities projects. A site-specific safety plan will be created for these projects and will outline the STF exposures and safety precautions to follow. (Insert copies of site specific safety plans.) P. Winter Season STF Prevention Plan: Formal snow removal and salting procedures have been established to combat winter exposures. Snow removal contractors have been hired to plow and salt the lots before most employees arrive for work and are on call if additional snow removal and surface treatment is needed during the course of the workday. (Insert Winter Season STF Prevention Plan and link to the UH WalkSafe Campaign.) Q. Traveling Off Premises: Employees traveling on business away from the company s facility are presented with unique STF exposures. Safety tips for travelling on business are attached in the Appendix. (Insert Traveling on Business Safety Tips.) R. Transportation Department: Drivers within our transportation department are exposed to falls when entering/exiting the vehicle and when walking down the ramps at customer locations to deliver products. Given these unique exposures, drivers will receive special information, including three-point contact training. (Insert three-point contact informational materials.) S. Health and Wellness: Some personal medical or physical conditions may increase an individual s risk of a slip, trip or fall. The first step in indentifying these risk factors is to have regular checkups with your physician. They can review your health history, current medical conditions or symptoms, and recommend treatment or wellness plans to assist you. (Insert health and wellness resources.) T. Client-Employee Falls Assessment: For client-employees with special needs, the organization has developed a falls assessment system. We recognize that some of our employees may have physical, cognitive and other conditions that may increase their chances for a slip or fall. (Insert Client-Employee Falls Assessment resources.) V. Management and Employee Responsibilities The section above has outlined the best practices of our STF prevention program. The key to the success of the program is to ensure that every employee knows their particular roles and responsibilities. This section outlines these specific responsibilities for the STF program administrator, department managers, supervisors and employees. A. STF Program Administrator: The STF program administrator is (insert name) and reports directly to (name of manager). The program administrator is responsible for overseeing the program and monitoring the effectiveness of each element of the program. The core responsibilities of the program administrator include: (insert customized responsibilities for the operation.) B. Department Managers and Supervisors: The responsibilities of department managers and supervisors include: (insert customized responsibilities for the operation.) C. Employees: The responsibilities of employees include: (insert customized responsibilities for the operation.) VI. Appendix and Resources United Heartland has developed a variety of resources that can be used for informational purposes, training and education.