The Commercial Motor Vehicle Safety Act of 1986 sought to improve highway safety by ensuring that drivers of large trucks and buses are qualified to operate those vehicles and to remove unsafe and unqualified drivers from the highways.

The Act made it illegal for CDL holders to have more than one license and required States to adopt testing and licensing standards for truck and bus drivers to check a person’s ability to operate the type of vehicle he/she plans to drive.

The Federal standard requires states to issue a CDL to drivers according to the following license classifications:

Class A

Any combination of vehicles with a Gross Combined Weight Rating (GCWR) of 26,001 or more pounds provided the Gross Vehicle Weight Rating (GVWR) of the vehicle(s) being towed is in excess of 10,000 pounds.

Class B

Any single vehicle with a GVWR of 26,001 or more pounds, or any such vehicle towing a vehicle not in excess of 10,000 pounds GVWR.

Class C

Any single vehicle, or combination of vehicles, that does not meet the definition of Class A or Class B, but is either designed to transport 16 or more passengers, including the driver, or is transporting certain hazardous materials.

Endorsements and restrictions

Drivers who operate special types of Commercial Motor Vehicles (CMVs) also need to pass additional tests to obtain any of the following endorsements on their CDL:

T — Double/triple trailers (knowledge test only)
P — Passenger (knowledge and skills tests)
N — Tank vehicle (knowledge test only)
H — Hazardous materials (knowledge test only and TSA threat assessment)
X — Combination of tank vehicle and hazardous materials
S — School bus (knowledge and skills tests)

More information on CDLs

Visit the CDL section of the Federal Motor Carrier Safety Administration’s website. 

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you. The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC JAN 2019 12-61
171-0839 (11/13)

How to avoid hitting another vehicle

• Begin braking early for reserve braking power as you near final stopping point.
• Pay strict attention — Don’t daydream or look away from the road for more than one second. Keep in mind that a vehicle can move a considerable distance in one second. For example, at 40 mph, a vehicle travels 60 feet in one second.
• Use good vision habits — Don’t crowd up so close that you can’t see ahead. Look through rear window area of vehicle ahead to see the road ahead. Look over the top of car ahead when on hills.
• Look for things that could cause the driver ahead to stop — The other driver’s problems become your problems only a second or two later.
• On icy roads, look for a swerve path to the right — Many times on ice you can steer around a vehicle that you could not stop for. Avoid swerving to the left — you’re inviting a head-on. Better yet, you won’t need a swerve path at all if you increase your following distance to allow for road conditions and weather.
• Be patient — The hurry habit is the beginning of many a rear end mash-up.

Stay alert for danger signals

• Brake lights on the vehicle ahead — Get your foot off the gas pedal and to the brake pressure point quickly.
• Diminishing distance between your vehicle and the vehicle ahead — You’re in a collision course. The vehicle on the road ahead is slowing down or it may be standing. Relate vehicles ahead to fixed objects out to the side.
• Problems in adjacent lanes — Stay alert for brake lights and slowdowns in adjacent lanes. Expect quick swerves into your lane by other drivers.

How to minimize the chances of being hit

Preventive measures to control rear-end crashes:

• Know what’s going on behind you — Adjust outside mirrors and inside rear-view mirror before moving the vehicle. Then, scan at least one mirror every 5-8 seconds to follow-up hazards and update driving conditions in the rear. Checking mirrors before slowing down, before and after making turns, and while stopped keeps you properly informed with what’s approaching from behind.
• Flash brake lights when stopped, moving slowly or preparing to stop. Check brake lights frequently to verify they are working, and maintain clean brake light lenses for clear visibility of other motorists.
• Signal well in advance for turns, stops and lane changes.
• Slow down gradually over a long distance to give vehicles following more time and space to react. Never try to beat a green light — always anticipate a changing green light.
• Keep pace with traffic when road and weather conditions and speed limits permit.
• Get rid of tailgaters — First, signal in advance and move to the right, if space is available, to let the tailgater pass. If this does not work, encourage them to pass by gradually slowing down to wave them on. Exercise caution when slowing down by flashing brake lights several times, use proper arm signals, and slow down as traffic permits to discourage tailgaters. If the tailgater does not pass or increase following distance, exit the roadway at the first available safe location.
• Don’t cruise in another driver’s blind spot — If the vehicle suddenly swerves into your lane you may have to brake hard and risk a rear-end crash from following vehicles.
• Raise hood if your vehicle stalls and can’t be moved from the traffic lane. Then safely do everything else you can to make your disabled vehicle visible to approaching drivers. A stalled vehicle is particularly dangerous at night. If you have flashers, use them. A professional driver usually has a flare or other signal device handy for driving emergencies. Call authorities for assistance.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC APR 2019-389
171-1188 (5/14)

Your decisions can affect your fire protection

Your facility is equipped with an automatic sprinkler system for fire protection. Do you expect that a few sprinkler heads will operate and control the fire until the fire department finishes extinguishment? There is no way you could have a large fire, right? Well, think again. Automatic sprinkler systems are designed to a specific performance level to protect what is underneath them. An office building will have very different requirements than a warehouse. A warehouse storing paper goods will have different requirements than one storing plastics.

Considerations when making changes to operations

• Leasing or buying a building — do you know if the sprinkler system design is going to be adequate for your intended use of the space?
• Changing the storage configuration in your existing building — does this impact the adequacy of your current fire protection?
• Introducing a new service or product that changes the type of storage, for example adding plastic storage — can your sprinkler system protect higher hazard storage?

Critical factors in sprinkler system design for warehouses

These are some of the factors that are part of the design considerations for sprinkler systems that protect warehouses:

• What is being stored (paper, plastic, wood)?
• How is it packaged (in cartons, plastic bins, no packaging)?
• What is the maximum storage height?
• What is the storage configuration?
• Is storage on the floor in piles?
• Are pallets wood or plastic?
• Are storage racks being used?
• Do the racks have open mesh shelves, solid shelves or no shelves?
• What is the width of the racks?
• How much aisle space is between the racks?
• Are flue spaces (clear space between abutting racks) being maintained?
• How much space is there from the top of the storage to the sprinkler head?

A change in just a single item above can make your existing sprinkler system go from one that will perform as designed to one that may become overwhelmed and allow a fire to grow uncontrolled.

When should I seek help?

You should contact Hanover Risk Solutions for help in evaluating your sprinkler protection when considering any of the following:

• Leasing a new space or buying a new building
• Building a new building or addition
• Adding a new process
• Changing the storage configuration

Assistance from Hanover Risk Solutions

Your Hanover Risk Solutions consultant can meet with you to discuss your options to protect your business from the hazards common to your industry. Hanover Risk Solutions can help you by:

• Offering practical options to help ensure your fire protection system provides an expected level of control over a potential fire.
• Partnering with you in the decision making process to help avoid costly upgrades to a building sprinkler system when buying a building or leasing a space.

Services we offer include the following:

• Evaluation of the existing sprinkler system to determine the maximum performance level for the existing system.
• Comparison of the existing system to the most current NFPA requirements that apply to your specific situation.
• Modeling specific changes in the system and/or storage configuration such as:
  • Lowering your storage height
  • Changing sprinkler heads
  • Adding in-rack sprinklers if you have solid shelving in storage racks
  • Removing solid shelves or replacing solid shelves with open metal mesh shelves, perhaps avoiding the use of in-rack sprinklers
  • Adding hard stops to your racks to avoid storage encroaching on flue spaces
• Work with you to develop sprinkler systems design criteria to ensure you obtain comparable quotes from sprinkler contractors when bidding on a new installation or revamping an existing system.
• Review working drawings of new system installations to ensure the system meets insurance requirements, based on NFPA Standards.
• Provide a field review after a new installation, to validate that the contractor completed the installation in accordance with submitted plans.
• Provide recommendations and options to ensure the facility is adequately protected.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you. The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC NOV 2018 12-81
171-0832 (1/14)

A catalytic converter is a device used to reduce fuel-burning vehicle emissions. It is affixed to the underside of a vehicle and has been mandatory on all U.S. vehicles since 1975.

Theft of catalytic converters has been a constant since their inception as they contain the precious metals palladium, platinum and rhodium. Thefts of catalytic converters have fluctuated for years along with the market values of these metals. In fact, according to the National Insurance Crime Bureau, in 2019, an average of 282 converters per month were stolen. That figure jumped to 1,203 per month the next year due to a sharp increase in the value of rhodium alone.

Catalytic converters can be easily removed with a socket wrench or battery-operated reciprocating saw in as little as 45 seconds; they can then be re-sold to metal recyclers. While all vehicles are at risk, SUVs, busses, vans and trucks are an easier target for catalytic converter thieves as their factory ground clearances are higher, allowing a thief to maneuver under the vehicle without having to use a jack.  Vehicles parked close to each other present an opportunity for multiple catalytic converter thefts at one time. 

The typical cost of replacement of a catalytic converter can range from $900 to $2,500 depending on the vehicle. This does not include the loss in revenue from downing one or more vehicles in your fleet, towing fees, etc.

What you can do to protect your investment and deter catalytic converter theft

• Whenever possible. park vehicles in a secured garage or building.
• Utilize fenced properties equipped with motion sensor lights, security cameras and signage indicating cameras are in use, help to deter thieves.
• Park vehicles in well-lit areas or areas that are more visible and have higher pedestrian traffic
• Space parked vehicles adequately apart to allow security lighting to properly illuminate the area.
• Install and calibrate vehicle security systems set to detect and alarm with contact or vibration.
• Avoid leaving vehicles parked for prolonged periods of time in the same spot.
• Equip your vehicles’ catalytic converters with physical theft deterrent systems, including caging and other affixed aftermarket components. 
• Engrave your VIN and phone number into the converter to alert a scrap dealer it may be stolen and help identify you as the owner.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation.  By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you.  The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC DEC 2018 08-47
171-1003 (5/2021)

How to avoid phishing attacks

Phishing is criminal activity where cybercriminals target organizations and individuals through emails, phone calls and text messages. Their communications appear to be legitimate and trusted sources in emails and phone calls. Once cybercriminals gain your trust, they will then solicit your sensitive information, such as passwords, social security numbers and financial information. They will then use that information to engage in identity theft for monetary gain at your expense.

Recognizing phishing scams

Cybercriminals will use various phishing scams to try to trick you. They will try to convince you that something urgent is needed, that there is a great deal that you cannot pass up, or that you’ve won a lucrative prize. They may often put time limits on the so-called deals, or their need for urgent information, to get you to act quickly without fully questioning them.

Phishing scams include many different tactics. They may provide threats of suspending or terminating important accounts. They may threaten you that immediate harm may come to you or a family member if you do not provide the information they request or the payment that they need.

Cybercriminals will also work to gain your trust. Their phishing emails will often have what look to be legitimate links to trusted websites. However, if you hover over the link without clicking, this will show the actual URL address where you would be directed to upon clicking the link. Many times, this will be an invalid website where they will try to solicit personal and sensitive information. 

Phishing emails may also have attachments that contain malware or ransomware. It is important to never open attachments from an unexpected or unknown sender.   Phishing emails may also come from unusual senders, with grammatical errors and spelling errors in the subject line or in the body of the email. Do not click or open suspicious emails from unknown senders.

Phishing prevention tips

Remember that banking institutions and other legitimate companies will never ask for personal information through an email. Also, they will have appropriate identification measures in place and will not ask you to provide sensitive information over the phone. Never trust an unsolicited call or email, even if they claim to be from a trusted source. 

Never provide sensitive data over the phone from an unexpected call, even if the caller claims they are legitimate. Hang up and call your banking institution, or whatever organization they claim to be calling from, to verify the legitimacy of the call. Use phone numbers provided to you direct from the institution or company and not from an unknown email or phone call.

Use spam filters for your emails. Spam filters help determine the origin of the email and what type of software was used to send the message, which helps detect if it was a large, broadcast scam. Although spam filters may not always be accurate, they can help minimize unwanted and phishing emails.

Do not click on links and do not open any attachments in suspicious emails. Remember, legitimate companies rarely send emails with grammatical or spelling errors. They will not immediately suspend or terminate your account if you do not provide personal details within a set timeframe. Legitimate companies will also not have one-time deals or special offers that seem incredible, outrageous, and just “too good to be true.” Be wary of any special deals and the need for you to immediately divulge any sensitive information about yourself or your company.

Additional resources

Cybercriminals are always looking for new ways to scam people or organizations. Each day the news covers these scams and new ways that cybercriminals are working to get sensitive information. It is important to stay informed of the latest scams so that you and your company do not become a victim. 

Additional information and regular updates regarding phishing attacks can be found on the Department of Homeland Security, Cybersecurity & Infrastructure Security Agency web site:  Avoiding Social Engineering and Phishing Attacks | CISA.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation.  By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you.  The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC 2022-224
 

Roofers exposed to asphalt fumes may experience headache; eye, nose, throat and skin irritation; nausea; fatigue and drowsiness. Asphalt fumes are associated with lung cancer as well. This document provides recommendations developed by the National Institute for Occupational Safety and Health (NIOSH) for reducing roofer exposures to asphalt fumes.

What steps should contractors take before starting work?

Assign a competent person to be responsible for safety and health on the job. This person, usually the superintendent or the foreman, will have knowledge about roofing hazards and the authority to take prompt corrective measures to eliminate unsafe acts or unsafe conditions on the job.

Ensure that workers have been properly educated about the hazards of applying hot asphalt and trained in the use of safe work practices as well as the use of the personal protective equipment (PPE) needed to reduce exposures to asphalt fumes.

Plan each worksite before work begins to reduce asphalt fume exposures for workers and building occupants.

• Consider using a tanker to supply asphalt to the kettle or directly to the rooftop.
• If kettles must be used, place them where the operator and workers will be least exposed to the fumes. Keep the kettle away from air intakes, doors and windows.
• Consult with building owners about how to minimize concerns from occupants about asphalt fumes. Consider notifying occupants before the job begins. Discuss with building owners whether air intake systems should be turned off and whether all applicable building air intake vents should be closed or covered.
• Consider scheduling work during off hours for commercial buildings and during school or work hours for private residences.
• Consider using roofing equipment and accessories that have lids to reduce exposure to fumes.

What safe work practices should roofers use?

If tankers cannot be used, employ the following safe work practices when operating the kettle and applying hot asphalt to the roof:

Use the proper equipment

• Whenever possible, select an insulated kettle that is the right size for the job. Make sure it has temperature controls and the right pumping capacity for its size.
• Make sure the kettle is in good operating condition. Report any defects to the foreman or superintendent.
• Insulate the pipeline that delivers hot asphalt to the roof.
• Use the proper PPE.

Follow safe procedures

• Set the kettle on firm, level ground to avoid spilling or tipping.
• Place warning tape, traffic cones or signs around the kettle to keep the public at a safe distance.
• Keep a fully charged ABC-type fire extinguisher near the kettle. Make sure all workers know how to use it.
• Reduce the number of times the lid is opened. Fill the kettle to capacity when reloading and check the temperature, stir and skim at the same time.
• Pre-chop the asphalt into pieces that can be easily handled and melted.
• Consider using fume-suppressing asphalts.

Maintain asphalt temperature

Take the following steps to maintain proper asphalt temperature and reduce exposure to asphalt fumes (unless manufacturer recommends otherwise):

• Find the equiviscous temperature (EVT) and flash point of the asphalt on the keg package or bill of lading.
• To begin, set the kettle temperature at the EVT plus 50˚F (10˚C).
• Communicate with the rooftop crew as they periodically measure the asphalt temperature in the mop bucket at the application point.
• Adjust the kettle temperature to maintain proper temperature [the EVT plus or minus 25˚F (14˚C)].
• Always keep the kettle temperature at least 25˚F (14˚C) below the flash point to avoid fires and explosions.
• Read the temperature after skimming, stirring, loading or transferring the asphalt.
• Use a hand-held or infrared thermometer to get an accurate reading of the temperature of the hot asphalt.
• Do not point the infrared thermometer gun at anyone's face or eyes. This could result in damage to the eyes.

Safely apply hot asphalt to the roof

Use the following work practices:

• Keep lids closed on rooftop equipment and accessories used to transport and apply hot asphalt.
• Stay out of the fume cloud whenever possible.
• Consider using a fan to reduce exposures in certain work areas. Make sure the fan blows air away from workers, all cords and fans are kept out of the workers' walking paths, and electrical connections for fans are grounded.
• If buckets are used, use ones with half lids, fill the buckets only three-fourths full and carry buckets on the down slope of the roof.
• Twist mops to unstick them from buckets — do not pull them.
• Twist buckets to unstick them from the roof.
• Minimize time spent on the knees working with hot asphalt, since exposures may be higher when the breathing zone is closer to the fumes. Use long-handled tools whenever possible.

What personal protective equipment (PPE) should roofers wear?

Roofers should wear the following types of PPE to minimize the risk of burns and breathing asphalt fumes:

• Hard hat (for kettlemen).
• Goggles or safety glasses with side shields (use a full-faceshield for operating the kettle).
• Respirators when necessary to keep exposures below Occupational Health and Safety Administration (OSHA), NIOSH, and American Conference of Governmental Industrial Hygienists (ACGIH®) exposure limits. At a minimum, respirator use must conform to the requirements of OSHA's Respiratory Protection Standard, 29 CFR 1910.134 for general industry and 29 CFR 1926.103 for construction (the general industry and construction respirator protection standards are identical).
• Cotton shirt with long sleeves.
• Leather or heat-resistant gloves that fit tightly around the wrists.
• Long pants with no cuffs.
• Nonskid shoes or boots with six-inch leather uppers.

What personal hygiene practices should roofers follow?

Personal hygiene is important to protect workers from a variety of different chemical exposures that are common in roofing work. Employers should provide workers with clean water, soap or other safe cleaners. Workers should follow these personal hygiene practices:

• Wash hands before eating and before leaving the worksite. Use soap or other safe cleaners — do not use gasoline or other chemicals.
• Eat lunch away from asphalt fumes. Sit where the wind will blow fumes away from you.
• Shower after work as soon as possible.
• Change work clothes before going home to keep asphalt and solvents out of worker cars and homes.

Copyright © 2018 ISO Services Properties, Inc.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you. The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC NOV 2018 10-241
171-0831 (11/18)

The Hanover routinely makes recommendations to our insureds to install motion detection in small store rooms, furnace rooms and restrooms. Many alarm companies have responded that the existing installation meets the UL criteria for an Extent 2 protection and that these additional devices are not required. The UL standard allows a door contact on these small rooms and does not require interior motion sensors.

The Hanover insureds have experienced losses where someone has hidden in a small utility room or rest room that did not have a motion sensor, waited until the alarm was turned off and then emerged to rob the store. Had motion detectors been present in these areas, they may have caught this intruder and prevented a criminal act.

We use UL standards as a benchmark and fully support the role UL plays in developing, testing and listing products. But these standards are the minimum standards that apply to all alarm installations. In this case, we have experience that indicates that the minimum does not always provide the level of protection that our customers deserve and expect.

Look at your facility and determine if there are small rooms or areas that lack intrusion detection. The cost to upgrade the protection is far less than the potential loss of property or the damage that a robbery presents to your associates.

If you are planning to install a new alarm, change service providers, or make changes to your existing service and have questions, call your Hanover agent or Hanover Risk Solutions Consultant for advice that is specific to your situation.

The recommendation(s), advice and contents of this material are provided for informational purposes only and do not purport to address every possible legal obligation, hazard, code violation, loss potential or exception to good practice. The Hanover Insurance Company and its affiliates and subsidiaries ("The Hanover") specifically disclaim any warranty or representation that acceptance of any recommendations or advice contained herein will make any premises, property or operation safe or in compliance with any law or regulation. Under no circumstances should this material or your acceptance of any recommendations or advice contained herein be construed as establishing the existence or availability of any insurance coverage with The Hanover. By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC DEC 2018 11-217h
171-0862 (01/14)

Screen out potential abusers

Human service organizations are always on the lookout for the brightest, most talented and highly qualified people to add to their teams. Whether hiring for direct care, office support or top management positions, we strive to find the people with the most expertise and skill. A great deal of time is spent on reviewing a potential staff member’s education, work and volunteer experience, as well as personal presentation, hoping to provide clients with the best people to meet their needs. In that search, it is most important to remember that our clients’ biggest need is to be kept safe. Thus the top priority during any employee search must be to screen applicants for the potential of abuse and neglect.

There is no foolproof way of keeping abusers off your team. However, the following steps should help you minimize the risks.

Screen everyone

Whether the hiring agent knows the person personally, they come highly recommended by well respected employees, or even if they are related to the top management of the organization, anyone associated with a human service agency (no matter the client base) needs to be thoroughly screened.

Policies and procedures

Make sure that you have clearly-defined policies and procedures that address the issues of abuse and employee conduct. These policies should include expectations for all interactions with clients whether they are during work hours or outside the employee’s shift.

An abuse-free organization

Send the message early and often that the organization’s top priority is to protect the clients and staff from abuse.

1. Before a potential candidate even fills out an application they should be given and asked to read the agency policies on abuse and neglect and employee conduct.
2. Have the potential candidate sign a statement that they fully understand those policies and that if hired they will adhere to the policies at all times.
3. Have the potential candidate fill out a release for a criminal background check.
4. Give them a written statement letting them know exactly what will immediately disqualify them from consideration.
5. Give them a written policy on your stance of keeping all information confidential and secured.

Background checks*

Once again let the candidate know you are serious about hiring only safe employees. Before they are given an application, ask them to sign a release to conduct a full criminal background check. It is important to have the candidate sign an authorization for the background check, before one is performed. Be aware that if the background check is conducted by a third-party vendor, your organization must comply with the Fair Credit Reporting Act’s pre-adverse and adverse notification requirements.

Also, be sure to comply with all Federal, State and local laws on background checks The release should include an area for the potential candidate to document all of the addresses they have resided at, whether it is in the organization’s state or not. However, checking only the state the organization is in, is just not enough. A national background check must be a part of your screening process to ensure that those convicted of abuse in a different state are identified before an offer of employment is made. National background checks can be costly, and non-profit budgets are always tight, but the short term costs will more than benefit the organization if just one perpetrator is identified or discouraged from moving forward with the process.

The application

At this point, a candidate can be given a thorough written application form. Make sure that the application includes a statement that all former employers must be documented. If you find any gaps in employment, they should be addressed during the personal interview stage. In addition, ask the candidate to put their direct supervisors name and contact information. Assure the applicant that you will not contact past employers without discussing it with them first. Again, follow up during the interview to ensure this is the correct person and not a co-worker, friend etc.

The interview

If the determination is made to bring a candidate in for a personal interview, make sure that everyone involved in the interview process is formally trained on interview techniques for screening the potential for abuse, i.e., open ended questions, scenarios of potential incidents, etc.

Whenever possible try and have all candidates interview with multiple people. When the process is complete those who participated in the interviews should meet and formally debrief. Any deviations or inconsistencies should be seen as a red flag that warrants follow-up.

Reference checks

The best predictor of the future is the past. Reference checks provide critical information about candidates. What past employers say about the candidate shouldn’t be the ultimate decision maker, but they clearly know the person better than you. Always seek verbal references, as written references are difficult to verify. Conversations can elicit much more information than written responses but make sure you are talking with the right person. One phone call to HR should clarify the role that the reference plays at the agency and whether they can officially give an employer reference. While some employers will only give you dates of employment, at a minimum try and get them to commit to the question of whether they would consider hiring the candidate back in the future.

Hiring an employee is a long process; and again while these steps will not guarantee that you will keep potential abusers from joining your team, if they screen out just one won’t it be worth the time, cost and effort?

*Ensure that your organization's process for conducting criminal background checks is legally sound. Consult county, state, and national laws and regulations, as well as your organizations attorney and insurance company, as needed.

This material is provided for informational purposes only and does not provide any coverage or guarantee loss prevention. The examples in this material are provided as hypothetical and for illustration purposes only. The Hanover Insurance Company and its affiliates and subsidiaries (“The Hanover”) specifically disclaim any warranty or representation that acceptance of any recommendations contained herein will make any premises, or operation safe or in compliance with any law or regulation. By providing this information to you, The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC JAN 2019 14-74
171-1071 (02/14)

Background information:

Providing safe and effective care requires all healthcare providers to work closely together to achieve optimum patient outcomes. One study completed in the intensive care setting found that communication between physicians and nurses was the most significant factor associated with patient mortality.

The study Silence Kills: The Seven Crucial Conversations in Healthcare found that more than half of the healthcare workers surveyed had occasionally witnessed broken rules, mistakes, lack of support, incompetence, poor teamwork, disrespect and micromanagement. They witnessed colleagues cutting corners, making mistakes and showing serious incompetence. Yet, 90 percent of them failed to discuss their concerns. In fact, a majority of these healthcare workers believe it is not their duty or responsibility to call attention to these issues. Those individuals also felt that the repercussions from having a conversation about the actions or mistakes they witnessed outweighed the benefit. Researchers found the 10 percent who do speak up achieve positive outcomes for their patients, the hospital and themselves.

What can happen?

In healthcare organizations, it is not uncommon for a situation to arise that requires a healthcare professional — a nurse, aide, assistant or technician — to speak up. Below are some examples, which are for illustrative purposes only, of what can happen in a clinical setting:

• A surgeon performs a wrong-sided surgery resulting in a patient suffering a stroke. When the staff is questioned, they state that they were afraid to confront the surgeon even though they strongly suspected he was operating on the wrong side. When asked why they were fearful, they explain that past acts of bad behavior resulted in shaming and publicly belittling staff by the surgeon.
• The colleagues of a pediatric nurse are concerned about her competency and take it upon themselves to follow her and check on her patients. This work-around is not sustainable and an error occurs when a child requires resuscitation.
• A pharmacist, whom colleagues have noted is distracted by personal problems, is not performing standard quality checks. This results in the filing of an incorrect drug for a patient who later dies.

All of these cases illustrate the missed opportunity for a crucial conversation to occur. If the surgeon's behavior had been addressed, or the staff's work-around for the nurse been brought forward, perhaps harm could have been avoided.

Risk reduction strategies:

1. Review current policies and procedures regarding communication and what steps are available in the event staff feels they are not being heard and patient safety is being compromised.
2. Determine if these steps are being followed and if not, why not. Interviews with staff may be helpful to determine how effective communication is in current setting.
   1. Is there a zero tolerance for behavior that would inhibit staff/physicians from speaking up as a patient advocate? Are codes of conduct regarding behavior equally applied across all disciplines?
   2. Is insidious intimidation tolerated in your facility? For example passive aggressive behavior, non-verbal insidious behavior: staring, sighing, or positioning to exclude others. Gossiping and sarcasm are types of verbal intimidation. These types of behavior inhibit the building of a safe patient environment. Question staff on experiences regarding this type of behavior. Ask them what they did about the behavior and what resulted from the action.
3. Consider training staff in effective ways to communicate. Examples include Team STEPPs. Many of the state hospital associations in conjunction with AHRQ have engaged with various providers to offer training courses. During these sessions they go over effective ways to communicate within the healthcare environment. A few examples are the use of CUS, two challenge rule, and DESC. CUS is an acronym for I am Concerned, I am Uncomfortable, this is a Safety Issue! Stop the line.
4. Remember that this is not a one and done type fix. Continuous monitoring is recommended to ensure that change is maintained.

Industry data, as well as findings from root cause analysis of incidents, tells us that communication breakdowns are factors in malpractice cases 30 percent of the time. Not having the capability to speak up puts patients as well as the healthcare entity at risk. Focusing on communication will help to ensure safe patient care for all.

Should the unexpected occur, it is crucial to have the right insurance protection. The Hanover offers tailored coverages that address the unique risks faced by healthcare providers and facilities. In addition our risk solutions team provide an array of tools and resources to help you minimize risk and create a culture of safety.

References

• _{Silence Kills The Seven Crucial Conversations in Health­ care. D. Maxfield, Joseph Grenny, Ron McMillan, Kerry Patterson and Al Switzler. VitalSmarts Industry Watch.}
• _{Joint Commission on Accreditation of Healthcare Organ- izations, Root Causes of Medication Errors 1995-2003.}
• _{To Err Is Human: Building a Safer Health System. Institute of Medicine. National Academy Press. November 1999.}
• _{AHRQ Pub. No. 14-0001-2. Revised Dec. 2013. ISBN 978-0-16-092760-7}
• _{Malpractice Risks in Communication Failures. 2015 Annual Benchmarking Report. Crico Strategies. The Risk Management Foundation of the Harvard Medical Institutions Incorporated.}

Safe handling can help prevent injuries to patients and providers.

The Department of Labor enacted the Nurse and Health Care Worker Protection Act of 2015 to establish standards regarding safe patient handling, mobility, and injury prevention to prevent musculoskeletal disorders for healthcare workers. The act requires healthcare employers to:

1. Develop and implement a safe patient handling, mobility, and injury prevention program
2. Train workers on safe patient handling, mobility, and injury prevention
3. Post a notice that explains the standard, procedures to report patient handling-related injuries, and workers' rights under this Act.
4. Conduct unscheduled inspections to ensure compliance with the standard. (H.R.4266 — 114th Congress) (2015-2016)

Findings included:

• In 2014, registered nurses ranked sixth among all occupations for the number of cases of musculoskeletal disorders resulting in days away from work, with 11,360 total cases.⁵
• Nursing assistants reported 20,020 cases in 2014, the second highest of any profession.⁵
• The leading cause of these healthcare employees' injuries is patient lifting, transferring, and repositioning injuries, which constitute a significant risk to the health and welfare of those employees under the Occupational Safety and Health Act of 1970.²
• Patients are not at optimum levels of safety while being lifted, transferred, or repositioned manually.⁵
• Appropriate mechanical lifts can substantially reduce skin tears and pressure ulcers suffered by patients and the frequency of patients being dropped, thus allowing patients a safer means to progress through their care and avoid disabling injuries due to unsafe practices.¹
• The development of assistive patient handling technology, equipment, and devices has essentially rendered the act of strict manual patient handling outdated and typically unnecessary as a function of nursing care.⁵
• Establishing a safe patient handling, mobility, and injury prevention standard for direct-care registered nurses and other healthcare workers is a critical component reasonably necessary for protecting the health and safety of nurses and other healthcare workers, addressing the nursing shortage, and increasing patient safety. (H.R. 4266. Introduced 12/16/2015)⁵

Occupational Safety and Health Administration (OSHA) recommendations:

• Minimize or eliminate manual lifting as feasible.
• Establish a process to systematically assess ergonomic issues to prevent occupational safety and health hazards.
• Effective solutions usually require modifications to eliminate hazards and promote safer environment.
• Solutions usually will include the use of equipment or modifications to practices.

Patients should be assessed prior to attempting any transfer for:

• Level of assistance required to complete transfer.
• Size and weight of patient.
• Ability of patient to understand and assist with transfer.
• Any medical conditions that need to be considered when transferring.

Evaluation of caregiver skills and capabilities:

• Increased level of skill and experience of caregiver usually equates to less injury.
• Matching caregiver size and experience level to patient needs.
• Education and training of caregiver to specific tasks and equipment reduces likelihood of injury.
• Document annually verification of competencies.
• Establish metrics to measure: appropriate use of equipment, setting up of equipment, utilization of proper body mechanics, and utilization of risk assessment.

Equipment and aids: (not inclusive)

• Medical beds, wheelchairs, lifting devices, sit-to-stand devices, turning aids.
• Shower chairs, height-adjusted toilet seats, sliding sheets/boards, limb lifters, stand aids, walkers, and canes.

Should the unexpected occur, it is crucial to have the right insurance protection. The Hanover offers tailored coverages that address the unique risks faced by healthcare providers and facilities. In addition our risk solutions team provides an array of tools and resources to help you minimize risk and create a culture of safety.

References

1. BxHealthcare: Safe Patient Handling and Mobility-Successful Implementation Techniques. Prepared by Amber Perez, MHA AND CSPHP. 2017 Briotix Limited Partnership.
2. Fitzpatrick MSN, RN FAAN, Melissa A. Safe Patient Handling and Mobility: A call to action much more must be done to enhance safety for patients and caregivers. Supplement to American Nurse Today- Curent Topics in Safe Patient Handling and Mobility. Sept. 2014
3. http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment/SafePatient
4. http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/SafePatient
5. https://www.congress.gov/bill/114th-congress/house-bill/4266/text?q=%7B%22search%22%3A%5B%22%5C%22hr4266%5C%22%22%5D%7D

The recommendation(s), advice and contents of this material are provided for informational purposes only and do not purport to address every possible legal obligation, hazard, code violation, loss potential or exception to good practice. The Hanover Insurance Company and its affiliates and subsidiaries ("The Hanover") specifically disclaim any warranty or representation that acceptance of any recommendations or advice contained herein will make any premises, property or operation safe or in compliance with any law or regulation. Under no circumstances should this material or your acceptance of any recommendations or advice contained herein be construed as establishing the existence or availability of any insurance coverage with The Hanover. By providing this information to you. The Hanover does not assume (and specifically disclaims) any duty, undertaking or responsibility to you. The decision to accept or implement any recommendation(s) or advice contained in this material must be made by you.

LC 2018-004