OSHA has recently stepped up its efforts to hold employers accountable who violate OSHA standards. Unfortunately, some employers prioritize cutting corners and maximizing profits over their patient’s safety, leaving risk of serious injuries and even death. New guidelines go into effect March 27, 2023, which include changes to how inspections are conducted, how penalties are assessed, and how settlements are reached. The overall goal of the changes is to increase accountability and transparency while also providing employers with more options to remedy violations.

Instance-By-Instance

The updated policy outlines factors to be considered when determining whether to issue a violation on an instance-by-instance basis:

• The employer has received a willful, repeat, or failure to abate violation within the past five years where that classification is current.
• The employer has failed to report a fatality, inpatient hospitalization, amputation, or loss of an eye pursuant to the requirements of 29 CFR 1904.39.
• The proposed citations are related to a fatality/catastrophe.
• The proposed recordkeeping citations are related to injury or illness(es) that occurred as a result of a serious hazard.

Grouping Citations

In a second action, OSHA is reminding its Regional Administrators and Area Directors that they have the authority to cite violations separately rather than grouping them together.

OSHA states that grouping violations should be considered when:

• Two or more serious or other-than-serious violations constitute a single hazardous condition that is overall classified by the most serious item;
• Grouping two or more other-than-serious violations considered together create a substantial probability of death or serious physical harm; or
• Grouping two or more other-than-serious violations results in a high gravity other-than serious violation

How Your Dental Office May be Affected

Several of the conditions listed in the OSHA bulletin are directly applicable to the dental industry, including lockout/tagout, respiratory protection, and cases with other-than-serious violations specific to recordkeeping.

As an example of the new enforcement guidelines, consider this list of violations using the Bloodborne Pathogens Standard. Violations of this standard typically fall into OSHA’s top violations in healthcare. Under the new enforcement guidelines, the violations listed below could potentially garner multiple individual penalties as high as $15,625 each (the maximum per violation) for the same standard.

• No Exposure Control Plan—or not having documentation that the plan has been reviewed and/or updated on an annual basis.
• No record of team training. (Must be a written sign-in roster, not just CE certificates)
• Incorrectly handling an exposure incident.

Insufficient PPE, such as using patient exam gloves instead of utility gloves when handling contaminated sharps during operatory clean up and in sterilization.

Documentation Systems Helping You Stay Compliant

Safeguarding both patient safety and profitability is essential for protecting your practice. One way to ensure compliance is by using digital documentation systems, such as UptimeHealth, to record your paper records, ensure that there are no gaps in compliance during times of staff turnover, and enhance monitoring capabilities across offices. Technology has greatly advanced the quality and outcomes of patient care—there’s no reason not to leverage it in your compliance efforts as well.

Although OSHA has been around for more than 40 years, it continues to evolve to keep pace with the evolving needs of industries. The new enforcement guidelines taking effect on March 27, 2023 will no doubt have an impact on your business’ operations. With this in mind, it is important to stay informed and educated regarding the requirements of OSHA and how they can be implemented within your practice to ensure compliance and patient safety.

About the Author

Linda Harvey, MS, RDH, is a nationally recognized expert in dental risk management and regulatory compliance. She is the Founder and Chief Knowledge Officer of the Dental Compliance Institute, which provides train-the-trainer education and certification for HIPAA and OSHA regulatory compliance and dental risk management. The DCI compliance coursework has been awarded the distinction of being Quality Matters™ Certified.