Health Alliance Hospital Partnership Takes Lead in Promoting Safety and Health within the Construction Industry


In November 2006, the Health Alliance Hospital OSHA Strategic Partnership (OSP) was formed to promote safety and health during the construction of the 207 million dollar new hospital and medical office building in West Chester, Ohio. The construction project was a joint venture between M.A. Mortenson Company and Messer Construction (also referred to as "Mortenson Messer Healthcare Construction"). The two companies merged their individual best safety and health practices together to develop one of the most thorough safety and health management systems (SHMS) available. Main purposes of the OSP include providing a safe and healthy environment within the construction industry and increasing communication between stakeholders. The OSP will end upon completion of the project within the next three years.

Success Impact:
Development of Safety and Health Management Systems Enforced

There were 50 onsite contractors who performed work on the West Chester Medical Center project, and 47 of the 50 developed and implemented their own SHMS. The three contractors who had not yet developed their own system adopted Mortenson Messer Healthcare Construction's. However, all of the onsite contractors - even those with their own SHMS in place - were also required to follow Messer Construction's "Safety4Site (S4S)" Commitment and M.A. Mortenson's Zero Injury Procedures while performing all work. The S4S Commitment specifically addressed the four key hazards within the industry (falls, electrocution, caught in-between, and struck-by). The S4S Commitment started at top executive level. However, all employees had to provide "buy-in" before it was formally implemented. All contractors' employees received training on S4S.

OSP Enforces a Safety and Health Culture at All Times

M.A. Mortenson and Messer Construction take safety and health very seriously. When the project first began, all contractors, tiered subcontractors, supervisors, and onsite management staff went through a two-month "trial" period. During this period, any violation of the S4S requirements resulted in stopping all operations and participating in a safety and health education course.

Messer Construction's S4S Commitment identified 20 non-negotiable behaviors not tolerated on projects, and applied them to all subcontractor employees. Contractors are removed from the project for one day if a non-negotiable occurrence takes place. Two non-negotiable occurrences will result in dismissal from all Messer Construction projects for one year. If two or more occurrences occur, the contractor must submit a plan of action for correction and hire a full-time safety specialist onsite at the contractor's expense until Mortenson Messer Healthcare Construction determines that they have made a significant improvement in their safety performance.

During the hospital project, 15 S4S non-negotiable violations were noted resulting in 15 employees receiving a one-day suspension and being re-educated on the specific violation. In addition, 21 other safety violations resulted in formal discipline (with actions ranging from temporary suspensions to removal from the project indefinitely). There was a clear message that general employees were not the only ones who needed to comply with safety rules - five foreman/supervisory personnel were also disciplined after violating safety requirements. To date, there have been no repeat offenders. Also, three full-time safety specialists were hired by individual contractors as a result of the multiple occurrence requirements.

>Safety and Health Training Leads to More Attention of Potential Onsite Hazards

One of the key objectives of the Health Alliance Hospital OSP is to increase safety and health training. Since the OSP began, nearly 4,100 educational hours were provided to 237 management and non-management participants. Over the past year, over 135 employees completed the OSHA 10-Hour course. The increased number of safety and health training sessions offered to employees working on the project led to more employees noticing potential safety hazards on the site.

Over the course of the project, 200 self-inspections (not including daily "walk-throughs") were conducted. During these inspections, 33,842 safety observations were noted and/or questioned resulting in 272 (1.2%) being classified as "unsafe operations." All serious violations were corrected and/or abated immediately. These observations were captured using the "dbo2" safety inspection system, which includes pre-determined categories with multiple options within each category.

OSHA On-Site Consultation conducted six on-site inspections during the tenure of the project. Any serious and non-serious violations were abated immediately. Also, three OSHA enforcement inspections were conducted under the terms of the OSP resulting in 100 percent compliance.

Days Away, Restricted, and Transferred (DART) Rate below National Average for Construction

One of the key objectives of the OSP is to reduce illness and injury rates during the project. Therefore, six-foot fall protection was a requirement of the OSP's SHMS. A daily Jobsite Safety Analysis (JSA) was conducted by each contractor, with findings being regularly submitted to Mortenson Messer Healthcare Construction for review. Also, to help avoid injuries, a daily stretching program (M.A. Mortenson's Strech & Flex), as well as "Daily Morning Huddle" meetings were implemented with all contractors.

As a result of these programs and the overall all commitment to safety, the OSP's DART rate decreased from 2.6 during the first year to zero during the second year. The OSP's two-year average of 1.3 was 54 percent below the 2007 Bureau of Labor Statistics' (BLS) national average for construction. The table below presents information on the OSP's DART rate during the first two years of the project:



# of Fatalities

Year 1 of OSP (2007)



Year 2 of OSP (2008)



OSP 2-Year Average Rate



BLS Industry National Average (2007)



Percentage Difference



Over 750,000 safe hours were worked on the project without any DARTs instances occurring. There have been no fatalities. Multiple contractor safety luncheons with awards were given for reaching the milestones of 200,000; 500,000 and 750,000 safe work hours.

OSP Develops Safety and Health Best Practices to Ensure Project Success

Since the West Chester Medical Center hospital project began, the OSP has developed several new safety and health best practices to reduce injuries and illnesses, promote a safety and health culture, and increase safety collaboration. These best practices include the following:

Daily Stretch and Flex Program

All employees working on the Mortenson Messer Healthcare Construction project (subcontractor and construction management staff) were required to participate in a daily stretch and flex program. This program is one component of the M.A. Mortenson Zero Injury Program. It includes a series of nine exercises to help employees warm up their muscles prior to performing work duties. The implementation of this program has helped M.A. Mortenson and Messer Construction reduce repetitive motion injuries (sprains/strains) and lower injury and illness rates on the worksite.

Activities with Local Organizations that Promote Safety and Health

Mortenson Messer Healthcare Construction has worked closely with the West Chester Fire Department (WCFD) and West Chester Police/Special Weapons And Tactics (SWAT) teams to gain their insight on developing search and rescue drills. During the OSP, three drills were conducted with assistance provided by WCFD. The drills consisted of search and rescue procedures for an occupied facility, fire hose rotations in the bed tower, and high-angle rescue simulation using both tower cranes and aerial fire truck ladders from neighboring fire departments.

Numerous tours were also conducted during each phase of construction for the WCFD crews. Mortenson Messer Healthcare Construction representatives attended WCFD meetings to provide information regarding the building layout and construction safety. At the latter part of the project, the West Chester police department and SWAT teams used the newly-constructed facility to conduct hostage-situation and terrorist-response training drills, because neither the police nor the fire department had access to a building of this size and magnitude in their area prior to the project.

New Personal Protection Equipment (PPE) Requirement

During the project, new PPE requirements were implemented that included a new 100% hardhat, safety glasses, boots, and hi-visibility vest policy. Following orientation, all employees were provided with stickers that had to be displayed at all times on their hardhats. Implementing requirements such as these leave no room for question and error, and help to create a safe worksite.

Partnership Objectives:

Key objectives of the OSP are to: reduce injuries, illnesses, and fatalities in the construction industry through training focusing on the four key industry hazards (falls, electrocution, caught in-between, and struck-by); implement best work practices and enhance safety and health management systems (SHMS); and ensure compliance with applicable OSHA standards and regulations.

Origin: Region V, Cincinnati Area Office
Partners: M.A. Mortenson & Messer Construction and the OSHA On-Site Consultation Program
Partnership Signed: November 28, 2006
Industry (NAICS Code): Construction (23)
Employees: 500
Employers: 30
Source and Date: Dick Gilgrist, AD and Gaye Johnson, CAS, Cincinnati Area Office James Dillard, Chicago Regional Office (Region V)/March 2009