Supervisor Incident Protocol

Overview

This outlines the steps a supervisor should follow when they learn an employee may have sustained a work-related injury, illness, or exposure.

When an injury or illness occurs at work

For campus employees

When a near miss or exposure occurs at work

  • Immediately fill out the Supervisor Incident Report (SIR) form:
    • Fax it to HR Disability Management Services (DMS) at fax number: 415-353-9652, or
    • Email it to your DMS representative (using "Secure:" in the subject line of the email)

For exposure to body fluids or blood

 Advise the employee to call:

The employee should follow all established infection control and medical center protocols. Workers' compensation is a separate process.

For exposure to other hazardous substances

Call Environmental Health & Safety (EH&S): 415-476-1300

When an injury or illness occurs at work

Upon knowledge of injury or illness there are three immediate actions a supervisor must take:

  1. Refer the employee to UCSF's Designated Medical Provider (see below).
  2. Remove, tag, and store any broken equipment that caused injury, and contact EH&S.
  3. Fill out the Supervisor Incident Report form:
    • Fax it to HR DMS at fax number: 415-353-9652, or
    • Email it to your DMS representative (using "Secure:" in the subject line of the email)

Detailed procedure for injury or illness

Emergency (serious injury)

  1. Escort the employee to the nearest emergency medical care facility.
  2. Call an ambulance if necessary.
  3. For follow-up care, refer the employee to one of our designated occupational medicine providers:

Acute care (non-emergency)

  1. Advise the employee to call one of our designated occupational medicine providers:

      2. If injury occurs after clinic hours, refer the employee to Long Emergency Department.

Remove and store any broken equipment that caused injury.

  • Do not discard equipment or furnishings that have caused injury:
    • Remove the equipment from service
    • Tag the equipment for identification
    • Call Environmental Health & Safety at 415-476-1300 for inspection

If the employee loses time from work due to injury or illness.

  • Notify your HR generalist that they may need to initiate Family Medical Leave procedures.

Provide transitional (modified) work

  • Make every effort to reduce lost workdays by providing medically appropriate, modified work during the transitional stages of your employee's medical recovery.
  • Call Disability Management Services at 415-476-2621 for assistance and consultation in designing transitional/modified work.

For Health employees

When a near miss or exposure occurs at work

Immediately complete an online RL Solutions Incident Report (via Carelinks or My Access).

For exposure to body fluids or blood

Advise the employee to call the UCSF hotline: pager 415-353-7842 or 415-353-STIC

The employee should follow all established infection control and medical center protocols. Workers' compensation is a separate process.

For exposure to other hazardous substances

Call UCSF Health Safety Office (Environmental Health & Safety): 415-885-3538

When an injury or illness occurs at work

Upon knowledge of injury or illness there are three immediate actions a supervisor must take:

  1. Contact UCSF Occupational Health Services: 415-885-7580.
  2. Remove, tag, and store any broken equipment that caused the injury, then contact the Health Safety Office, 415-885-3538, and Workers’ Compensation manager, 415-353-7328.
  3. Complete the online Incident Report via Carelinks or My Access.

Detailed procedure for injury or illness

Emergency (serious injury)

  1. Escort the employee to the nearest emergency medical care facility.
  2. Call an ambulance if necessary.
  3. For follow-up care, refer the employee to: Occupational Health Services: 415-885-7580, 2330 Post St., Suite 460, San Francisco, CA 94115
  4. Call the Health Safety Office at 415-885-3538 and the Workers’ Compensation manager at 415-353-7328 as soon as possible to report all serious or fatal injuries by phone
  5. Review Reporting Work-connected Fatalities and Serious Injuries.

Acute care (non-emergency)

  1. Advise the employee to call Occupational Health Services: 415-885-7580
  2. If injury occurs after clinic hours, refer the employee to Parnassus Emergency Department.
  3. Remove and store any broken equipment that caused injury.
    • Do not discard equipment or furnishings that have caused injury:
      • Remove the equipment from service
      • Tag the equipment for identification
      • Call Health Safety Office at 415-885-3538 for inspection
  4. If the employee loses time from work due to injury or illness:
    • Open a work-related leave in HR Umbrella and notify the Health Workers’ Compensation Department at [email protected].
  5. Provide transitional (modified) work
    • Make every effort to reduce lost workdays by providing medically appropriate, modified work during the transitional stages of your employee's medical recovery.
    • Contact the Health Workers’ Compensation department ([email protected]) for assistance and consultation in designing transitional/modified work.
    • The day your employee returns to work, contact the Health Workers’ Compensation Department ([email protected]) to prevent overpayment of workers’ compensation disability benefits.

Why do we take these actions?

By taking the above actions, the supervisor will:

  1. Prevent future injuries by maintaining a safe work environment.
  2. Minimize the severity of any injury or illness that occurs. This helps to minimize time away from work.
  3. Avoid legal fines and penalties being assessed against their departments.
  4. Minimize financial loss to the employee, the department, and the University as a whole.

It is our collective responsibility to focus on workplace safety and, where possible, propose reasonable accommodations to allow our employees to continue working. This is beneficial to our employee's recovery, supporting the needs of the University, and is in accordance with our responsibilities under state and federal law regarding the interactive process.