As a health care Group, we are responsible not only for the well-being of our patients, but also for the health and safety of our employees. We have implemented numerous management systems and measures throughout the Group to prevent employee accidents and work-related illnesses. Creating a safe and healthy working environment is our top priority. In health protection, prevention is our guiding principle; this is why we offer our employees comprehensive programs that promote their health and prevent occupational diseases.
GRI 403/103-2, GRI 403-2, 403-3
Ensuring the health and safety of our employees is an essential part of our corporate responsibility. The Fresenius Code of Conduct states that we must take the necessary measures to protect our employees and to prevent work-related accidents. All four business segments focus on preventive measures and on the individual responsibility of employees when it comes to occupational health and safety. The occupational safety concepts are adapted to the specific business models of the four business segments. These focus on occupational health and safety within production, as well as occupational health management for health care facility or administrative employees. The aim of all the measures is not only to protect employees, but also to ensure the health and safety of patients. All Fresenius business segments continually record data on occupational health and safety in line with regulatory requirements.
During the ongoing COVID-19 pandemic in 2021, the safety and health of our employees, their families, and the communities in which we work were again the focus of our response activities. In early 2021, our clinics in Germany and Spain started with the implementation of a vaccination campaign which was expanded to our administrative offices. With regard to hygiene in particular, we had to take special measures. At times, our employees also had to face restrictions, e. g., by wearing personal protective equipment (PPE), or carry out additional work, for instance in the case of necessary admission controls. A major challenge for us in this regard was developing individual protection concepts, measures, and working regulations that allow us to continue all operational and administrative activities. Depending on the evolution of the incidence rates and changes in regulatory provisions, it was necessary to promptly adapt our protection concepts and guidelines and to communicate these to the employees. This also meant equipping our employees with suitable protective material.
Within the Fresenius Group, local or regional vaccination campaigns were initiated. In Germany, as part of the vaccination campaign against coronavirus, the data of the employees who had registered for voluntary vaccination was recorded by the plant medical service or the local occupational health function and the responsible HR department for the period of the first and second vaccinations as well as the booster vaccination. All data was collected exclusively in accordance with the applicable regulations, with the involvement of the Data Protection Officers and the local works council committees for this purpose. In the event of a COVID-19 infection, the relevant crisis team was contacted in order to inform potentially affected colleagues, coordinate measures with the responsible health department, and clean the work or building area. No further data was collected. Information on our Data Protection Management can be found in the Compliance and integrity chapter, section Data protection.
In our clinics, we have intensified infection control practices that were already in place in order to protect both our patients and our staff.
In the production facilities, we introduced strict hygiene measures in 2020, such as disinfection and distancing.
Since March 2020, a large number of our employees in administrative functions have been working from home to avoid infection. There has been continuous and direct communication with the employees of all sites and companies ever since the beginning of the pandemic. The specially established crisis teams communicated the hygiene and medical requirements as part of regular communication in the Group, taking into account the respective local official regulations and country-specific ordinances and laws.
Occupational Health and Safety (OHS) is decentrally organized within the Fresenius Group. The business segments have internal specialists and dedicated functions that ensure that the respective guidelines and requirements for the local entities are applied, and define specifications such as company-wide guidelines for the business segments. Relevant data is reported regularly, for example on a monthly or quarterly basis, to identify deviations. If deviations occur, our specialists initiate root cause analysis and evaluation, and corrective or preventive actions are implemented where necessary. Regular internal audits, partly annually, support the verification of data and management approaches, for entities both certified in accordance with ISO 45001 and without certification. Thus, we ensure that internal guidelines and regulatory provisions are complied with.
No Group results are available for occupational health and safety in fiscal year 2021. Although no effects can yet be reported at Group level, we report on the measures initiated in the reporting year and related progress in the business segments.
Certifications and commitment
Our commitment in the business segments regarding OHS is supported, monitored, and certified by external partners or regulatory bodies. The overarching ambition of the management system according to ISO 45001 – which replaces the OHSAS 18001 standard – is to improve occupational health and safety management and ensure the effectiveness of existing procedures and systems. To drive this forward, we are consistently expanding the number of entities certified with this management system standard. Audits performed by other external bodies are scheduled with the local management.
Fresenius Medical Care
Some of the production sites and dialysisDialysisForm of renal replacement therapy where a semipermeable membrane – in peritoneal dialysis the peritoneum of the patient, in hemo dialysis the membrane of the dialyzer – is used to clean a patient’s blood. clinics of Fresenius Medical Care are certified according to international health and safety standards. These include ISO 45001 in Europe, Middle East, and Africa, Latin America, and Asia-Pacific, and the Australian Council on Healthcare Standards (ACHS) in Asia-Pacific. In addition to external audits by relevant authorities, internal reviews and audits are conducted to monitor compliance with corresponding regulations, policies, and procedures. The business segment is working on harmonizing the management concepts for occupational health and safety as part of its Global Sustainability Program.
A global management system in accordance with the international ISO 45001 standard supports occupational health and safety at Fresenius Kabi. The global management handbook and standard operating procedures provide global management requirements for the certified organizations’ local management. The management system covers all employees as well as temporary workers at certified sites. The certified entities set local targets to enhance the occupational health and safety management. The local management reviews it at least once a year with regard to its continued suitability, appropriateness, effectiveness, and potential for improvement. Global internal audits ensure implementation of the management system. Furthermore, it is audited on an annual basis and certified by TÜV Rheinland.
At Fresenius Kabi, 30 organizations are certified according to the ISO 45001 standard1. The company is working on rolling out the certification globally according ISO 45001 to all manufacturing plants by 20232. Fresenius Kabi aims to improve occupational health and safety processes and align them with internationally recognized standards. In 2021, nine additional manufacturing plants were included in the ISO 45001 certification of Fresenius Kabi.
1 The standard OHSAS 18001 has been replaced by the international standard ISO 45001. The business segment concluded the transition in 2021.
2 The implementation will be concluded at all manufacturing plants of Fresenius Kabi in 2023. The certification issuance from the individual certification companies may extend into the following year.
Helios Kliniken in Germany have local approaches to occupational safety and occupational medicine that comply with regulatory requirements.
Helios Spain works continuously to ensure the safety and health of its employees. With the implementation of SAP at all its hospitals in Spain, Helios Spain changed the management of occupational health and safety from local systems to a single company-wide system. Based on ISO 45001 (formerly OHSAS 18001) and Spanish regulatory provisions, all hospitals are required to report occupational health and safety incidents along with their cause, lost time, illnesses and absenteeism as well as other KPIs in a tool. The local management, which is responsible for ensuring that regulatory requirements for occupational health and safety are met, is guided by a handbook and standard operating procedures (SOPs). A central department for corporate ill-health prevention coordinates all activities and the reporting.
All four business segments have notification systems for accidents at work.
At Fresenius Medical Care responsibility for occupational health and safety lies with regional and local management. This structure allows the company to comply with different regulatory and legal requirements, and to report incidents to authorities based on local specifications. Representatives at local level collect relevant data and report it to regional representatives. The management regularly reviews this information.
Fresenius Kabi organizations document all accidents worldwide – for both its own employees and temporary workers. Occupational accidents are categorized according to their severity and reported to the responsible central OHS function and other relevant functions of the business segment depending on their severity. For example, work-related accidents that result in at least one day of absence must be reported within two working days to the central OHS function; other, less severe accidents without or with less than one day of absence are reported on a quarterly basis. All reported accidents are investigated, and the results are documented in respective reports. Additionally, in 2021 Fresenius Kabi started to include first-aid cases and unsafe situations including near misses in the reporting of occupational accidents. These can be taken into account in the analysis of occupational health and safety.
Fresenius Helios uses a Critical Incident Reporting System (CIRS) for critical incidents and near misses at all hospitals. This is anonymous, can be used in all areas of a hospital site, and primarily serves the preventive protection of both patients and employees. The reporting system can be used to make preventive corrections in processes and workflows and thus eliminate risks from everyday work. Further information can be found in the chapter Patient and product safety, section Patient satisfaction measurement and grievance processes.
If an accident occurs in a clinic, a defined process must be followed in order for the person affected to have recourse against the accident insurance organization: the person involved in the accident reports the event to the responsible function depending on the local organizational structure, e. g., the human resources department. The clinic must then file a report with the accident insurance organization within a specified period.
At all Fresenius Vamed sites, reporting procedures are in place to identify and prevent work-related injuries. In Austria these are, for example, the reporting of occupational accidents and near-accidents and preventive workplace evaluation. All work-related accidents and all events that almost lead to an accident are documented locally. In addition, the human resources department reports all accidents with lost days to the accident insurance, in accordance with country-specific requirements.
Fresenius SE & Co. KGaA and all four business segments conduct regular occupational health and safety training to prevent incidents in their fields of operation. In our clinics, employee health and safety training courses cover topics such as the safe use of sharps and disposables, and hand hygiene as well as infection control, and prevention of emergencies and their control. Health and safety training provided in our production sites focuses, for instance, on hand hygiene, the safe handling of work equipment, hazardous chemicals, and emergency prevention and response.
Fresenius Kabi holds, for instance, monthly training sessions on work-related risks. For example, training sessions were held with occupational health and safety managers in 2021 on emergency preparedness, OHS committees according to ISO 45001, behavioral safety and general safety aspects in the handling and storing of chemicals. Fresenius Vamed offers employees in Austria a separate e-learning module on employee protection.
Company reintegration management
In Germany and for Fresenius Vamed in Austria, the statutory company integration management system applies to the Fresenius sites.
In Germany, if an employee is unable to work continuously or repeatedly for more than six weeks within a year, a reintegration procedure is initiated. The relevant employee representatives jointly clarify with the management of the site, and with the consent and participation of the person concerned, the options for overcoming the incapacity for work and what benefits or assistance can be used to prevent renewed incapacity. The aim is to make reintegration flexible and as needs-oriented as possible, thereby ensuring that employees can return to work in the long term. In a first step, affected employees of Fresenius are informed in writing about the options available and about the structure of an initial discussion and its participants. In this context, it is also important to transparently communicate the goals of company reintegration management and the type and scope of the data collected and used for this purpose.
If further measures result from the initial discussion, these can also take place in an extended group in consultation with the person concerned. The extended group may include, for example, supervisors, a member of the works council, the representative of the severely disabled, the company medical service, the company social counseling service, a representative of the company health management, and, if a severe disability or handicap is imminent, a representative of the integration office.
In Austria, the beforementioned measures are initiated in similar form. Affected employees receive what is known as a “reintegration allowance” from the responsible social insurance agency for the duration of this part-time employment in addition to the remuneration due from the part-time employment, which – similar to partial retirement – compensates for a large part of the financial losses.
Occupational health and safety is highly relevant for the Fresenius Group. The aim is to define a Group-wide KPI that will serve as a long-term performance indicator and be reported. Further details can be found in the Compensation Report.
Our business segments manage their occupational health and safety measures in line with segment-specific ambitions.
Fresenius Medical Care plans to include further global indicators in the internal reporting from 2023 to reflect overall performance: the total recordable injury frequency rate and lost time injury frequency rate. In certain segments of the regional businesses, the business segments has already defined targets for incident rates, safety training, or the monitoring of occupational health and safety performance. The business segment plans to set global targets for occupational health and safety by 2023.
Fresenius Kabi wants to continue the improvement of its occupational health and safety management. The ambition of the business segment is to prevent all work-related accidents and improve workplace safety. To achieve this, Fresenius Kabi is developing appropriate occupational health and safety programs and measures with local managers.
The introduction of a system for the comprehensive recording of occupational accidents at all German Helios hospitals is planned for 2022. In future, key figures such as the lost time injury frequency rate (LTIFR) are also to be collected. To this end, Fresenius Helios is closely cooperating with the German accident insurance institutions and internal managers. In the future, Helios Germany will also collect data for preventive health and safety at work purposes.
Fresenius Vamed currently collects relevant key figures locally that may result from occupational accidents. In the future, changes in occupational health management will also be evaluated to an increasing extent.
Fresenius Medical Care
Fresenius Medical Care is committed to providing a safe and healthy work environment for its employees and contractors. In 2021, the company established a new global Occupational Health and Safety Policy, which outlines the key principles. The policy was approved by the Management Board of Fresenius Medical Care.
Fresenius Medical Care strives to prevent work-related accidents and hazards to protect employees and contractors. The business segment tracks and analyzes accidents and injuries at local and regional levels, identifies their root causes, and takes corrective action.
To prevent incidents and increase awareness, Fresenius Medical Care provides health and safety training. Employee training courses in the dialysis clinics cover, for example, the safe use of sharps and disposables, hand hygiene, infection prevention, and emergency management. Training provided at the production sites focuses on, among other topics, the safe handling of work equipment and chemicals, and emergency prevention and response. In the United States alone, more than 48,000 employees completed health and safety training in 2021.
Progress and measures in 2021
As part of the Global Sustainability Program, Fresenius Medical Care began a global risk assessment in 2021. The company identified the biggest physical risks as injuries from needlesticks, slips, trips, and falls. The business segment is working to identify and prioritize high-risk areas and plans to develop specific risk mitigation measures in the coming years. It has also piloted an initiative in the production sites in Europe, Middle East, and Africa. This initiative aims to facilitate the sharing of information concerning significant accidents, near misses, and occupational health and safety best practices.
Fresenius Medical Care also offered COVID-19 vaccinations to its employees at various locations.
GRI 403/103-3, GRI 403-2, GRI 403-10
No work-related fatalities were reported between 2019 and 2021. In the reporting year, the business segment is reporting on work-related fatalities for the first time.
The safety of employees at their workplace is Fresenius Kabi’s central concern. The aim is to prevent all work-related accidents. Fresenius Kabi’s occupational health and safety guidelines focus on the following principles:
- implementing the necessary measures to ensure the health and safety of employees,
- provision of appropriate information, training, and instruction to employees and all persons at our locations,
- ensuring and supporting continuous improvement,
- preventing work-related injuries, illnesses, and other incidents, e.g., implementing technical protection measures,
- performing hazard and risk assessments for all routine and non-routine activities,
- complying with applicable legal requirements and other occupational health and safety requirements,
- providing and ensuring the continuous safe operation of facilities, machinery, and equipment,
- safe handling, use, storage, and proper disposal of hazardous substances.
Experts in the central OHS function analyze and evaluate occupational health and safety programs, working procedures, risks, and objectives, and facilitate exchange of information about occupational health and safety throughout the company. Risk assessment is an important part of occupational health and safety management. Based on the outcomes of risk assessment, occupational health and safety measures are developed and implemented locally. This is supplemented by a notification system, in which work-related incidents and accidents are reported and analyzed. In addition, regular training on work-related risks, procedures, and precautionary measures is provided at all sites.
Fresenius Kabi provides special occupational health services at some locations; these help to identify and eliminate hazards and minimize risks in line with local legislation, e.g., with on-site occupational health service providers or contracted off-site providers.
Responsibility for occupational health and safety management lies with the divisional and local organizations; global management responsibility lies with the central organization, which reports to the responsible member of Fresenius Kabi’s Management Board.
Fresenius Kabi has implemented standard operating procedures (SOPs) and further instructions as well as guidelines to provide a global framework for occupational health and safety. A management handbook and additional SOPs provide a consistent framework for the local occupational health and safety management of ISO 45001-certified organizations.
Progress and measures in 2021
In 2021, the management approach and the governance structure of Fresenius Kabi remained as reported in 2020. Progress focused on the transition of sites certified according to OHSAS 18001 to the international standard ISO 45001, and implementation of the ISO 45001 management system at additional manufacturing plants to further improve occupational health and safety management. Furthermore, the exchange of occupational health and safety management practices has been facilitated internally.
GRI 102-15, GRI 403-2, GRI 403/103-3, GRI 403-10
Fresenius Kabi performs global internal audits at its organizations to confirm compliance with applicable requirements and identify potential improvements. As necessary, the company develops measures to exploit this potential together with local responsible persons. Due to the COVID-19 pandemic, most audits continued to be conducted digitally in 2021. Quarterly virtual meetings took place with representatives from the organizations to exchange learning points about work-related accidents and their future prevention.
Occupational accidents are categorized according to their severity and are investigated by means of a standard investigation template. Furthermore, local management assesses the investigation reports to decide whether technical improvements, additional working equipment or instructions, or further training are required to avoid reoccurrence in future and to improve occupational health and safety for employees.
Fresenius Kabi calculates the LTIFR1 from the data it collects and uses this as an indicator to measure performance; the LTIFR deteriorated by about 4% compared to the previous year due to an incident at a production site in China. Fresenius Kabi also considers the lost time injury severity rate (LTISR)2 in the analysis. Occupational health and safety reports are submitted to the Management Board and other relevant functions of Fresenius Kabi on a quarterly basis. The occupational health and safety report provides information about, for example, LTIFR, LTISR, the severity of the occurred injuries, the type of accidents and the identified root causes.
Lost time injury frequency rate1Download(XLS, 35 KB)
In December 2021, a serious fire occurred at a production site in China, resulting in the deaths of five employees and one other person being hospitalized. An investigation of the incident and the cause of the fire was initiated immediately; an investigation by authorities concluded in February 2022 that no misconduct by a Fresenius Kabi employee caused the fire. The business segment will adopt measures to address the incident and its potential or actual consequences, and to prevent future occurrences, based on the review results by the business segment and local authorities.
In addition, the company recorded one serious work-related accident, which was attributable to insufficient risk assessment. This has prompted additional preventive measures at the respective site, e. g., training and reassessment of hazards and risks connected with the respective work activities. In 2021, Fresenius Kabi saw only a limited number of COVID-19 cases at its facilities, with no significant impact on production output. Precautionary and hygiene measures to protect employees and limit the impact of COVID-19 developed and implemented in 2020 have been continued to be monitored and stringently maintained in 2021. Furthermore, COVID-19 had no impact on the further roll-out of the ISO 45001 management system in 2021 and did not affect OHS performance of the business segment.
1 LTIFR: Number of work-related accidents resulting in at least one day of absence from work in relation to 1,000,000 working hours.
2 LTISR: Number of days absent due to work-related accidents in relation to 1,000,000 working hours.
Fresenius Helios hospitals have risk assessments for the individual workplaces and maintain lists of hazardous substances. As a preventive measure, Fresenius Helios conducts occupational health and safety inspections of areas of the hospitals to detect potential risks. The main risk areas are identified via accident reports or information from employees and undergo rigorous assessment. As part of a risk assessment, these are then analyzed.
In Germany, clinic experts use the S-T-O-P principle (substitution, technical, organizational, and personal measures). Fresenius Helios then reviews the implementation process and its effectiveness. The procedure used is the equivalent of a classic PDCA loop – plan, do, check, act – for continuous improvement. In coordination groups, for example for mental health risk assessments, specialized employees work together with managers to develop cross-functional measures. Similar procedures can be found for example in occupational health management and occupational reintegration management. The business segment is currently reviewing whether to introduce an integrated management system for occupational health and safety in Germany.
Helios Spain strives to develop an exemplary culture within health care provision, in order to avoid occupational health risks and promote healthy habits among its workforce. This is also implemented in the company’s policy on workplace safety, which is applicable at all company levels and locations. Helios Spain has standardized occupational health and safety across the Group’s hospitals and companies and developed a company-wide training platform for specific workplace-related risks. Various KPIs, including absenteeism, occupational illness, and work-related injuries, are consolidated for all hospitals on a monthly basis in a single standardized system and are evaluated. Based on this, measures are then taken to reduce absenteeism and prevent accidents at work.
As a hospital operator, Fresenius Helios implements in Germany occupational medicine measures primarily with own medical personnel. At numerous locations, Helios Germany supplies occupational health services to external companies. The safety-related support of the clinics is ensured specifically by highly qualified personnel.
In Spain, the range of services encompasses about 300 institutions that provide occupational health management. Via these prevention centers, around five million employees are examined annually in cooperation with companies.
Helios Spain has a management system for health and safety at work that has been coordinated with the health and safety committees and approved by management. It has undergone the legally required audits in Spain, as well as internal audits and certifications. The implementation and monitoring of the OHS system is taken care of by specially authorized employees.
Since 2021, the OHS system has included a process for continuously identifying hazards and deficiencies, assessing risks for incidents, and determining measures for control, correction or mitigation, and prevention,and improvement. It complies with applicable legal requirements for risk assessment and the implementation of necessary controls. This process includes all employees who perform or have access to routine and non-routine activities in Helios Spain workplaces. All current and planned workplaces, procedures, (OHS) processes, and tasks located or performed at the centers, as well as their design, are assessed – as are human factors such as personal behavior. Also covered are (the design of) infrastructure, equipment, and materials in the workplace, whether provided by Helios Spain or by third parties. The process also includes hazards that arise in the immediate vicinity of the workplace from work-related activities under the control of the business unit, as well as those that exist outside the workplace but potentially affect the safety and health of its employees.
An integral part of Helios Spain’s OHS management system is training in the prevention of occupational risks. For each of the professions practiced at Helios Spain, there is a special course dealing with the risks and associated preventive measures. Each year, the division also identifies additional training needs for risk prevention in the workplace. In addition, courses and exercises are held on emergency measures.
Organization and responsibilities
The senior management team of Fresenius Helios, the Helios Occupational Health business segment as well as the Helios segment Infrastructure have the task of coordinating occupational health and safety in Germany.
In terms of organization, the Helios Occupational Safety segment is assigned to the area of Authorized Officers & Environmental Management in the Infrastructure business segment. It was founded in 2019 and currently looks after about two-thirds of all the employees in the business segment, in addition to Fresenius Vamed and Xenios, a Fresenius Medical Care company.
Helios Occupational Safety within the segment Infrastructure and its engineers are responsible for almost all Helios clinics and their subsidiaries (e.g., cleaning, logistics, or catering). They look after all aspects of health and safety at work for Fresenius Helios' employees, as well as the employees of Fresenius Helios subsidiaries, ensuring coordination is carried out in close collaboration with the supervisory authorities on a daily basis.
The Helios Occupational Health business segment in Germany also has an Occupational and Organizational Psychology department.
At local level, the members of the Occupational Health and Safety Committee take a targeted approach to monitoring the various aspects of occupational safety and health promotion. The meetings held by the Occupational Health and Safety Committee meet the legal requirements set for composition and number of participants. In addition, specialist personnel and managers in special steering groups at the hospital sites work on dealing with specific areas, such as occupational health management.
At Helios Spain, the OHS system defines the functions, roles, and responsibilities for health and safety in the workplace.
Helios Germany follows the legal requirements and takes all necessary measures to comply with them. At local level, we work closely with the relevant accident insurance institutions in the interests of our employees. Preventive measures to maintain occupational health and safety standards are a priority.
The Fresenius Helios policy on workplace safety in Spain promotes safe behavior among its workforce; it applies at all levels of work and at all locations in Spain.
Progress and measures in 2021
Since 2021, Helios Germany has been involved in a project of the responsible professional German association Institution for Statutory Accident Insurance and Prevention in Health and Welfare Services (BGW). This initiative, launched in September 2021 at the Park Hospital in Leipzig, aims to develop and establish unified occupational medicine and occupational safety standards, and improve internal and external interface management. In addition, a pilot project was launched in October 2021 to expand the existing range of occupational health services to include digital services such as online consultations.
GRI 102-15, GRI 403-2, GRI 403/103-3, GRI 403-10
Qualified occupational health and safety specialists and occupational physicians examine whether the requirements for occupational health and safety are met at Fresenius Helios in Germany. In addition, the requirements are regularly reviewed by supervisors from the BGW. Various audits, sometimes internal, of Fresenius Helios in Germany enable consistent analysis of existing procedures, validation of processes, and effective optimization of the occupational health and safety management already in place. Experts from the field of occupational health and safety, and hygiene, monitor jointly the management of occupational health and safety based on regulatory provisions. They are constantly cooperating across segments and developing improvement processes.
Helios Germany documents accidents locally and assesses the potential for associated risk, with a specific assessment carried out on-site; this is then discussed and assessed together with the relevant supervisory authorities.
Time management reports, which document absences and absenteeism and their development are recorded and evaluated locally in hospitals. Further, accident figures are evaluated at each meeting of the local health and safety committee. Based on this, Fresenius Helios takes measures to reduce absenteeism and prevent occupational accidents. In addition to the figures resulting from accident reporting, on-site local audits in particular serve to monitor the effectiveness of risk evaluations and local occupational safety and health management approaches.
Helios Spain collects data for preventive occupational safety on a monthly basis. The division has defined key figures to document absenteeism and accident rates, as well as the status of compliance with important legal requirements at employee level. Each location in Spain reports on a monthly basis on the development of the key figures. At Helios Spain, there are dashboards for monthly monitoring of absenteeism, occupational accidents, and general illness. The development of the indicators is assessed, and in case of deviations, the business unit implements optimizing projects to reduce absenteeism.
COVID-19: extended risk assessments, more e-learning, and support services at Fresenius Helios
Over the course of the COVID-19 pandemic, Fresenius Helios has been adapting the existing risk assessments. In Germany, specific pandemic-related aspects were factored in, while existing aspects were re-evaluated to take protection against the pandemic into account: these include use of personal protective equipment (PPE), establishing isolated COVID-19 stations in the hospitals, specially protected separate access to sensitive areas, protection of mothers while giving birth, taking into account COVID-19, occupational health and safety measures for office work, and creation of storage facilities for PPE and disinfectants.
Based on pandemic-related legal requirements and official recommendations, Fresenius Helios in Germany has adapted and expanded its range of e-learning courses in the area of occupational health and safety. All in-person events were coordinated in close collaboration with the respective hospital hygiene and management teams. Overall, it was possible for most of the training sessions to be held in accordance with local recommendations and protection measures.
In addition, Fresenius Helios set up a hotline to provide mental health support to its employees in Germany; this is also available to employees in other business segments. To help them cope with the pandemic, the business segment also offered online training courses to its employees. Last but not least, Fresenius Helios increased its childcare provision for employees in Germany to cover the pandemic-related closure of kindergartens and schools.
Helios Spain introduced the new procedure for hazard identification and risk assessment, among other things, as part of its OHS system in the wake of the COVID-19 pandemic. It is regularly updated in accordance with the new regulations of the Spanish Ministry of Health and Labor. In addition, Helios Spain has a procedure for informing, evaluating, and following up on positive COVID-19 cases and close contact with infected individuals. This provides for a daily report to management and a personal follow-up with affected employees.
In 2021, a fire occurred in a ward at a hospital site in Germany. The night services on duty in all departments evacuated patients in accordance with the emergency and fire protection plans. Three patient fatalities were reported in the context of the fire. No employees were harmed. The hospital management, the hospital pastoral care and the psychological service took care for patients and employees.The hospital staff is prepared for such crisis situations through annual mandatory training. The remediation work is still ongoing and will be completed in the course of spring 2022.
The health and safety of employees is firmly embedded in our company’s culture and the Fresenius Vamed mission statement. All employees, and in most instances patients and customers too, are covered by the company’s holistic approach to occupational health and safety. Due to the diverse range of services and the different responsibilities involved, the implementation process is organized in very different ways throughout the business segment – nationally and internationally. In the area of occupational health and safety, all locations are subject to the respective local laws and regulations. Compliance with these regulations is also ensured at local level.
Due to the decentralized organizational structure of Fresenius Vamed, a range of different legal and internal guidelines play a significant role in occupational health and safety. The Code of Conduct covers administration and the area of technical services, while the Clinical Code of Conduct regulates the area of health care and medical personnel. To prevent work-related injuries and occupational accidents, all new employees receive safety training at the very beginning of their employment.
Risk management is a fixed component in the area of occupational health and safety and has also been taken into account as such in the organizational structure. In Austria, for example, a certified risk manager and auditor was appointed to ensure competence in this area. Further, the respective workplace-specific risks were identified, analyzed, evaluated, and reduced to an acceptable level by means of targeted measures in the process organization; this was carried out in close coordination with the divisional managers. With regard to COVID-19, specific attention was paid to reducing risks relating to infection as well as the physical and mental stress involved in dealing with the overall situation. Corresponding documentation was provided in the safety and health protection documents.
In Austria, the safety center of VAMED Technical Services employs several safety specialists. This center is responsible for the safety-related support of Fresenius Vamed’s operations. In order to maintain and further develop their competence, all safety specialists are subject to a focus-specific training program adapted to the respective needs of the organization. In addition, the manager of the safety center is certified as quality, safety, risk, and environmental manager and as lead auditor.
Switzerland has its own safety officers who are responsible for occupational safety and data protection. In addition, there is a dedicated CIRS Circle: this is a committee of representatives from different areas, who analyze critical and near-critical situations, in order to develop and implement solutions.
In the Czech Republic, there are not only safety officers, but also a legally required categorization of work into safety levels. This categorization is performed by in-house responsible persons. The categories determine what protective clothing the employer must provide for the respective workplace and the scope of occupational health examinations of the respective employee.
Progress and measures in 2021
In 2021, the management approach and the governance structure of Fresenius Vamed remained as reported in 2020. Progress focused on health protection during the COVID-19 pandemic.
Wherever logistically possible, COVID-19 testing was offered to employees free of charge on site, and vaccinations were provided centrally by the facilities. Masks, protective equipment, and adequate disinfection facilities were provided. Maintaining minimum distances in the office was supported by a rotation system and working from home.
In some facilities, more psychological support was offered and bonuses were paid to employees in direct contact with patients for the particular stress they experienced during the pandemic.
GRI 403-2, GRI 403/103-3, GRI 403-10
All Fresenius Vamed locations are subject to regular occupational health and safety inspections. At Fresenius Vamed, work-related incidents must not only be reported, but they also trigger an audit of existing work processes and of any proposed changes and the implementation thereof. Corresponding internal guidelines are available. The aim is to minimize risks and prevent the recurrence of hazards. Therefore, all incidents are subject to a structured evaluation by means of a root cause analysis including the corresponding improvement measures. These are prioritized in terms of technical, organizational and personnel criteria. The effectiveness of the measures is validated on site by the responsible local safety specialists. To ensure a holistically structured approach, a standard operating procedure has been implemented.
In 2021, an evaluation of mental stress in the workplace was carried out by an external provider. The lead companies at the headquarters participated in the evaluation, which set out to derive further findings for improved working conditions. The results are expected to be available at the beginning of 2022. Based on the results, measures will be developed going forward.
Promotion of good health in the business segments
Fresenius Medical Care’s commitment to providing a healthy work environment also includes offering flexible working options wherever possible. Depending on the regional requirements, the business segment implements additional measures to support its employees’ well-being. In North America, for example, Fresenius Medical Care offers employees access to a digital platform that provides personal recommendations and activities to help employees stay fit, eat better, manage stress, and improve their sleep. Over 28,000 employees were actively using this platform by the end of 2021.
Fresenius Kabi is committed to the health of its employees worldwide. In addition to comprehensive occupational health and safety measures, the business segment has developed further measures for health promotion. It relies on decentralized offerings, which it tailors as precisely as possible to the needs of its employees.
Staff in the region North America, for example, can take advantage of a health promotion program that also includes their dependents. It comprises offers to promote and maintain general fitness, as well as more specific topics such as skeletal-muscular pain, high blood pressure, and diabetes. Employees also have access to counseling services.
At the site in Haina in the Dominican Republic, the business segment offers its employees, for example, the opportunity to undergo an annual health evaluation. Employees can also take part in programs on ergonomics and well-being in the workplace, and are regularly informed of preventive health care activities, e.g., to raise breast cancer awareness. In 2021, employees at this site were also offered COVID-19 vaccinations. Fresenius Kabi has also promoted COVID-19 vaccination at other sites, e.g., by allowing employees to be vaccinated during working hours.
Helios Germany offers its employees activities to promote good occupational health – this includes offering employees use of the company’s own fitness studios, and providing back- health courses and team events such as “Rowing Against Cancer” or company runs. The programs also cover topics such as healthy nutrition, relaxation techniques, and healthy sleep. The Helios PlusCard is a comprehensive supplementary insurance policy for all employees working for Fresenius Helios. It is also part of the company’s occupational health management system.
For Helios Spain, employee health is a comprehensive issue. The division conducts occupational health examinations, the protocols of which are supplemented by tests; these are intended to help employees better assess their state of health. In 2021, Helios Spain also launched the Contigo project, one aim of which is to promote a healthy corporate culture through high-impact projects that can be extended to the entire organization. It also aims to raise awareness among professionals of the importance and necessity of taking care of their own health, both at work and in their private lives. All of this helps to retain talent and reduce absenteeism due to common illnesses. Other, smaller health promotion projects are also being developed under the Contigo umbrella. Two of these are currently underway: Contigo Salud provides access to the digital hospital. Contigo Bienestar, on the other hand, gives employees access to the company university; they can also sign up for weekly digital courses and workshops for greater well-being in the areas of exercise, nutrition, and mental health.
Fresenius Vamed offers its employees occupational health care and health examinations at the company on an individual basis. Health management includes, for example, company doctors, occupational psychologists, vaccination programs, preventive examinations, workplace visits, and assessment of possible psychological stress.