SPH Policy, SPH Plan, and Staff Requirements

Did you know: Assisting patients to move or position without proper training and use of equipment has a high risk of injury and that these injuries can be career ending.  In October 2014, Cal-OSHA passed regulations that all manual assisting of patients had to be replaced by the use of equipment (except in emergency situation) to help protect staff and patients.

Staff Requirements and Expectations:  All UCSF Staff and Vendors are expected to comply with UCSF Safe Patient Handling Policy.  This Policy is to help protect staff, vendors, and patients from injuries associated with the high risk activity of assisting patients.   You have the right and responsibility to notify your manager of any safety concerns and complete and incident report (even if there was no harm caused from the concern/issue).

Unit/Department SPH Plans

Inpatient, ED, Imaging, Procedure Areas

UCSF Health requires that all inpatient care areas providing direct patient care have a department specific SPH plan. As of 2024, all SPH plans will be managed through the Smartsheet platform. 

For assistance with updating your Smartsheet SPH Plan, please submit an MCSS ticket to request support.


Ambulatory Departments

Ambulatory departments will no longer be required to maintain a SPH dept plan but it is still recommended, especially for departments at risk for patient handling incidents.

Ambulatory department opting out of maintaining a department specific SPH plan can reference the UCSF SPH policy in place of a department SPH plan.

For those ambulatory departments opting to maintain a dept SPH plan, these are managed using the RSS (Risk & Safety Solutions) platform:

RSS Video Tutorial on Use of RSS Procedures Platform:

Cal-OSHA Safe Patient Handling Regulation




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