一项关于医疗保健领域职业健康与安全管理系统领先指标的研究。
A study of leading indicators for occupational health and safety management systems in healthcare.
作者信息
Almost Joan M, VanDenKerkhof Elizabeth G, Strahlendorf Peter, Caicco Tett Louise, Noonan Joanna, Hayes Thomas, Van Hulle Henrietta, Adam Ryan, Holden Jeremy, Kent-Hillis Tracy, McDonald Mike, Paré Geneviève C, Lachhar Karanjit, Silva E Silva Vanessa
机构信息
School of Nursing, Queen's University, Kingston, ON, Canada.
School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada.
出版信息
BMC Health Serv Res. 2018 Apr 23;18(1):296. doi: 10.1186/s12913-018-3103-0.
BACKGROUND
In Ontario, Canada, approximately $2.5 billion is spent yearly on occupational injuries in the healthcare sector. The healthcare sector has been ranked second highest for lost-time injury rates among 16 Ontario sectors since 2009 with female healthcare workers ranked the highest among all occupations for lost-time claims. There is a great deal of focus in Ontario's occupational health and safety system on compliance and fines, however despite this increased focus, the injury statistics are not significantly improving. One of the keys to changing this trend is the development of a culture of healthy and safe workplaces including the effective utilization of leading indicators within Occupational Health and Safety Management Systems (OHSMSs). In contrast to lagging indicators, which focus on outcomes retrospectively, a leading indicator is associated with proactive activities and consists of selected OHSMSs program elements. Using leading indicators to measure health and safety has been common practice in high-risk industries; however, this shift has not occurred in healthcare. The aim of this project is to conduct a longitudinal study implementing six elements of the Ontario Safety Association for Community and Healthcare (OSACH) system identified as leading indicators and evaluating the effectiveness of this intervention on improving selected health and safety workplace indicators.
METHODS
A quasi-experimental longitudinal research design will be used within two Ontario acute care hospitals. The first phase of the study will focus on assessing current OHSMSs using the leading indicators, determining potential facilitators and barriers to changing current OHSMSs, and identifying the leading indicators that could be added or changed to the existing OHSMS in place. Phase I will conclude with the development of an intervention designed to support optimizing current OHSMSs in participating hospitals based on identified gaps. Phase II will pilot test and evaluate the tailored intervention.
DISCUSSION
By implementing specific elements to test leading indicators, this project will examine a novel approach to strengthening the occupational health and safety system. Results will guide healthcare organizations in setting priorities for their OHSMSs and thereby improve health and safety outcomes.
背景
在加拿大安大略省，医疗保健部门每年在职业伤害方面的支出约为25亿加元。自2009年以来，在安大略省的16个行业中，医疗保健部门的误工伤害率排名第二，其中女性医护人员的误工索赔率在所有职业中排名最高。安大略省的职业健康与安全系统非常注重合规性和罚款，然而，尽管关注度有所提高，但伤害统计数据并未显著改善。改变这一趋势的关键之一是营造健康安全的工作场所文化，包括在职业健康与安全管理系统（OHSMSs）中有效利用领先指标。与侧重于回顾结果的滞后指标不同，领先指标与积极主动的活动相关，由选定的OHSMSs计划要素组成。在高风险行业中，使用领先指标来衡量健康与安全已成为惯例；然而，医疗保健行业尚未发生这种转变。本项目的目的是进行一项纵向研究，实施安大略社区与医疗保健安全协会（OSACH）系统中被确定为领先指标的六个要素，并评估该干预措施对改善选定的工作场所健康与安全指标的有效性。
方法
将在安大略省的两家急性护理医院采用准实验纵向研究设计。研究的第一阶段将侧重于使用领先指标评估当前的OHSMSs，确定改变当前OHSMSs的潜在促进因素和障碍，并确定可以添加或更改到现有OHSMSs中的领先指标。第一阶段将以制定一项干预措施结束，该干预措施旨在根据已确定的差距支持参与医院优化当前的OHSMSs。第二阶段将对定制的干预措施进行试点测试和评估。
讨论
通过实施特定要素来测试领先指标，本项目将研究一种加强职业健康与安全系统的新方法。研究结果将指导医疗保健组织为其OHSMSs确定优先事项，从而改善健康与安全成果。
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