A study of leading indicators for occupational health and safety management systems in healthcare.

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.

New strategies for monitoring the health of Canadian nurses: results of collaborations with key stakeholders.

The aim of this descriptive study was to help policy- and decision-makers enhance the health of the Canadian nursing workforce by highlighting key factors of concern and exploring options for collecting and utilizing nurses' health data. This paper describes the views of 62 nursing stakeholders from a diverse spectrum of professional, labour, management and government perspectives from across Canada, regarding key factors contributing to work-related health problems in the nursing profession, particularly those relating to the work environment and hospital restructuring. The results were combined with a synthesis of existing information sources about the health of nurses in Canada. With respect to the key concerns, musculoskeletal conditions/injuries and stress and burnout were identified as nurses' major work-related health problems. An examination of the data synthesis inventory revealed that no existing data sources can adequately profile nurses' health, especially in relation to the components of the Conceptual Model of Nurses' Health developed in the study. Three strategies for monitoring nurses' health are proposed.