Integrated Health & Safety Index
Guide to a Healthy & Safe Workplace
THE INTEGRATED HEALTH and SAFETY INDEX
Theriseofinterestinhealthandsafetymeasuresasindicatorsofcorporatevalueisgainingtractionamongthoughtleaders,whobelieveauniversalsystemofhealthandsafetymetricsreportingcouldemergeasanewstandardofvaluation,muchassocialandenvironmentalsustainabilityemergedascorporateindicatorsviatheDowJonesSustainabilityIndex(DJSI)inthelate1990s.TakingintoaccounttheglobalsuccessandimpactoftheDJSI,andincreasingdiscussionsamongworkplacehealthexpertsabouttheneedforstandardized,publicmetricsreportingofhealthandsafetydata,ACOEMandUnderwritersLaboratories(UL)havepartneredtocreateaconsistent,replicable,publicmetricsreportingsystemsimilartoDJSI,makingitpossibleforinvestorstoassessthebusinessvalueofhealthandsafety.Oneofthelong‐termgoalsofthiseffortistohelppropelfasterestablishmentoftrueculturesofintegratedhealthandsafetyintheworkplace–justastheDJSIledtogreatercorporateadoptionofeconomic,socialandenvironmentalsustainabilityprogramsinthelate1990s.Theresultingsystem,calledtheIntegratedHealthandSafetyIndex,usesa1,000pointassessmentscalethatemployerscanusetomeasuretheirperformanceinthreekeydimensionsofsustainabilitymodeledbytheDJSI:economic,socialandenvironmental.Detailsofthescoringsystemareprovidedbelow.TheIntegratedHealthandSafetyIndexprovidesavitalresourcetoassessyourcompany’seffectivenessinprovidingasafeandhealthyworkplace.Byusingthe“GuidetoaHealthyandSafeWorkplace”andtheIHSChecklist,containedinthisdocument,alongwiththeIHSIndexSelf‐AssessmentTool,youcandetermineyour company’sabilitytomaintainandenhanceworkplacesafetyandhealth.Usingalloftheseresourcestoreviewandrateyourcompany’sprogressinmeetingstandardsforexcellencewillprovidevaluableinsightintoareasforimprovement.Note:ThebasicmethodologyfortheIHSIndex’smeasurementsystemwasadaptedfromACOEM’sCorporateHealthAchievementAward(CHAA)program,whichrecognizesemployerachievementinhealthandsafetyprogramming.Formanyyears,theCHAAprogramhasrecognizedthebesthealthandsafetyinitiativesinNorthAmerica.TheCHAAprogramhasnowbeenupdatedtoalignwiththeprinciplesofIntegratedHealthandSafetyprogramming–includinguseoftheIHSIndexformeasurement–andemployersareencouragedtoapplyforCHAArecognitionasawayofgaugingthesuccessoftheirintegratedhealthandsafetyeffortsandreceivingpublicacknowledgementoftheirwork.Tolearnmore,visithttp://www.acoem.org/echaa.
Copyright©2017ACOEM
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THE IHS INDEX PROCESS
TheIHSIndexallowsforathoroughandcomprehensiveevaluationofanorganization’soccupationalandenvironmentalhealthandsafetyprogramsasmeasuredagainstkeystandardsforperformance.TheIHSIndexratesanorganizationbasedonfourcomponents:ProgramDescription,ProgramDissemination,OutcomeMeasureandTrendData.Pointsareawardedforeachitemwithinthefoursectionsbasedonthefollowing:
A. ProgramDescription:Organizationhasevidencethatappropriateprogramsexistinthecategoryindicated.Theorganizationshouldclearlydelineatewhatprogramsithasimplementedthatarerelevanttoeachsectionthatenableittomeetthekeystandardsdefinedineachsection.
Forexample,foritem2.1,theorganizationmightindicate:
Thatitconductspre‐placementexaminationsonallemployeesaswellasevaluatingemployeesuitableforjobtransfers
ThatitconductsmedicalsurveillanceasrequiredundertheOSHAstandardsforleadandbenzeneaswellasfornoiseexposure
Thatallemployeesareofferedanexitexaminationwhentheyleavethecompany
B. ProgramDissemination:TheIndextakesintoaccounthowwelldeployedprogramsareinallappropriateareasanddepartmentswithintheorganization.
Forexample,anorganizationmaynote“weofferannualmedicalexamstoallemployeeswhoworkatlocationswherethereisanon‐sitehealthservice.”Thisstatementdoesnotclearlyindicatewhatpercentageoftheorganization’semployeeshasaccesstotheseannualmedicalexams.Amorecompleteresponsewouldbe,“annualmedicalexamsareprovidedtoallemployeeswhoworkatlocationswherethereisanon‐sitehealthservice;thisrepresents85%ofourworkforce.”
Ifaprogramisnotdeployedtoeveryoneintheorganization,theorganizationshouldbeclearastowhatpercentageofitsemployeepopulationiscovered.Forexample,respiratorclearanceexamswouldonlybeexpectedtobeofferedtoemployeeswhoarerequiredtouserespiratoryprotection.Again,specificinformationastotheapplicablepopulationwillaidinunderstandingyourprograms.Astatement–“allemployeeswhowearrespiratorsreceiveannualclearanceexams”isnotspecific.Theapplicantshouldidentifyhowmanyemployeesarerequiredtouserespiratoryprotectionandwhatpercentagecompletedtheirannualclearanceexams.
Programdisseminationisanimportantcontributortothescore.Agreatprogramthatisonlydisseminatedto5%oftheworkforcewillnotcontributesignificantlytoyouroverallassessment.Ifanewprogramisbeingimplementedonapilotbasisortoonlyasmallpercentageofthepopulation,theseprogramsshouldbeincludedinthenewinnovativeoruniqueprogramsunderStandard1.5.
C. OutcomeMeasures:Anorganizationshouldhavedevelopedmetricsforitsprograms.Theorganizationshouldunderstandthemetricsithasdevelopedforallprograms.Outcomemeasuresandtrendsareoftenpresentedusingnumericaldata,graphs,andcharts.Acombinationofanarrativedescriptionofthemeasuresandtheirtrendsandgraphsorchartsisrecommended.Anarrativedescriptionmightread“In2005weseta5‐yeargoalofmovingouruseofneedlelessdeliverysystemsandretractablesyringesfromthebaselineof45%to96%.Weachievedthisgoaltwoyearsearly(2008)andhavecontinuedtosustaina>95%compliancein2009and2010.”Achartorgraphdepictingoutcomemeasuresandtrendsshouldbeincludedforkeyprograms.Combined,theseelementsgiveyourleadershipteam–andanyoneelseyousharetheIndexmeasurementswith–acomprehensiveandeasilyunderstoodguidetothemeaningandimpactofthesemeasurements.
D. TrendData:Trenddataispresentedshowingareductionofhealthrisk,health‐costsavings,orotherimpactonthebusinessovertime.
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Scoring Thescoreisbasedonaweightingofelementsforeachofthe18standardscontainedinthethreesections.Eachofthestandardsisscoredaccordingtoaprogram’scomprehensiveness,disseminationtoapplicablepopulations,anddocumentationofqualityassuranceandcontinuousimprovement.TocompletetheIHSindexprocess,andcompileyourIHSindexscore,youwillusetheIHSSelf‐AssessmentTool,aspreadsheetwithpre‐setformulasandcalculationsthatyoucanpopulatewithyourowndata.TheIHSSelf‐AssessmentToolautomaticallytabulatesafinalintegratedhealthandsafetyscoreforyourorganization,dependingonthedatayouenter.Thisscorehelpsyouunderstandwhereyourprogramsaredoingwell,wheretheyarelagging,andhowyourorganizationmeasuresup,overall,toanobjectivestandardforeffectivehealthandsafetyprogramming.TheIHSSelf‐AssessmentToolisfreeandavailableforpublicuseat:http://www.acoem.org/uploadedFiles/Knowledge_Centers/Health_and_Productivity/IHS Self Assessemnt.xlsx.
ABOUT THE “GUIDE TO A HEALTHY AND SAFE WORKPLACE” AND THE IHS CHECKLIST
TohelpthoseusingtheIHSSelf‐AssessmentTool,the“GuidetoaHealthyandSafeWorkplace”hasbeendeveloped,whichisincludedhereanddescribesindetaileachIHSstandardandwhatorganizationsshouldbeaddressingastheytrytoachieveeachstandard.TheguideprovidesallofthebackgroundinformationyouneedtocompleteanIHSself‐assessment.Usersoftheself‐assessmenttoolareencouragedtousetheguideastheyratetheirprograms.TheguideincludesanIHSChecklist,whichcanprovideaquickdeterminationofyourorganization’scurrenthealthandsafetyenvironmentbeforeyoucompleteafullself‐assessment.Youcanusethechecklistasyougothroughthe“GuidetoaHealthyandSafeWorkplace”togetaquicksenseofwhereyoustand.
How to use the checklist: Step1:Simplymatchupthenumberineachboxontheleftsideofthechecklistwiththecorresponding
sectioninthe“GuidetoaHealthyandSafeWorkplace”;thereyouwillfindmoredetailsonbestpracticesthatareusedtodeterminethelevelofyourorganization’sworkplacehealthandsafetyprograms.
Step2:Putacheckinalltheboxesthatapplytoeachstandard.Themorechecksyouhave,themorerobustareyourcurrenthealthandsafetyefforts.AhighernumberofpointswillbelikelyforthatstandardwhenyoucompleteafullassessmentusingtheIHSSelf‐AssessmentTool.
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IHS CHECKLIST
Program Exists
Program Is Well Deployed
Program Is Consistently Measured
Program Trends Are Tracked Over Time
Total Points Possible
SCORE
1.1 Organization & Management 75
1.2 Health & Safety Information Systems 75
1.3 Occupational Injury & Illness 75
1.4 Absence & Disability Management 60
1.5 Integrated Health & Productivity Management
70
1.0 Economic Dimension TOTAL POINTS
355
2.1 Health Evaluation of Workers 75
2.2 Workplace Health Hazard Evaluations, Inspection & Abatement
60
2.3 Education Regarding Worksite Hazards 50
2.4 Personal Protective Equipment (PPE) 40
2.5 Toxicological Assessment & Planning 25
2.6 External Environment 30
2.7 Emergency Preparedness, Continuity Planning & Disruption Prevention
45
2.0 Environmental Dimension TOTAL POINTS
325
3.1 Evaluation & Quality Improvement 75
3.2 Innovation & Social Responsibility 25
3.3 Travelers Health 30
3.4 Health Promotion & Wellness Including Non‐Occupational Illness and Injury
70
3.5 Health Benefits Management 50
3.6 Mental/Behavioral Health 70
3.0 Social Dimension TOTAL POINTS
320
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Sample Metrics for Select Standards
Economic Dimension
1. Workers’ Compensation a. Number of workers’ compensation claims filed annually b. Total workers’ compensation costs incurred each year – trend data minimum 3 years c. Total temporary disability (TTD) days paid each year
2. Percent of Senior Management Reviews a. Number of leader/senior manager reviews per year divided by total number in leadership position
3. Turnover Rate a. Number of employees leaving during the year x 100 divided by number of employees at start of year
Environmental Dimension 4. Accident/Incidence Rates for Employees and Contractors (Trend over 5 years)
a. Frequency: OSHA Total Recordable Incidence Rate (OSHA TRIR) Employees and Contractors – (# of OSHA Recordable x 200,000/# of hours worked)
b. Severity: OSHA restricted duty days for employees and contractors (# of lost/restricted work days x 200,000/# of hours worked)
c. Severity: OSHA lost/restricted workday case rate (# of OSHA lost/restricted workday cases x 200,000/# of hours worked) 5. Hazard Recognition (minimum 3 years of data)
a. Total # of inspections and/or audits per year to include # of correct (safe conditions) and # of adverse/at-risk (unsafe) conditions/inspection or audit
b. Total # of near miss reported/year c. Total # of observations reported/year (safe conditions) and # of adverse/at-risk (unsafe) conditions/observation reported d. The % of owned or leased work locations that have implemented an occupational safety health management system.
The % of those locations that have been audited by an independent 3rd party. 6. Participation
a. % of workforce submitting observations (safe, at risk conditions), near misses annually 7. Hazard Prevention/Closure Rate
a. % completion of corrective actions for adverse (unsafe) conditions reported for inspections/audits/near miss and observations within due date
8. Education and Training a. # of hours of training/employee as % of objective b. Total training days completed during year divided by the average number of employees for the year c. The percent of employees trained prior to start of work
Social Dimension
9. Wellness Programs a. Percent of employees completing an annual HRA b. Percent of employees completing Annual Labs/Biometric Screenings c. Percent of employees completing a primary care physician periodic wellness visit
10. Prevalence of Chronic Health Conditions and Health Risks a. Percent of employees in individual high health-risk levels at baseline and annual follow up. (As an example, the percent
of employees that are high-risk with each of the individual 15 health risks in Dee Edington’s assessment model as outlined in the book, “Zero Trends.”)
b. Percent of employees in low, medium and high health-risk categories at baseline and annual follow up (as outlined in “Zero Trends.”)
11. Impact of Health Conditions a. Working days lost per year by disease category (i.e., diabetes, obesity, hypertension etc.) x 100 divided by working
days available in the same year. 12. Community Engagement
a. Number of community activities engaged in annually by the employer that are related to community health and/or environmental sustainability
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GUIDE TO A HEALTHY and SAFE WORKPLACE
Overview ThefollowingGuidetoaHealthyandSafeWorkplacewillsteeryouthroughallthecomponentsyoumustaddressintheIHSself‐assessment.Itisdividedintothreesections–EconomicDimension,EnvironmentalDimensionandSocialDimension.Eachsectioncontainsasetofstandards,allofwhichmustberespondedtointheself‐assessmentintheorderpresentedinthisGuide.EachsectioncontainsIHSstandardsfortheareaandexamplesofhowthesestandardshavebeeninterpretedandimplemented.Examplesofoutcomemeasuresandtrendsareprovided;however,thesearejustexamplesandarenotintendedtobeallinclusiveorrequiredforanyparticulararea.Intheeventyoudonotbelieveanitemisapplicabletoyourorganization,youshouldindicatethisintheself‐assessmentandprovidejustificationastowhyitisnon‐applicableinthecommentarea.
Throughoutthefollowingdiscussion,weusetheterms“OEM”and“OEH”professionals.OEMreferstooccupationalandenvironmental(OEM)physicians,whohavereceivedtraininginoccupationalandenvironmentalmedicine,whetherthroughanaccreditedresidencyprogramoradvancedtraininginOEMcoupledwithworkexperiencefocusedonworkplacehealth,wellness,safetyandtheenvironment.OEHreferstooccupationalandenvironmentalprofessionals,suchasoccupationalhealthnurses,registeredorlicensedpracticalnurses,nursepractitioners,industrialhygienists,safetyexpertsandotherhealthandsafetypersonnelwhosefocusisworkplacehealth,safetyand/ortheenvironment.
SECTION 1.0 ECONOMIC DIMENSION ThefollowingsectioncontainscriteriafortheEconomicDimension.Tofulfillthisdimension,organizationsneedtodemonstrateongoingfinancialsupportforcompre‐hensiveIHSprogramming,includingshowingtheyade‐quatelyfundbudget‐linesforhealthandsafetyprograms,thatsufficienttrainingisprovidedfortheseprograms,thatwelldefinedbenchmarksforperformanceoutcomesareinplaceandthatemployeesaremakingprogressinmeetingsuchoutcomes.Moregenerally,organizationsneedtodemonstratethebroadeconomicbenefittosocietythatderivesfrominvestmentinthehealthoftheiremployeesandthecommunitiesinwhichtheydobusiness.
1.1 Organization & Management IHS Standards Employersshouldassurethatoccupationalmedicine,industrialhygiene,safetyandenvironmentalhealthpro‐fessionalshaveinputintothedecision‐makingprocessrelatedtohealth,safety,andenvironmentalissues.Inallsettings,thisrequiresclosealliancebetweenoccupationalandenvironmentalmedicine(OEM),occupationalandenvironmentalhealth(OEH),andsafetyprofessionals,withallreportingtoalevelintheorganizationthatwillhaveabroadinfluenceandglobalimpact.OEM,OEHandsafetyprofessionalsshouldworkcollaborativelytoidentify,designandimplementimprovementstoenhancehealthandproductivityoftheworkforceaswellasmaintainasafeworkplace.
Health,safety,andenvironmentalprogramsshouldassistininterpretinganddevelopingpertinentregulationsandguidelinesforbusiness,labororganizations,governmentagencies,andcommunities.Health,safety,andenviron‐mentalprogramsaremosteffectivewhenorganizationalsupportandcommitmenttothehealth,productivity,andsafetyoftheworkforceexists.Managementmustbewillingtoprovideappropriateresources,encourageinnovationandsupportpositivechange.OEM,OEHandsafetyprofessionalsmustcollaboratewithmanagementtomeetthechallengeofdesigninganddisseminatingcosteffectivehealth,safety,andwellnessprogramstoanincreasinglydiverseandagingpopulation,oftenatwidelydispersednationalandinternationalsites.Programsshouldsetuniformstandardsofcareandencouragebestpracticesthroughouttheorganization,includinginter‐nationally.Managersshouldunderstandthevalueofworkplaceandenvironmentalhealthandsafetyandmustbeabletomanagechangeinaconstructiveandpositivemanner.
✔ CHECKLIST ❑ Programs exist ❑ Programs are well deployed ❑ Programs Measured Showing Trends ❑ Trends Tracked Over Time ❑ Data Used for Continuous Quality Improvement
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Application Response Describeindetailtheorganization’smanagementandleadershipstructure,thereportingrelationships,theresponsibilitiesandtheauthoritiesofeachoftheOEM,OEHandsafetyprofessionals.Describethefrequencyofreviews,themethodsbywhichthedepartmentsareencouragedtocollaborateandprovideevidenceoftheprogramsthatresultfrommeetingtheIHSStandards.Explainhowtheprogramsarereviewed,howthedecisionsweremadefortheprogramimplementation,speedandbreadth.Providethespecificgoalsandmeasuresfortheseprograms,thebreadthoftheirimpactandthemeasurableresults.Providedataontheorganization’sresponsetotheresults.Explainleadership’sinvolvementandhowitdemonstratesadherencetotheIHSStandards.
Examples of Program Components, Processes and Dissemination Asystemformanagingworkersafetyandoccupationalhealthisclearlydocumentedandcommunicated Measurablegoalsaredefinedforkeyoccupationalhealth,safetyandenvironmentalprograms Policiesandprocedurestoensureenforcementarereviewedandupdatedonaregularbasisand
disseminatedthroughouttheorganization Programsexisttoaddressemployeehealthandwell‐beingwithwell‐definedoutcomeshighlighting
thereturnoninvestmentsfortheprograms Linesofauthority,responsibilityandaccountabilityarewelldefined Systematicandregularreviewswithresultsprovidedtoallhealth,safetyandenvironmentalprofessionals PolicieswrittenandenforcedthatsupportethicalprinciplesofACOEMandotherorganizations,e.g.,
AmericanAssociationofOccupationalHealthNurses(AAOHN),AmericanIndustrialHygieneAssociation(AIAA)etc.
Trainingavailableandencouragedtoensurethehealthandsafetystaffisawareoflateststandardsandguidelines
Medical,healthandsafetypersonnelencouragedandsponsoredtobeactiveinlocalprofessionalsocietiesandcommittees
OEM,OEHandsafetyprofessionalssystematicallymaintainawarenessoflegalandregulatoryissuesthatmayimpacthealthprograms
Systemsareinplacetoensureapplicablelaws,regulationsandpermitrequirementsaremet Systematicprogramforplanningwiththeinputandalignmentofallthehealth,safetyandmedicaldisciplines Fundingtoensurethattypicalaswellasunusual/emergencysafetyandhealthexpenditureswillbecovered HealthpoliciesandlegislationofconcerntotheorganizationareaddressedbymanagementandOEMand
OEHprofessionalswithmedicalandhealthprofessionalsprovidingappropriateexpertise Managementreviewstheresultsofprograms,includingparticipationandachievementofgoals,onaregular
basistoensureprogramsareontrackorappropriateadjustmentsaremadeandsupported Theorganizationandthemanagementarerecognizedasmodelsofthepracticesthatarebeingsupported Leadershipencouragesbenchmarkingprogramsandresultsinordertoimprovetheoverallhealth,
safetyandwellnessoftheworkforceandtheorganization
Examples of Outcome Measures and Trends Frequencyofleadershipreviewsscheduledandconfirmed Numberofprogramsintroducedwithspecificgoalsthathavebeenreviewedandapproved Frequencyoftraining,whoistrainedandextentitisreviewed Leveloffundingprovidedtosupporthealth,safety,wellnessandenvironmentalprogramsovertime Numberofhealthandsafetyprogramsthathavebeendesigned,deliveredandhavedemonstratedoutcomes Numberofbenchmarkingactivitiesthatwerecompletedandresultsoftheseactivities Participationofoccupationalhealth,medicalandsafetyprofessionalsinexternalcommitteesandactivities Externalaccreditation Staffturnover
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1.2 Health and Safety Information Systems
IHS Standards Effectivehealth,safetyandenvironmentalprogramsuseinformationsystemstopromoteworkerhealthandsafety.Occupationalhealthinformationsystems(OHIS)andoccupationalsafetyinformationsystemscanandshouldbeusedformultiplereasons,including:aggregatedatacollectionandanalysis,documentationofworker’smedicalsurveillance,trackingmedicalappointments,deliveryanddocumentationoftrainingprogramsandhealthandwellnessprograms,communicationsbetweenstakeholders,benefitseducationandtracking,aswellasmonitoringofchemicalandotherhazards.Thesesystemshelpprovideaccesstosafetydatasheets(SDS),OccupationalSafetyandHealthAdministration(OSHA)accidentandinjurylogs,researchdata,updatestoregulatoryandgovernmentalchangesatthestateandfederallevels.Thesesystemssupportstatisticalanalysis,integratedcasemanagementandenableresearchofpeerreviewedliteratureanddeliveryofcontinuingprofessionaleducation.OHISareneededtogeneratemetricsusedtoidentifyproblems,trackcompliance,manageprogramsandassurequalityandeffectiveness.Thesesystemsarealsousedtowiselyallocatehealthresources.Health,safetyandenvironmentalprogramsmustmaintainoccupationalmedicalrecordsoneachworker,documentingthereasonsforandresultsofallevaluations.Ideallytheserecordsshouldcontaindatasufficienttoreproduceachronologyoftheworker’smedicalhistory,workplaceexposures,medicalevaluations,illnesses,andinjuries.Asthesesystemsprovidepowerfulanalyticaltools,theorganizationmustmaintainappropriatecontrolandmeetallprivacyrequirements.Proceduresmustpreserveconfidentialityofallhealthinformationandmedicalrecordswhileallowingaccesstothosewithabonafideneedtoknow.Iftherecordsarecomputerized,theirsecuritymustbeassuredandtheinformationtheycontainkeptconfidential.
OEHprofessionalsmustremaininformedonregulatoryissuesaffectingmedicalrecords,suchastheHealthInsurancePortabilityandAccountabilityActof1996(HIPAA)theAmericanswithDisabilitiesAct(ADA),andGeneticInformationNondiscriminationAct(GINA)regulations.Application Response Describeindetailtheorganization’sHealth&SafetyInformationSystems,howtheyareused,whohasaccessandhowthedataareused.ExplainhowthesystemsareusedtosupportthemanyelementsidentifiedintheIHSStandards.Explainthepoliciesandproceduresformaintainingworkerhealthrecordsincludingretentiontimesandmaintenanceofconfidentiallyandsecurity.Explainhowthedataareusedtoimprovetheeffectivenessand efficiencyofthehealth,safetyandwellnessprograms.Giveexamplesofimprovementsthatweremadeutilizingthedatafromthesesystems.
Examples of Program Components, Processes and Dissemination Healthandsafetyinformationisintegratedwithotherinformationmanagementtoolstodriveimprovementsinworkerhealth,safety,qualityandefficiency
Healthinformationsystemsaredevelopedinconcertwithotherorganizationalinitiativessuchasbusinessprocessre‐engineering
Implementationofmulti‐sitedatasystems(in‐houseandvendoroperated) Useofdataforsupportingfinancialimpactofthehealth,safetyandwellnessprograms
Electronicmedicalrecordsmanagement
Datalinksbetweenmedical,industrialhygienedataandjobexposureinformation
Medicaldecisionsupportsystems
Health&safetyinformationsystemssupportauditsandresearch
Dataprotectionprotocolsforallhealth&safetysystems Communicationofpatientinformationbetweenhealthcarefacilities
Validationofandconsistentmetricsacrossorganizationallines
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Examples of Outcome Measures and Trends QualityassuranceissuesidentifiedbyOHISutilization,suchasmedicationerrors
Quantitativedatashowingimprovementinspeedandaccuracyofinformation Quantitativedatashowingreturnoninvestmentofthetechnologytotheorganizationalperformanceandproductivity
Examplesofinsightsgainedthroughanalysisofdatatohelpimplementationofhighqualitycareinamorecost‐effectivemanner
DatademonstratingcostavoidanceduetoearlydataormoreaccuratedataduetoOHISutilization
ImpactofOHISonadministrativeprocesses
Systemsreliabilitydata Dataontheresponsetimeforprovidingmedicalrecordsand/orresponsetosafetyissues
Percentageofchartswithsignedconsentforms
Percentageofchartshavingallergynotationsclearlyvisible
Auditresultsforcompliancetosetregulatorycriteriainbothhealthandsafety
PercentageofcompliancewithHIPAAandothermedicalprivacylaws
1.3 Occupational Injury and Illness Management
IHS Standards Occupationalandenvironmentalinjuriesandillnessesshouldbediagnosedandtreatedpromptly.OEMphysiciansarebestqualifiedtodiagnoseoccupationalillnessesandinjuriesbecauseoftheirknowledgeoftheworkplaceandenvironment.TheOEMphysiciansandOEHnursesshouldobjectivelyresolveissuesaboutoccupationalcausationofillness,beknowledgeableregardingavailablerehabilitationprogramsandfacilities,andinteractwithprogramadministratorsasappropriatetofacilitatepostillnessorinjuryreturntoworkbasedonfamiliaritywiththeworksiteandinputfromsupervisory/managementpersonnel.
Post‐illnessorinjury,fitness‐for‐dutyevaluations,andindependentmedicalexaminations–Thehealthstatusoftheworkershouldbere‐evaluatedfollowingprolongedabsencefromworkduetoillnessorinjurywheneverthereareconcernsofabilitytoperformalljobtasks,andforgloballyassessingworker’sallegationsandclaims.Thegoalistoassurethattheindividualhassufficientlyrecoveredfromtheillnessorinjurytoperformthejobwithoutundueriskofadversehealthorsafetyeffectstotheindividualortoothers.ItisimportantforOEMandOEHprofessionalstobeinvolvedinreturn‐to‐workplanningtohelpdetermineiftheworkerisabletoreturntorestrictedorfull‐timeworkonatemporaryorpermanentbasis.
Terminationofassignment–Healthstatusmayneedevaluationwhenexposureceasesoremploymentterminates.Theworkershouldbeinformedconcerninghealthstatusandadvisedofanyadversehealtheffectsduetoworkorenvironmentalexposures.
Application Response Describeindetailtheprocessesandproceduresyourorganizationhastodiagnoseandtreatinjuryorillnessoccurringonthejob.
Examples of Program Components, Processes and Dissemination Availabilityofappropriatelytrainedandlicensedhealthprofessionalstoassessworkerhealth
statusforprevention,earlyrecognitionandtreatmentofillnessandinjury
Appropriatepoliciesandproceduresforrespondingtoandevaluatingoccupationalillnessorinjuries
Approved(andsigned)treatmentprotocolsthatconformwithACOEMorotherpracticeguidelines
Procedurestoensuretheproperreportingofcasesidentifiedasworkrelated
Operationalfirstresponderteams
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Patientinstructionsandeducationforworkrelatedinjuryorillness
Ifoff‐siteservices,thequalityassuranceprovidedtomanagersofalloffsiteservices Proceduresforfollowupandreportingofrelevantinspectionsbyregulatoryagencies
Improvementofnewcasesofworkrelatedinjuriese.g.,noise‐inducedhearingloss
Improvementinnumberofworkerswithabnormalbiologicalmonitoringresults,e.g.,bloodlead
Medicalpersonnelinvolvedinjobassessmenttoestablishfunctionalrequirements
Benchmarkedguidelinesusedforcomparisonsondisabilityduration
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
Outcome Measures and Trends Resultsofemergencyresponsesystem/providerinterfaces
Quantificationandrecordsofrelevantinspectionsbyregulatoryagencies
Injuryorillnessrates(OSHA300log) Lostworktime
Rateofinjuryandillnesscasesinvolvingdaysawayfromworkduetooverexertionorrepetitivemotion PercentcompliancewithACOEM’sOccupationalMedicinePracticeGuidelines,3rdEditionfor
treatmentofworkplaceillnessandinjuryorotherguidelines
Ratesofoccupationalenvironmentalillnessesandinjuriesovertimewithevidenceofactionstakentoimproveresults
Numberofworkrelatedinjuries/illnessesresultinginmedicaltreatment,losttimefromwork,restrictedworkactivityordeathcomparedtotargetsofHealthyPeople2020
Percentofeligibleworkersandlocationsreceivingprograms
1.4 Absence and Disability Management
IHS Standards Disabilitymanagementprogramsassessreasonsforworkers’poorperformanceorabsencefromworkduetoillnessorinjuryanddeterminewhenindividualsarewellenoughtoreturntoworksafely.Closelyrelatedistheprimaryroleofevaluatingillnessconditionsthatrenderworkunsafeandrequirejobaccommodations.Frequently,theworkplacecanbeusedforrehabilitatingworkers,especiallywhereselectiveworkcanbeprovidedonatemporary,limitedbasis.Disabilitymanagementisexpandingtoidentifyindividualsandworkerpopulationswhoareatincreasedriskofpoorperformancebecauseofhealthissuesandtofindpositivemeanstoenhancehealthandproductivityintheworkforce.
Application Response Describehowhealthprofessionalsandcasemanagerssupporthumanresources,managers,andsupervisorstohelpassurequalityofmedicalcareandfacilitatetheearlyreturn‐to‐workforworkersabsentfromworkduetoillnessorinjury.Discussyourdisabilitycasemanagementandreturn‐to‐workprograms.
Examples of Program Components, Processes, Dissemination Writtenabsence/disabilitymanagement/FamilyMedicalLeaveAct(FMLA)policiesand
proceduresincludingacomprehensivereturn‐to‐work(RTW)programsupportedbysupervisors
Reasonableandtimelyaccesstofollow‐upmedicalcare Activecasemanagementofabsenteeismanddisabilitiesconsistentwithorganization’spolicy
andstewardedtofacilitateworker’soptimalandtimelyreturntohealthandtowork
Medicalpracticeguidelinesusedforthemostcommoncausesofillness
Transitionaljobsavailablefortemporaryassignment
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AccesstoappropriateACOEMconsensusandguidelinestatementsonreturn‐to‐work
Integrationofsystems/processestoincludecommunityproviders FunctionaljobdescriptionstofacilitateeffectiveRTWprograms
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
Outcome Measures and Trends Rateofinjuryandillnesscasesinvolvingdaysawayfromworkduetooverexertionorrepetitivemotion
Numberofdaysabsentfromworkorwithrestricted/modifiedduty
Numberofworkdaysmissedduetospecificchronicconditions,e.g.,depression,diabetes
Disabilitymanagementcostsavingse.g.,fromcasemanagement
Comparisonofactuallostworktimeanddisabilitydurationv.publishedbenchmarks/guidelines
Evidenceofmonitoringqualityofcaree.g.,percentageofthose,whoafteraheartattackreceivedbetablockersordiabeticswhoreceiveyearlyhemoglobinA1Cdeterminations
Earlyreturn‐to‐worktrends Utilizationofreturn‐to‐workprogramsandnumberofworkerswithrestrictionsreturnedtoworkplace
throughstructuredreturn‐to‐work
Re‐injuryrates Vocationalrehabilitationutilizationandreturn‐to‐workafterrehabilitationtherapy
Patientsatisfactionrates
Percentageofthosewithdisabilitieswhoreturntowork(pre‐injuryoranotherjob)
PercentageofcompliancewithACOEM’sOccupationalMedicinePracticeGuidelines,3rdEdition
Permanentdisabilitylevelsandrates Occupationaldisabilityretirementawards(reductionovertime)
Litigationratesandworkers’compensationclaims/costs
Percentofeligibleworkersandlocationsreceivingprograms
1.5 Integrated Health and Productivity Management IHS Standards Integratedhealthandproductivitymanagementmeasuresthelinkbetweenworkerhealthandproductivityanddirectsemployerinvestmentsintointerventionsthatimprovehealthandorganizationalperformance.Withthisapproach,managingthehealthofapopulationisincorporatedasanimportantcomponentintheorganization’sbusinessstrategy.Organizationalresourcesarealignedtosupportanintegratedapproachtostrategicallyinvestinginworkerhealthandperformance.Effortsaremadetoquantifythetotaleconomicimpactofhealth,includingdirectmedicalandpharmacycostsofhealthcareaswellasindirectproductivity‐relatedcostssuchasabsenteeismandpresenteeism(presentatwork,butlimitedinsomeaspectofjobperformancebyhealthproblems).Healthinterventionsarechosenandevaluatedtomaximizepositiveimpactonhealth,attendance,andproductivity.
Fortheindividual,injuryorillnessimpactsonallaspectsoflife–athomeandatwork.Implementationofastrategythatpromotesworkerhealthandqualityoflifeisessentialtotheworker’soverallwell‐being.Foremployers,thisapproachisalsobeneficialasacost‐effectivemeansofreducinghealthcareexpenditures,improvingorganizationproductivityandhumancapitalmanagement,promotingworkerretention,loweringretrainingandreplacementcosts,andenhancingorganizationculture.
Application Response Discussintegratedprogramstoassessandenhancepopulationhealthstatusandreducetheimpactofoccupationalandnon‐occupationalillnessandinjuryoncostsandworkforceproductivityincludingturnoverrate,absenteeismandpresenteeism.
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Examples of Program Components, Processes, Dissemination
Analysisofhealthstatusandhealthneedsofthepopulation–numberofworkerswithchronicconditionsthataffectperformance,e.g.,asthma,arthritisareanalyzedformanagementandimprovement
Numberandrateofemployeeswithdisabilitiesareanalyzedformanagementandimprovement
Healthprograms,interventionsandbenefitsareselectedtooptimizeROIforhealth,attendanceandproductivity
Anintegratedhealthandproductivitymanagementapproachlinksmultipledepartmentsviacommittees,shareddataandprogramdevelopmentplans
Strategiesandinterventionsengageeffectivediseasemanagement,healthmanagement,andqualitycare
Preventivestrategiesandinterventionsfocusonenhancinghealthandproductivityoftheworkforceinalignmentwithbusinessstrategiesandappropriatefortheorganization’sworkforce
Workenvironmentsaredesignedtooptimizethebalanceofhealthandhumanperformanceoftheworkplace
Organizationpoliciesdemonstratecommitmenttoworkerhealth,well‐being,humanperformance,andproductivity
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
Examples of Outcome Measures and Trends:
Measurementofproductivity,e.g.,absenteeism,presenteeism,directandindirecthealthcarecosts
Impactofhealthstatusonabsenteeism,presenteeism,disability,turnover,workperformance
Numberofdifferentworkerassistanceprogramsoffered
Indicesofworkersatisfactionandorganizationalclimatesurveys
Calculationofcost/benefitanalysesorROIandVOI(valueofinvestment)
Clinicalandfinancialmeasureswithevidenceofactiontocorrectgapsfromevidence‐basedpreventionandtreatmentqualityofcarecriteria
Demonstratedimpactofimprovementsinhealthcareuponworkplacehealth‐relatedproductivity
Quantifythetotaleconomicimpactofhealth,includingdirectmedicalandpharmacycostsandindirectcostssuchasabsenteeismandpresenteeism
Percentofeligibleworkersandlocationsreceivingprograms
Demonstratedintegrationofhealthandsafetyactivities
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SECTION 2.0 ENVIRONMENTAL DIMENSION AsapartoftheircommitmenttotheEnviron‐mentalDimension,organizationswouldberequiredtoshoworganization‐wideresponsivenesstoawell‐definedsetofenvironmentalmetrics,includingreportingtheirratesofoccupationalandenvironmentalillnessesandinjuriesovertimewithevidenceofactionstakentoimproveresults,showingevidenceofstrictadherencetoproceduresforfollowupandresponsetoenvironmentalhazardsandreportingofrelevantenvironmentalinspectionsbyregulatoryagencies.
2.1 Health Evaluation of Workers IHS Standards Appropriatehealthevaluationsshouldbeperformedandworkersshouldbefullyinformedoftheresultsofeachhealthevaluation,whethernormalorifvariationsaredetected.Thoseperforminghealthevaluationsmustbefamiliarwiththeworkplace,understandanypotentialhazards,andhaveaccesstoworkerjobdescriptions.Arrangementsforcareshouldbemadewhenappropriateincludingtotheworker’sprivatephysician.Follow‐upinformationshouldbereceivedanddocumented,andappropriateactiontaken.Evaluationsshouldbecarriedoutonthefollowingoccasions:
Pre‐assignment/pre‐placement–Healthstatus,bothphysicalandemotional,shouldbeassessedbeforemakingrecommendationsregardingtheassignmentofanapplicantorcurrentworkertoajobtoassurethattheindividualcanperformtheessentialjobfunctionssafelyandwithoutendangeringthesafetyofothers.Thisrecommendationshallbebasedonanyorallofthefollowing:
Completemedicalhistory
Occupationalhistory(completeworkhistory)includingpastjobexposures
Assessmentoftheorgansorsystemslikelytobeaffectedbytheassignment
Evaluationofthejobdescriptionanddemandstowhichassignmentisbeingconsidered Compliancewithfederal,stateandlocallawsandregulationsincludingGINAregulations
Medicalsurveillance–Thehealthstatusoftheworkershouldbereviewedperiodicallywhenthereisapossibilitythatworkplaceexposuresorjobactivities(includingorganizationalstressfactors)couldhaveanadversehealtheffect.Medicalsurveillanceofworkersmayberequiredbyanemployerorregulatoryagencydirectivebecauseofpotentialexposuretohazardsintheworkenvironment.CertificationexaminationssuchasFederalAviationAdministration(FAA)orU.S.DepartmentofTransportation(DOT)commercialdrivermayalsoberequired.OEMand/orOEHprofessionalsshouldbeinvolvedindefininganddevelopingthemedicalsurveillanceprogramsthatidentifyearlysignsofpotentialhazardexposureandthusprotectworkers.
Infectioncontrol–OEMandOEHprofessionalsaresometimesinvolvedinscreeningforinfectiousdiseasesthatmayspreadattheworkplaceduringanepidemicorpandemic.Forthoseorganizationswithhealthclinicsorwhoofferon‐sitefluvaccineprogramsandhealthscreenings,programsshouldbeinplaceforinfectioncontrolandpreventionofthetransmissionofbloodbornepathogens.Appropriateinfectioncontrolproceduresshouldbeimplementedduringanepidemicorpandemic.
Application Response Describeyourworkerhealthevaluationandscreeningprograms.Providedetailedinformationonprogramstructureandspecificscreeningsfortargetpopulationsaccordingtospecifiedtimeframes,withfeedbackandfollow‐upofresults.Discussyourorganization’sinfectioncontrolprocedures,ifapplicable.
✔ CHECKLIST ❑ Programs exist ❑ Programs are well deployed ❑ Programs Measured Showing Trends ❑ Trends Tracked Over Time ❑ Data Used for Continuous Quality Improvement
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Example of Program Components, Processes and Dissemination Appropriatewrittenandauthorizedpoliciesandprocedures
Programsandprocedurestoassurethatrelevantmedicalsurveillanceinspectionsaredoneasrequiredbyregulatoryagencies
Listofhealthevaluationsavailablethatmeetregulatoryandorganizationrequirements
Schedulingsystemsinplacetotrackandidentifyworkerswhoneedexaminations Writtenjobclearance,certificationorreportofexaminationoutcome
Workerandsupervisornotificationofevaluationsrequiringchangesinjobfunction,workplacepractices,orotherenvironmentalfactors
Policyforobtainingworkerpermissiontoreleaseinformationtotheirpersonalphysicians Infectioncontrolproceduresclearlycommunicatedtoallmedical,healthandsafetyprofessionals
Periodicreviewofbloodbornepathogenprotocols
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
Examples of Outcome Measures and Trends Participationratesforevaluations(e.g.,documentedbyperiodicrandomchartaudits)chartedovertime
Recordofrelevantmedicalsurveillanceinspectionsasrequiredbyregulatoryagencies
Reportsofbiologicalmonitoringandotherhealthevaluationresults Compliancewithbloodbornepathogenstandards
Prevalenceratesforneedlesticks
Compliancewithappropriateinfectioncontrolstandards
No‐showandmissedappointmentratesforhealthandsafetyscreenings/monitoring
Satisfactionsurveyresultsbyusersofservicesandbymanagement
Medicalqualityauditresultsandpercentageofcorrectiveactions Compliancewithtechniciantrainingrequirements(e.g.,audiometry,pulmonaryfunction,EKGs),
calibrationofequipment,testingprocedures,andinterpretationparameters
Percentofeligibleworkersandlocationsreceivingprograms
Percentofparticipationinmedicalsurveillanceorhealthexaminations
2.2 Workplace Health Hazard Evaluations, Inspection and Abatement IHS Standards OEMphysiciansandOEHprofessionalsshouldroutinelyinspectandevaluatetheworkplacetoidentifypotentialhealthandsafetyhazardsandsub‐optimalworkpractices.OEMandOEHprofessionalsshouldbefamiliarwiththeworkingenvironment,workertasks,workerjobdescriptions,potentialchemical,physicalandbiologicalagentexposures,andmentalstressesthatmayresultfromthesejobsviaqualitativeand/orquantitativeassessments.
Application Response Describeindetailtheorganization’sprogramforinspectionandevaluationofpotentialrisksfromworkplacehealthandsafetyhazards.Discussproceduresincludingfollow‐upofidentifiedhazardsandasummaryoftheorganization’shealthandsafetyrecord.Alsoprovidetheorganization’simpactonthelocalcommunityenvironmentandtheorganization’splansofactiontopreventenvironmentalexposure.Provideanyinformationrelatedtobeinginvestigatedforenvironmentalexposuretothelocalcommunity.
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Examples of Program Components, Processes and Dissemination Writtenpoliciesandprocedures Systematicprocessforanalyzingtheunderlyingrootcausesofenvironmentalaccidents/incidentsand
recommending preventive measures to minimize or eliminate in the future
Rapidandappropriateresponsestohazardidentificationandaccidentinvestigations Frequent,systematicinteractionofOEHprofessionalswithindustrialhygiene,safety,andenvironmentalengineering
Systemstoensureriskassessment,riskmanagementandthehierarchyofcontrolmeasuresareinplace Reviewsofprocessesandproceduresaimedatusing“leasthazardous”technologyand“design‐in”principles(e.g.,forergonomics)
Anexposuremonitoringprogramensuringthatallregulatoryandorganizationrequirementsaremetandanyoverexposuresofpersonnelaredetected,monitored,evaluated,documented,mitigatedorcontrolled
Retentionofmonitoringrecordsofworkersexposuresastheyrelatetojobhistories Asystematicprogramforevaluationofinjuries,illnessesandOEH&Ssurveillanceprogramresultsforidentificationofrootcauses
Proceduresforsystematicmonitoringofexposuresandproperprotectivemeasuresarecommunicatedandpertinenthealthdataarerecordedandreviewed
Programsandservicesareofferedtoworkersaffectedinalllocations Newmaterials,designs,processes,products,procedures,acquisitions,divestmentsanddemolitionsarereviewedforhealthhazardcontrolevaluationsandrecommendations
Systemsareinplacetoensurethatthemanagementofenvironment,healthandsafetyiseffective,e.g.,self‐inspection,internalorexternalaudit
Examples of Outcome Measures and Trends Complianceratesforproceduresandresults Numberofcitationsfromhealth/safetyregulatoryagencies,orlawsuitsrelatingtohealth/safetyissues Resolutionsofworkplacehazardsorriskse.g.,reducednumberormagnitudeofactualandpotentialworkplacehealthrisksidentified
Numberofchangesandimprovementsthatpromotebetterworkersafetyperformancee.g.,ergonomics Percentageofrecommendationsthatrequireactionsforhealthprotectionthataredocumented,communicatedandcompletedtoresolution
Percentageofindustrialhygienemonitoringresultsthatexceedthepermissibleexposurelimit Outputfromauditse.g.,closureofactionitems;auditrating
2.3 Education Regarding Worksite Hazards IHS Standards Health,safetyandenvironmentalprogramsareinplacetoeducateworkersaboutpotentialhazardsattheworksiteandtheirpotentialforimpactingthelocalcommunityenvironment.Everyworkershouldknowthepotentialhazardsinvolvedineachjobtowhichheorsheislikelytobeassignedandwhatthepotentialrisksareinrelationtothesehazards.
TheOSHAHazardCommunicationStandard(“right‐to‐know”)stressestheimportanceofworkerknowledgeofchemicalusage.Stateandlocalstatutesalsomayrequirereportingofsomeoccupationalbiomonitoringresultsandillnesses.Effectivecommunicationproceduresshouldensurethatallstakeholders,bothwithintheorganizationandthelocalcommunity,areinformedonanongoingbasisoftheidentitiesofthesehazardouschemicals,associatedhealthandsafetyhazardsandappropriateprotectivemeasures.
Systematicreviewregardingthequalityofinformationdisseminatedundertheprogramisnecessarytodeterminewhethertheinformationisaccurate,up‐to‐dateandreadilyaccessiblefromthematerialsafety
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datasheets(MSDS)andothercommunicationmaterials.SubstantiveguidancefromOEMandOEHprofessionalsshouldassistworkerstoevaluatehazardsandrisks,provideworkertraining,andassistinthepreparationoftheMSDS.Along‐termapproachtoimprovinghazardcommunicationshouldbepartofanyprogramandincludeprovisionstoaddressworkercomprehensionofthehazardsorrisksandstandardizedapproachestoeducateworkersaboutlabelsandtheMSDSformat.
Application Response Describeyourorganization’sformalcommunicationprogramsandprocedurestoensurethatworkersareeducatedabouthealth,safety,andenvironmentalhazardsandrisksinherenttotheirspecificjobsincompliancewiththeOSHAHazardCommunicationStandard.Alsodescribeyourprogramsforensuringcommunicationsareupdated,appropriateandclearlyunderstood.DiscussthelinkagewithlocalcommunityofficialsandEMSresponderstoassuretheyareawareofallchemicalsand/orhazardsatyourworksiteandappropriateresponsemeasures.
Examples of Program Components, Processes and Dissemination Writtenpoliciesandproceduresinplace Systemtoensurethatallrelevantprogramelementsarecovered Up‐to‐dateprogramsfor“hazardouscommunications/workerrighttoknow” Acomprehensiveprogramforinitial,ongoingandperiodicrefreshertrainingonpotentialworkhazards Documentedworkertrainingonriskassessmentandknowledgetransferofreproductivehazards,
chemicalhazards,hearingprotection,bloodbornepathogens,manuallifting,ergonomics,safety,etc.
Programsthatensurethathealthhazarddataandexposurecontrolrequirementsarereadilyavailablethatlistchemical,physicalandbiologicagentsandradioactivematerials
Engineeringworkpracticestoensurecontrolofhazards Regularandsystematiccommunicationsprogramstotheworkerpopulationandlocalcommunity
officialsandEMSresponderswithspecialemphasistoallpotentiallyexposedpersonsasdefinedbylaw, organizationpolicyandgoodOEH&Spractices
Proactiveadviceprovidedonhealthandhumanfactorissues,suchasergonomicsandshiftwork Programsthatensureinformationiskeptcurrentaboutapplicablelaws,regulations,permits,
codes,workplacestandards,andpractices Systemsforresolutionofconflictsaboutpotentialhazardsandtheresultingoperating
requirementsdocumentedandcommunicatedtothoseaffected Programstoensureservicesareofferedtoallappropriateworkersandatalllocations
Examples of Outcome Measures and Trends Rateofcompliancewithpoliciesandprocedures Resultsofsurveysbyworkers Percentageofcompliancewithworker“right‐to‐know”forallknownidentifiedhazards,suchas
bloodbornepathogens,etc. Participationratesforworkertraining,trainingresultsandupdating Quantitativeresultsoforganization’smonitoringofeducationandtrainingneeds Effectivenessoftrainingasmeasuredbyposttestevaluationandcomplianceinspections Quantitativeevidenceofimpactoftrainingonhealth,safetyandenvironmentalprograms,issues,
illnessesandinjuries Number of changes to training that resulted from training being adapted to address actual environmental and/or
occupational injuries and illnesses
Number of adaptations of programs to address safety performance
Quantitative results of audits done by professionals to ensure compliance
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2.4 Personal Protective Equipment (PPE) IHS Standards Health,safety,andenvironmentalprogramsshouldensurethatworkerswhoneedpersonalprotectiveequipment(PPE)areclearlyidentified,providedwithproperselection,andfittedwithpersonalprotectivedevices.Theseincludeequipmentsuchashearingandeyeprotection,glovesandrespirators.Theorganizationshoulddeterminethatthedevicesprovideadequateprotectiontoworkers.Theorganizationshouldalsoprovideadequateeducationtoworkersintheproperutilization,cleaningandcare,andwhereapplicable,disposalofequipmentforallpotential uses.Furthermore,workerswhoutilizerespiratorsshouldbeenrolledinanappropriatemedicalevaluationprogram.Thisshouldbeprovidedtoallimpactedworkersatallrelevantsites.OEMandOEHprofessionalsandmanagementshouldactivelyencourageworkercompliancewithpropercareanduseofequipment.
Application Response DescribehowworkersareevaluatedregardingtheirneedforPPEdevices,howtheyarefittedfortheproperequipment,andtraining.Includeinformationaboutequipmentutilizationrates,workereducationandenforcementofuse.
Examples of Program Components, Processes and Dissemination DocumentedsystemforidentificationofneedforPPE AdocumentedprocessforevaluationofworkersrequiringPPEandtheproceduretoensurethatall
affectedworkers(includingcontractworkers)areprovidedwithequalhigh‐qualitysafetyandhealthprotectionaswellastraining
Asystematicmeasurementsystemtoprovidevisibilityandcontroloftheprocess AsystematicapproachthatreviewsallhazardsandensuresthatallhazardcontrolshavebeenevaluatedandusedpriortousingPPE
AprogramtoensurethatPPEiscertifiedbyappropriateindependententities,suchastheNationalInstituteforOccupationalSafetyandHealth(NIOSH),andAmericanNationalStandardsInstitute(ANSI)
WrittenpoliciesonvoluntaryuseofPPE WrittenpoliciesandtrainingonPPEstorage,cleaning,andrepairprocesses Programsthatensurethatservicesareofferedtoallworkersinalllocations ProgramstoensurethatemployeesareabletowearPPEandthatitfitsappropriately AuditofPPEprogramstoensuretheyarecontinuingtobeeffective
Examples of Outcome Measures and Trends Protectiveequipmentutilizationratesforhearingand/oreyeprotection,respiratoryprotection,radiationshielding,blood/fluidbarriers,heatresistantgarments(e.g.,Nomex®,gloves,etc.)
Quantitativeassessmentofworkersknowledgeandskillsrelativetorequirements Quantitativeresultsoftrainingdocumentationandassessmentoftrainingeffectiveness QuantitativeevidenceofeffectivenessofPPEproceduresandinstructionsinpreventingoccupationalinjuriesandillnesses
Trainingcompliancerates Impactoftrainingonissuespotentiallyrelatedtosub‐optimalPPEuse InjuryratesfromfailuretousePPEproperlyasrootcause(e.g.,needlestickinjuries) Resultsfromquantitativefittesting(bothrespiratorandhearingprotection) Resultsofinternalauditsforappropriateuseandcompliance Numberofnewcasesofworkrelated,noiseinducedhearingloss BenchmarkcomparisonsofuseofPPEwithotherorganizationsofsimilarsizeinthesameindustry NumberofworkersrequiredtowearPPEandreductionsinthepercentageovertimeowingtohazard
abatement
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2.5 Toxicological Assessment & Planning
IHS Standards Health,safetyandenvironmentalprogramsshouldincludeprocedurestoincorporateadviceonthenature,adequacy,andsignificanceoftoxicologicaltestdatapertinenttotheworkplace.Toxicologicalassessmentsshouldincludeadviceonchemicalsubstancesthathavenothadadequatetoxicologicaltesting.Whereadequatedatadoesnotexist,theOEMandOEHprofessionalsshouldrecommendappropriatecontrolmeasurestoprotect staffandwherethereisgoodsciencebasedrationale,medicalsurveillanceandtestingpractices.Processesshouldbeinplacefortoxicologicalassessmentofnewchemicalspriortointroductionintheworkplace.OEMandOEHpersonnelshouldrecommendappropriateprotectionandsurveillanceofworkersinkeepingwithdataavailableoruntilappropriatedataarereceived.
Application Response Describeyourprogramfortoxicologicaltestingofchemicalsthatareproducedorusedintheworkplaceincludingproceduresforchemicalsforwhichadequatedataarenotavailable.Discusstheprocessforassessmentofnewchemicalspriortobeingbroughton‐site.Includeyourproceduresforrelevantcommunicationstoworkersandappropriateactions.
Examples of Program Components, Processes and Dissemination Documentedsystemforidentificationofchemicalsfortoxicologicaltesting
Acomprehensiveprocessforreviewandcompletionofparticularlyhazardoussubstances
Aprogramtoensurethoroughnessoftoxicologicalevaluations
Procedurestoproactivelypreventfuturehealthand/orenvironmentalproblemsfromproducts/services
Theamountandthoroughnessoftestingonproducts/servicessoldbytheorganization,andrelevanceofthistestingtocurrentandfuturehealthconcernsisdocumentedandreviewed
Thehealthofficerisadvisedandreviewsproposedmaterialsoragentsbeforetheintroductionofthesenewmaterialsoragentstoasite
Informationavailableforrecognizingandtreatingoverexposuretofeedstockandtheenvironmentalimpactfromproductsfordistributiontothelocalcommunity
Workerandcustomerreportsofadversehealtheffectsrelatedtoproductsandservices
Informationonpotentialhazardsassociatedwithproductsandguidancetoensureproperhandling,useanddisposalisdocumentedandcommunicated
Safetydatasheets(SDS)arereadilyavailableatallrelevantworksitesforeaseinconsultingincaseofanaccident
Programstoensurethatservicesareofferedtoallworkersatalllocations
Examples of Outcome Measures and Trends
Numberoftoxicologicalevaluations
Numberoftimesthatthetoxicologicalevaluationsledtochanges/improvementsinworkprocesses
NumberofSDSdevelopedasmanufactureroftheproduct
FrequencyofupdatingtheSDS
Numberofdifferentsourcesofdatatheorganizationutilizestopredictfuturetrendsthatmayimpacttheirproducts,services,oroperations
Incidencesofexposurestojudgeneedsinthisarea
Fundscommittedfortoxicologicalresearch
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2.6 External Environment IHS Standards Health,safety,andenvironmentalprogramsfocusnotonlyonworkplacehazardsbutalsotheimpactofemissionsonthecommunityandprotectionoftheenvironment.Organizationsandworkersmustgobeyondtherisksofspecificjobs.Stepsmustbetakentoencourageidentificationofworkplacehazardsandexternalpollution.Energyconsumptionisanexpectationofthecompanyandworkerinvolvementandparticipationiskey.Appropriaterecyclingofsolidandhazardouswasterequiresthecommitmentofmanagementandcooperationoftheworkforce.Thesafetyofmaterialsused,manufacturingprocessesandprocesschanges,productsandbyproductsmustbeevaluatedfortheimpactontheworkplaceandtheexternalenvironment.Workerandcommunityawarenessofpotentialhazardsisnotonlyaregulatoryrequirementbutmustbemadeapartofdailypractice.Effectivedisasterandcriticalincidentmanagementrequireseducationandongoingdiligencewithafocusontheworkerandthecommunity.
Application Response Describeindetailtheorganization’smethodologyforreviewingandimprovingitsimpactontheexternalenvironment.Providedetailsonwhoreviewtheprogram,thefrequencyofthereviews,andwhohasresponsibilityforimprovementandimplementation.Providedetailsthatindicatehowtheinformationisgatheredandisusedinmakingdecisions.Describehowtheinformationisconfirmedtobecredible.Providedetailsontheimprovement process,includingtimetablesprocedures,relevantanalyses,metricsandcorrectiveactionstaken.Provideexamplesofprogramsthathavebeenevaluatedandmodifiedbasedonthisprocessandhowtheimprovedprogramsimpacttheexternalenvironment.
Examples of Program Components, Processes and Dissemination Documentedsystemforidentificationandquantificationofchemicalsthatentertheexternalenvironment Acomprehensiveprocessforreviewandidentificationofmethodstominimizeenvironmentalimpactof
chemicals Procedurestoproactivelypreventfuturehealthand/orenvironmentalproblemsfromproducts/services Efficientuseandmeasurementofenergyandreductionofgreenhousegases/CO2 Informationavailableforrecognizingandtreatingoverexposuretopotentiallyhazardouschemicals Informationavailableforrecognizingtheenvironmentalimpactfromproductsfordistributiontothe
localcommunity WorkerandCustomerreportsofadversehealtheffectsrelatedtoproductsandservices Recyclingofwastesfromtheproductionfacilities/workplace Recyclabilityofproductsmanufactured Supportforgreenareas/forestsatornearfacilities Manufactureofproductsofenvironmentallyfriendlyproductsfromsuppliers/rawmaterials(LifeCycle
Analyses)http://www.epa.gov/epp/pubs/guidance/finalguidance.htm Educationtocommunitytopotentialrisksofproductsincludingcatastrophes(compliancewith
environmentalRighttoKnowLaws) Personalsupportofenvironmentalorsustainablegoals(e.g.homewasterecycling/disposal,home
energyuse,carpooling,etc.)
Examples of Outcome Measures and Trends Numberofregularenvironmentalevaluationsandaudits Numberoftimesthattheevaluationslettochanges/improvementsinworkprocesses Postingofcommunityairpollutionlevels Numberandfrequencyofregularenvironmentalauditsandreviewoffacilitiesandwastedisposalsites TheToxicReleaseInventory(TRI)requiredbyEPAannuallyandrecordsoftheamountof“toxics”used RequirementstofollowISOenvironmentalguidelines(14001) Fundscommittedfortoxicologicalresearch
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2.7 Emergency Preparedness, Continuity Planning, and Disruption Prevention IHS Standards Theorganizationshouldassurethathealth,safetyandenvironmentalprogramsincorporateplansformanaginghealth‐relatedaspectsofemergencies,includingdisasters,terrorismandpublichealthhazards.Thisisimportantforthesafetyandwelfareoftheworkersandthelocalcommunity,aswellasforthecontinuityplanningandpreventionofdisruptionoforganizationalinitiatives.Sincetheorganization’shealthandsafetypersonnelareanessentialpartofdealingwithanemergencyattheworkplace,planningforemergenciesshouldbedoneinconjunctionwiththelocalcommunity.UnderTitleIII‐SuperfundAmendmentsandReauthorizationAct(SARA),organizationscoveredundertheHazardCommunicationStandardarerequiredtomaketheirchemicalinventoriesknowntoemergencyresponsegroupsofthelocalcommunity.Wherethesestandardsarenotmet,itistheresponsibilityofOEMandOEHprofessionalstoworkforimprovement.Concernorfearofterroristattacksrequiresconsiderableprofessionaljudgment.OEMphysiciansandOEHprofessionalsshouldassurethatpropertreatmentreferralnetworks,suchasEAPandcriticalincidentdebriefing(CID)resourcesareinplace.
Application Response Describeyourplansforworkplaceandlocalcommunityemergenciesthatincludetheorganization’sresponsibility,procedures,drillsandcommunitycommunication.Includethedescriptionoftheparticipationofhealthservicespersonnelinhazardousmaterialsresponseandfollow‐up.
Examples of Program Components, Processes and Dissemination Asystematicresponseplanexiststhatisintegratedwiththelocalcommunityemergencyservices
Theresponseplanincludescleardelineationofmeasuresofresponsibilityincludingemergencycare
Asystematicprocessisusedtodefinestandardsandgoalsandprofessionalnetworkstomitigatedisastereffects
Goalsandstandardsspecifylevelsofperformancethatwillleadtheorganizationtoaworldclasslevelofperformanceonthesefactors
Thereisarobustsystematicprocessforidentifyingpotentialrisksandassessingthoserisksandpossibleconsequences
Regularreviewmeetingsandtabletopexercisesareheldtoassessemergencypreparednessplans
Plansarereviewedasnecessarybaseduponchangesinrequirements,theenvironment,orotherfactors
Workerandpublicconcernsareincorporatedintotheorganization’splanningprocess
Thereisaprocessforintegratingfutureoremergingtrendsintotheplanningprocess
Localmedicalresourcesareinformedofpotentialworkplaceinjuriesandillnesses
RegularfirstaidandCPRtrainingandemergencymedicalresponseisdocumented
Investigationsanddebriefsofallutilizationofemergencyservicesareaccomplishedwithidentificationofkeylearnings
Aprogramisinplacetoensurethatallworkersknowemergencyproceduresandservices
OEM,OEHandsafetystaffaremembersofcommunitypanels
EAPstrainedandskilledinconductingCriticalIncidentDebriefing(CID)
Thereisaprocesstoensurethatallprogramsandservicesareofferedtoallworkersinalllocations
Emergencyresponseteams
Firstaid/CPR/automaticexternaldefibrillator(AED)trainingandemergencydrills
Agreementwithemergencymedicalservicesforrapidresponsewhennecessarywithregularlyscheduleddrills
UseofappropriateACOEMconsensusstatementsonAEDsandworkplaceemergencies
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Examples of Outcome Measures and Trends Numberofdrillsandassessmentsofreadiness
Reportsondegreeofsuccessinresponsetorealorneardisasters
Progressinmeetinggoalsandstandardsinareasofpublicresponsibilityandcorporatecitizenship
Surveyresultsofworkerandpublicconcerns
Numberofcorrectiveactionsand“lessonslearned”fromdrills,table‐topsessions,andrealincidents
NumberofCIDsandresults
NumberandfrequencyofmeetingswithcommunitygroupsinvolvingOEM,OEHandsafetystaff
NumberofusesofAEDsandnumberofsaves
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SECTION 3.0 SOCIAL DIMENSION Asapartoftheircommitmenttothesocialdimension,organizationswouldberequiredtodemonstrateadherencetodiverseactivitiesaimedatensuringengagementofIHSstrategieswithemployees,rangingfromestablishingandmaintaininghealthandsafetyeducationprogramsandwellcommunicatedpopulation‐healthstrategiestoprovidingevidenceofextendingequalaccesstobenefits,thereductionofdisparitiesamongemployeesinhealthandsafetyoutcomes,andbeingagoodcorporatecitizenofthecommunity–includingparticipationincommunity‐widehealth,safetyandenvironmentalprograms.
3.1 Evaluation and Quality Improvement IHS Standards Programevaluationisnecessarytoensurethatprogramsmeetobjectivesandoperateeffectivelyandefficiently.Programevaluationmethodswillvarybutperiodicreviewisnecessarytomakesurethathighstandardsarebeingmetandmaintained.Datacollectionisnotsufficient;theinformationmustbecollated,validated,tracked,trendedandusedinplanningappropriate,specificinterventionsforqualityimprovement.
Application Response Describeindetailtheorganization'smethodologyforreviewingandimprovingitshealth,safetyandenvironmentalprograms.Providedetailsonwhoreviewstheprograms,thefrequencyofthereviews,andwhohasresponsibilityforimprovementandimplementation.Providedetailsthatindicatehowtheinformationusedinmakingdecisionswasgatheredandwhatmakesitcredible.Providedetailsontheimprovementprocess,includingtimetables,procedures,relevantanalyses,metricsandcorrectiveactionstaken.Provideexamplesofprogramsthathavebeenevaluatedandmodifiedbasedonthisprocessandhowtheimprovedprogramsimpacthealth,safetyandenvironmentalresults.
Examples of Program Components, Processes and Dissemination Annualevaluationofsafetyandhealthmanagementsysteminordertomaintainknowledgeofthesite’shazards
Welldefinedprogramcomponentsandexpectationssubjecttoreview Benchmarkingofeffectivenessofsystemelements
Verificationofgoalscompletedandmodificationofgoals,policiesandproceduresaswarranted
AdherencetoACOEMandotheroccupationalhealthandsafetyorganizations/CodeofEthicalConduct Evidenceofcommunicationacrossallchannelsincludingworkerinvolvementandinvolvementofsafetyandhealthdepartmentsinplanningfornewequipment,processes,buildings,etc.
DeterminationofeffectivenessofOEH&Smanagementaftereachaccidentorincident Positiveresponsetointernalandexternalaudits
Robustauditprogramsandconsiderationofexternalaccreditation,e.g.,ISO14001andISO18001
Examples of Outcome Measures and Trends Percentageofcompletedrecommendationsinperiodicwrittenevaluations
Resultsofauditsandmanagementplans
Programgoalsthathavebeenachievedandmodifiedtoaddressopportunitiesforimprovement
Resultsandtrendsofpatientandclientsatisfactionsurveys
Numberofrecognitionawards(state,nationalorother)
Programs exist Programs are well deployed Programs Measured Showing Trends Trends Tracked Over Time Data Used for Continuous Quality Improvement
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3.2 Innovation and Social Responsibility IHS Standards Inthespiritofcontinuousimprovementandinnovation,organizationswillcontinuetoexpandtheeffectivenessandreachofprogramsthatimpactthehealth,safety,and/orenvironmentofemployeesandthecommunitiesinwhichthecompanyoperates.Thesocialresponsibilityofthecompany—thatis,itsleadershipandengagementincommunityhealthandsustainabilityactivities,aswellasitsemploymentofalldemographicgroups—isanimportantaspectofitsoverallIHSrating.TheIHSStandardsaresetforthtoprovideinsightintoprogramsthatprovidepositiveimpactandevidenceoftheseprogramsshouldbeprovided.
Application Response Describeindetailanynewinnovativeprogram(s)thathasshownpositiveimpactonthegoalsandobjectivesofworkerhealth,safetyorenvironment.Discusstheinsightfortheprogram;providetheprocedures,processesandgoalsthatwereestablished.Provideinformationondatacollection,analysesandreportingofresearch.Giveevidenceoftheresultsachievedfromtheprogram.Giverecommendationsandinsightsthatsupportthecontinuationofthiseffortandacommitmenttoongoingresearch.Indicateanyarticlesorpublicationsfromtheresearchconducted.
Theworkforcecompositionshouldbereflectiveofthedemographicsofthecommunityinwhichthecompanyresidesandthisdiversityoftheworkforceshouldbeevidentatallorganizationallevels.Organizationsshouldengageincommunityactivitiesonanannualbasis.
Examples of Program Components, Processes and Dissemination
Areasofunmetneedsthathavebeenidentified,suchas:
Immunity/conversionrates
Illness/injuryclusterinvestigation
Patternsofillnessandinjuryevaluationstoassesspossibleworkplacecausalfactors
Epidemiologicortoxicologicalstudiesconductedtoaddressspecificconcernsoraspartofgeneralhealth surveillance
Descriptionoftheprogram,includinghowanunmetneedwasidentified,developmentandimplementationoftheprogramandpreliminaryresultsoftheprogram
Examples of Outcome Measures and Trends
Useofresultsformedicalscreeningandsurveillancepurposes
Resultsusedtodevelopnewworkplacesafetyand/orwellnessprograms
Studiespublishedinpeer‐reviewedjournals
Impactofthestudiesonreducinghazardsandonorganizationalpoliciesandprocedures
Positiveinfluenceonscientificregulatorydecisions
Employeecompositionreflectsthedemographicsofthecommunitybygender,ethnicity,sexualorientation,ageetc.determinedbythenumberofemployeesinanequitygroupX100dividedbythetotalnumberofemployeesatthesamepointintime
Numberofcommunityactivitiesengagedinannually
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3.3 Traveler Health
IHS Standards Organizationsshouldhaveamethodtoadvisetravelersconcerningvarioustravel‐relatedissues,suchaspreventionofjetlag,foodandwaterbornediseases,localoutbreaksofillness,motionsickness,andtheneedformedicalcareabroad.Vaccinationsandinformationareavailabletoworkerswhomaybeexposedtoadiseaseforwhichthereisaneffectivevaccination(e.g.,hepatitisAandBvirusexposureintraveltocertainareas).
Application Response Describeyourtravelhealthprogramforemployeesincludingavailabilityofimmunizationsagainstinfectious diseaseandothervaccinationsaswellasmedicalevacuationprotocolsandgeneraltraveladvice.
Example of Program Components, Processes, and Dissemination
Formaltravelprogramsfordomesticandinternationaltravelers/assigneesasappropriatepre‐tripandpost‐trip/expatriatesevaluation
Travelmedicineadviceforinternationaltravelers/expatriatesandfamiliesincludingsendingcompanyteamstoaidinresponsetonatural/man‐madedisasters.
AdvicebyOEMandOEHprofessionalsonsanitationandhygiene
Systemanddatabaseusedforprovidingup‐to‐datetravelhealthadvisories
Medicalevacuationplansforinternationaltravelers
Mentalhealthassessmentandpreparationforexpatriatesandfamilies
Assessmentofmedicalneedsofinternationaltravelersandqualityofcareforinternationaltravelers/assignees/expatriates
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
Examples of Outcome Measures and Trends
Immunizationcompliancerateswithnationalguidelines(e.g.ACIP)forappropriategroupsforrequiredroutine(influenza,pneumococcaldisease)andrecommendedvaccines(e.g.HepAandB,typhoid,yellowfever,tetanus,Japaneseencephalitis,meningitis)
Compliancewithguidelines(e.g.ACIP)withmalariaprophylaxis
Participationratesoftravelerswhoneedmedicalassessments
Assessmentofsatisfactionofprogressbytravelers/expatriates
Post‐triphealthstatusreports
Failureratesofexpatriateassignmentsduetomedicalormentalhealthproblems
Percentofeligible(indicatedatrisk)workersandlocationsreceivingprograms
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IHS Standards Healtheducationandhealthpromotionprogramsareintegraltomaintainingandenhancingthehealthofworkerpopulations.Periodichealthscreeningexaminationsandeducationaimedatmaintainingandpromotingthehealthofworkersareimportantaspectsofcomprehensiveworkerhealth,safety,andenvironmentalinitiatives.Healthriskappraisals(HARAs)canbeusedtoidentifyandprioritizebeneficialhealthbehaviorchangeprograms.
Forexample,smokingcessation,nutrition,andexerciseprogramshavebeendocumentedtoimprovehealthandproductivity.Evidenced‐basedapproachesareusedtodevelopthecontentandperiodicityofpreventiveservicesandarereviewedregularlybyknowledgeableprofessionals.Workerparticipationistypicallyvoluntaryhowevertheseprogramshelpmaintainandpromotethehealthandproductivityoftheworker,improvemoraleandfosteremployerconcernforworkers’generalwelfare.
Thehealth,safety,andenvironmentalprogramsshouldalsoprovidetreatmentforemergencyconditions,includingemotionalcrisesthatoccuramongworkerswhileatwork.Thistreatmentmayonlybepalliativeandtopreventlossoflifeandlimbor,wherepersonnelandfacilitiesareavailable,maybemoredefinitive.Theseservicesareconvenientfortheworkerandenhanceproductivityintheworkplacebyhelpingtoreducetimeawayfromtheworksiteforminorinjuryorillness.Employersmayevenarrangeforpersonalmedicalcaretobeprovidedattheworkplace.Careattheworkplaceshouldbeconsistentwithlocalstandardsofpatient/physicianrelationships.OEM/OEHprofessionalscanmotivateandeducateworkerstotakeresponsibilityformakingwise,healthierchoicesinlifestylebehaviorandpersonalhealthcaredecisions.
Application Response Describeyourhealthandwellnessprogramsincludinghealthriskfactoridentification,populationhealthstatusassessmentsandactivitiestoreducetheriskofcommonacuteandchronicdiseases,andotherhealth‐relatedconcernsthatmayadverselyaffecttheworkforce.Describetheprocessesandproceduresyourorganizationhastodiagnoseandtreatnon‐occupationalinjuryorillnessoccurringwhileatwork.Describeprogramsinplaceforperiodichealthscreeningstoidentifyrisks,promotehealthylifestyles,andencourageappropriateuseofpreventivehealthservices.
Examples of Program Components, Processes and Dissemination Seniormanagementsupport,participationandperiodicfeedbackonprograms
HRAsandassessmentofreadinesstochangehealthbehaviors
Riskfactorscreening,e.g.,cardiovascularfitness,bodymassindex(BMI),bloodpressure,immunizations,allergydesensitizationandcholesterol
Specificcancerscreeningprogramsforearlydetectionfollowingnationalguidelines Healthinformationandhealtheducationprogramse.g.,weightloss,smokingcessation,healthclubs,
smoke‐freeenvironment,healthyvendingmachineandcafeteriaselections
Personalfollow‐upofthoseathighrisk
Evidenceofapreventiveapproachtoworkerhealth,safety,environmentandergonomics
Non‐occupationalillness,ergonomically‐relatedcomplaints,symptomsanddiseaseprevalence reviews
GuidelinesandcommunicationstoOEMandOEHhealthprofessionalstoencouragehealthpromotion
Effectivecommunicationstoemployeesonwhattheycandotoreduceillness,diseaseandaccidents
Policiesandprotocolsonmedicalcare/treatmentfornon‐workrelatedinjuriesandillnesses
Patientsatisfactionsurveys
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
3.4 Health Promotion and Wellness Including Non-occupational Injury and Illness Management
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Examples of Outcome Measures and Trends ParticipationratesforHRAs,screeningprograms,andhealtheducationandbehaviorchangeprograms
Prevalenceofhealthrisksandchronicdiseaseinworker/beneficiarypopulations
Projectionofhealth‐relatedcostsandreturnoninvestment(ROI)analyses
Effectivenessofriskreductionprograms
Impactofprogramsonclinicaldataandproductivityandonsafetyi.e.reductionofillness/injury/absence
Treatmentactivitylogs
Costsofdifferentpatternsoftreatment Participation/utilizationratesforfluvaccineprograms
Productivityimprovementsduetoon‐sitemedicalservices,e.g.,numberoflostwork‐dayssavedperworker
Patientsatisfactionrates
Utilizationratesforon‐sitemedicalservices
Percentofeligibleworkersandlocationsreceivingprograms
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3.5 Health Benefits Management
IHS Standards Organizationsarechallengedtoskillfullymanagehumancapitaltomaximizethehealth,safety,andpro‐ductivityoftheworkforce.Healthbenefitsmanagementincludesassessingandidentifyingspecifichealthcareneedsofagivenworkerpopulationandhelpingtomaximizeavailableresourcestohavethelargestimpactondeliveryofhigh‐qualitycaretoworkers,retirees,andtheirfamilies.Actuarialclaimsanalysisfortrendsindiagnosesandcostscanfacilitateplanningappropriatediseasemanagementandhealthpromotionprograms.Actuarialrate‐settingcanhelpguideappropriateutilizationofmedicalservices.Pharmacybenefitplandesigncanreducecostswhileprovidingaccesstoappropriatemedications.Qualityofcareofnetworkproviderscanbeevaluatedagainstevidence‐basedbestpracticesandstandardsandproviderscanberewardedforhighestqualitycare.OEMandOEHprofessionalsprovidevaluableassistanceinevaluatingworkerhealthbenefits,benefitcosts,andtheadequacyofcareprovided.OEMandOEHprofessionalsareinauniquepositiontoapplyepidemiology,statistics,andinformationsystemstoassurequalityofcareandidentificationofthemosteffectiveopportunitiestoimprovethehealthofadefinedpopulationofworkers/beneficiaries.
Application Response Discussthehealthplandesignanditsresponsetoemployeeriskfactorsandassuringqualitycareservicesbyallhealthproviders.DescribehowOEMandOEHprofessionalscollaboratewithhumanresourcespersonnelinthedesign,evaluationandqualityassuranceofworkerhealthbenefits.
Examples of Program Components, Processes, Dissemination Informationforemployeesonmedicalplanchoicesandexplanationof availableservices,benefitsandhow
planswork
Listofplanprovidersincludingprimarycarephysicians,specialistsandotherhealthpractitioners
Policiesavailablethatdefinerightsandresponsibilitiesofplanmembers
Programsavailablethateducateworkersaboutself‐careandappropriateuseofmedicalcare
Healthbenefitplanactivitiesthateducateandpromotegoodhealth
Healthbenefitstailoredtoworkerhealthneeds,organizationalcultureandproductivitygoals
Benefitplancoverspreventiveservicesbasedonnationalguidelines
Assistanceprovidedtoworkerstoaccessappropriatecareandensuremembersreceivethelevelofcareneeded
Evidenceofimprovingaccesstoprimarycareandbehavioralhealthcare
Guidelinestoassistplanphysicianstoprovideoptimalcare
Programsandservicesutilizationtrends(includingwhereappropriatepointofservicesurveys)
Healthbenefitsandaggregateclaimsdatareadilyavailablefrominsurancecarriersor3rdpartyadministrators
Measuresofappropriatenessandaccesstomedicalcare
Healthplanactivitiestoassistinthemanagementofchronicillnesswhileworking,e.g.,NCQA®LivingwithIllnessbooklet
Measuringandtrackingofaggregatehealthriskfactorsforemployeesandotherbeneficiaries
Integrationofhealthbenefitplandesignwithstrategicdirectioninhealthpromotion
Dataontheoutcomesforprimarycarephysicians,specialists,andotherpractitionersinhealthplans
Localphysiciancommunityproactivelyengagedtopracticeevidence‐basedmedicineusingpracticeguidelines
Pharmacybenefitdesignbasedonbeneficiaryhealthriskfactors
Effectiveprogramforimprovingthequalityofclinicalcareprovidedtohealthplanmembers
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Examples of Outcome Measures and Trends
Evaluationofhealthplanquality,e.g.,NationalCommitteeforQualityAssurance(NCQA),HealthPlanEmployerDataandInformationSet(HEDIS®)–changesresultingfromreviewofhealthbenefits
Financialoutcomes,e.g.,temporarydisability,medicalcare,permanentdisabilityandfuturemedicalcostsQualityimprovementmetrics,e.g.,appropriatecaretothosewithchronicdiseasessuchasasthmapatientswhoreceiveappropriateasthmacareaccordingtotheNationalAsthmaEducationandPreventionProgram(NAEPP)Guidelines
Percentageofplanmembershospitalizedformentalillnessseenbyproviderwithin30daysofdischarge
Actualimprovementsthattheplanhasmadeincareandservice
Attainmentofrecommendedparticipationratesinscreeningprograms,e.g.,mammography,Paptest,prostatespecificantigen(PSA)
Percentageofpregnantwomenwhoreceivedtheirfirstprenatalcarevisitduringthefirst3monthsofpregnancy
Percentageofnewmotherswhoreceivedacheck‐upwithineightweeksafterdelivery
Percentageofthosecoveredhavingannualdentalvisits
Utilization,e.g.,visitspercase,diagnostictestspercase,andmodalitiespercase
Workersatisfactionopinionofprogramsofferede.g.,surveyorfocusgroupresultsandoutcomes
Evidencethatthehealthplanisworkingtoimprovethequalityofcareprovidedtoplanmemberswithspecificacuteconditionsandcorrectinganyproblemsofpoorquality
Evidencethatplanmembersgetneededemergencyservices
Evidencethatthehealthplantakesactiontoimprovethequalityofcarebasedonqualityassurancefeedback
3.6 Mental and Behavioral Health and Misuse of Substances IHS Standards Theorganizationshouldhaveappropriatewrittenpoliciesforworkereducation,prevention,andrecognitionofsubstanceabuse,mentalhealthissuesandviolenceintheworkplace.ManagementandsupervisorsshouldbeskilledintheidentificationandrecognitionoftroubledworkersandreferthemtoOEMandOEHprofessionals,EmployeeAssistanceProgram(EAP)counselors,and/orsubstanceabuseprograms(SAPs).OEMandOEHprofessionalsareofteninvolvedincounselingandrehabilitationofthetroubledworkerinaconfidentialmanner,realizingtheimportanceofrehabilitationofimpairmentfordrugoralcoholmisuse.OEMandOEHprofessionalsareappropriatelyinvolvedinmandated(e.g.,DOTormilitary)orelectivedrugscreeningandtestingofworkers,andservingasmedicalreviewofficers(MROs)whoreceive,reviewandinterpretdrugtestresultsaspartofdrug‐freeworkplaceprograms.Confidentialityismaintained,withnodiagnosticortreatmentinformationprovidedtotheemployer.Workplaceviolencepreventionandresponseprogramsareinplace.
Application Response DescribeyourEAPand/orSAPreferral,drugandalcoholpolicies,substanceabusetesting,andworkplaceviolencepreventionprograms.Provideinformationonhealthinsurancecoveragefortreatmentandrehabilitationofmentalandbehavioralhealthissues.
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Examples of Program Components, Processes and Dissemination Writtenanddistributedsubstanceabusepoliciesandprotocols FormalEAPand/orSAPreferralplan Healthinsurancecoverageofdrug/alcoholtreatmentandrehabilitation Threatofworkplaceviolenceprocedures Impairedworkerevaluations Complianceaudits Workerandsupervisortraining Substanceabusetestingprogram EAP/SAPreferrals
Protocolfordisseminationofprogramofferingstoallapplicableworkersandlocations
Examplesofoutcomemeasuresandtrends Percentpositivealcoholanddrugtests
Successofrehabilitationandrecidivismrates
Ratesofaccidentsrelatedtoimpairmentduetomentalillness/substanceabuse
EAPandSAPutilization,referral,andpenetrationrates Positivesubstancesandadulterants
PercentofSAPreferralsactuallyreturnedtowork
Linksbetweenillness(behavioralorsubstanceabuse)andworkplaceissues,e.g.,terminations,jobturnover,absenteeism,theft,security,disciplinaryactions,medicalclaims
Work‐relatedassaultsanddeathsfromwork‐relatedhomicides Ratesofworkplaceviolence
Percentofeligibleworkersandlocationsreceivingprograms
NOTES