The healthcare sector has ranked second highest for lost-time injury rates among the 16 Ontario sectors since 2009 (WSIB, 2014), with approximately $2.5B being spent yearly on occupational injuries (WSIB, 2012). Historically, there has been a large focus on compliance and fines in Ontario's occupational health and safety system, however, injury statistics have not significantly improved. One way of changing this trend is through 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, leading indicators are associated with proactive activities within selected OHSMSs program elements. Using leading indicators to improve health and safety has been common practice in high-risk industries; however, this shift has not occurred in healthcare.

The overall aim of our project was to conduct a longitudinal study evaluating the feasibility of implementing interventions guided by six leading indicators, and the effectiveness of these tailored interventions on improving the health and safety climate in two healthcare organizations. The six leading indicators were senior management commitment, continuous improvement, communication, competence, employee involvement in occupational health and safety, and occupational health management (Bennett & Foster, 2005).

In active collaboration with the Public Services Health & Safety Association (PSHSA), knowledge users, and collaborators, the two-phase project was guided by the following objectives:

  1. To identify potential facilitators and barriers to changing current OHSMSs;
  2. To assess current OHSMSs at participating hospitals using the six leading indicators;
  3. To identify possible leading indicators to be added or changed in existing OHSMSs, then develop tailored interventions to optimize current OHSMSs;
  4. To pilot test and evaluate the feasibility of implementing interventions guided by the six leading indicators, and the effectiveness of these interventions on improving employees’ perception of their organization’s health and safety climate.

Funded by the Ontario Ministry of Labour and co-sponsored by Public Services Health & Safety Association, Health & Safety Professionals Inc., and The Ottawa Hospital.

Ontario Ministry of Labour LogoPublic Services Health & Safety Association LogoThe Ottawa Hospital Logo

Health & Safety Professionals Inc. logo


Workplace Safety and Insurance Board (WSIB). (2014). Workplace Safety and Insurance Board: By the numbers: 2014 WSIB Statistical reporthttps://www.wsib.ca/en.

WSIB. (2012). Enterprise information warehouse. https://www.wsib.ca/en

Bennett, J. & Foster, P. (2005). Predicting progress: The use of leading indicators in occupational safety and health. Policy and Practice in Health and Safety, 3(2),77-90.

Project Milestones

Spring 2019

Winter/Spring 2019

  • Report completed
  • Publications in progress

Summer-Fall 2018

  • Data analysis completed

Spring 2018

  • One-day symposium held at the Donald Gordon Conference Centre in Kingston

Winter 2018

  • Interventions and data collection completed

  • Data analysis and symposium planning in progress

Spring-Summer-Fall 2017

  • Intervention in progress at sites 1 and 2

Winter 2017

  • Interviews, survey and assessment completed at Site 2

  • Face-to-face team meetings held to review assessment at each study sites and develop interventions

Fall 2016

  • Interviews, survey and assessment completed at Site 1

Summer 2016

  • First team meeting held and study sites recruited