A Study of Leading Indicators for Occupational Health and Safety Management Systems in Healthcare

A Study of Leading Indicators for Occupational Health and Safety Management Systems in Healthcare

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Study Phases

The study was implemented in two phases:

Phase I - Assessment and Intervention Development
Assessment
Semi-structured interviews were conducted at the beginning of the study to assess potential facilitators and barriers to changing current OHSMSs and evaluate current OHSMSs in the participating hospitals using the Leading Indicator Assessment Tool (see below). Participants were identified in collaboration with the participating sites’ contact person (OHS representative), and included the Chief Executive Officer (CEO), members of the hospital Board, administrative team (e.g. VP, Directors, etc.), OHS Department (Director, Manager, Specialist and/or Advisor), and Joint Health and Safety Committee. Participants were also asked to provide documents to support their answers to each question. Documents including meeting minutes, newsletters, electronic communications, strategic plans, policies and job descriptions were then reviewed by the OHS consultants and incorporated into the OHSMS assessment using the Leading Indicator Assessment Tool.
Using the template of key leading indicators, proposed contributory indicators and measurable objectives identified by Bennett and Foster (2005), the Leading Indicator Assessment Tool was developed by the principal investigator and OHS consultants on the project team. The tool consists of 33 questions to measure how closely the organization’s OHSMS fits with the six leading indicators (senior management commitment, continuous improvement, communication, competence, employee involvement in OHS, occupational health management).
Intervention Development
Once completed, the final assessment and scoring of the Leading Indicator Assessment Tool was first shared with each respective site then presented during separate in-person meetings to each OHS department and the project team. Several gaps specific to the six leading indicators were identified in the OHSMS at each site. Both
sites independently selected to address gaps in the same three leading indicators: senior management commitment, employee involvement, and communication, while Site 1 also selected to address a gap in continuous improvement. Through a collaborative process with the project team, the interventions were developed at each site based on other initiatives taking place to improve buy-in and sustainability. The interventions included the inclusion of OHS objectives in the strategic plan and implementation of Safety Rounds at both sites. In addition, Site 1 created an incident reporting flowchart, and Site 2 promoted OHS through the organization’s newsletters and weekly communications.
References
Bennett, J., & Foster, P. (2005). Predicting progress: The use of leading indicators in occupational health and safety. Policy and Practice in Health and Safety, 3(2), 77-90.
 
Phase II - Implementation and Evaluation
During phase II, the interventions were pilot tested and evaluated. At Site 1, the main intervention was implemented on four pilot units (two inpatient units and two departments). At Site 2, the interventions were implemented hospital-wide. 
To assess the feasibility and acceptability of the interventions, semi-structured interviews were conducted at each site at the end of the project. Participants were identified in collaboration with the participating sites’ contact person (OHS representative) and included the Director/Manager/Safety Advisor of the OHS Department, members of the administrative team, and/or managers from the pilot units.
To assess the effectiveness of the interventions, The Health and Safety Climate Assessment Tool Section 1 (PSHSA, 2014) was completed before and shortly after the intervention monitoring was completed to evaluate participants’ perceptions of their organization’s health and safety climate over time. In the questionnaire, participants were asked to respond to 43 questions to inform the results for nine dimensions: management commitment, communication, priority of safety, safety rules and procedures, supportive environment, involvement, personal priorities and need for safety, personal appreciation of risk, and physical work environment. An algorithm was used to calculate a score out of 10 for each of the nine dimensions then plotted on a graph with zero being the worst score and ten being the best score. At Site 1, all employees and physicians from the pilot units where the intervention took place (n~200), as well as the entire hospital (n~4,200), were invited to participate to allow for a comparison between the intervention and non-intervention groups. At Site 2, all employees (n~2,200) were invited to participate.
References
Public Services Health and Safety Association (PSHSA) (2014). Health and safety climate assessment project.