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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


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


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


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


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


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


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


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



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


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


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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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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


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


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