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such, an intervention was required to address two or more of the 27 elements in the Redinger and Levine (1998) universal OHSMS framework, with at least one of these being a management element, as distinct from an operational/activity element.

OHSMS implementation While the primary focus of the review was on the effectiveness of OHSMSs, evidence was also sought about implementation at the workplace-level . There were for two reasons for this. First, it was anticipated that for some mandatory initiatives there might be measures only of the OHSMS and not of its effects in workplaces. Second, implementation information allows one to distinguish between the following two possible explanations for an absence of effect: poor intervention content and poor implementation of the intervention. It is evidently possible for a well-conceived intervention to fail if it is poorly implemented.

An evaluation of extra-workplace OHSMS initiatives could measure implementation by measuring changes in structures and processes external to the workplace. In this review, however, implementation was considered only at the workplace-level, (as a change in the state of the workplaces’ OHSMSs), in order to have consistency between the workplace-initiated and extra-workplace-initiated interventions included in the review. Examples of implementation changes include an increase in the number of OHSMS elements present in the workplace or improved quality of OHSMS elements.

Intermediate OHS outcomes Intermediate OHS outcomes were considered to be outcomes of secondary interest and potential proxies for final OHS outcomes. These would involve changes in constructs mediating between the OHSMS and final OHS outcomes. Examples would be: safety climate; employee knowledge, beliefs, values or perceptions; employee behaviours; OHS hazards; and risks of illness or injury.

Final OHS outcomes The review team identified the final outcomes of the interventions using a program evaluation approach (Rush and Ogborne, 1991). Outcomes were chosen so as to be consistent with the ultimate purpose of the intervention. For many stakeholders, this is improved employee health and safety. Thus, examples of final outcomes are changes in injury/illness statistics, musculoskeletal pain, and employee quality of life.

Economic outcomes Economic outcomes could also be considered to be final outcomes in the review framework, especially for stakeholders who had a primary interest in costs. A conventional notion of economic outcomes was adopted and so examples in this category are workplace workers’ compensation premium rates and workplace productivity.

Effectiveness of Occupational Health & Safety Management Systems: A Systematic Review


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