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The paper by Yassi (1998) also involved the introduction of an OHSMS, and also reported financial outcomes. The focus of the paper was on the utilization of databases to guide occupational health programs in an acute and tertiary care teaching hospital in Winnipeg, Manitoba, with 6000 employees (a number which appears to have gradually increased over the years reported). In addition to revealing a downward trend in assessment rates, and comparing the hospital’s workers compensation assessment rates for the years 1990-95 to the average rate paid in Manitoba, the authors reported estimated savings attributable to the reduced rate.

The intervention was a new risk assessment/risk management approach to different occupational hazards (biological/chemical, ergonomic, psychosocial) and was instituted in the early 1990’s. It involved improved record-keeping; more systematic data collection and analysis using databases; hazard identification; risk assessment; planning programs to address risks; defining the programs’ objectives and standards; assigning the responsibility for particular programs to particular individuals; program evaluation or surveillance’ performance measurement; and continuous improvement; and economic evaluation. Some specific areas of intervention which resulted from this program were: promotion of staff vaccinations against influenza; pre-placement assessments for new employees; the introduction of new technology to prevent needle-stick injuries; a program of prevention/early intervention for back injuries.

The time series design covered yearly intervals from 1990-95. Accumulated savings were estimated by applying the hospital’s 1990 premium rate to each of the payroll values for the five subsequent years, to estimate what the payments would have been in the absence of the program. The amounts actually paid for each of those years were subtracted from the estimated amounts and the differences presented as the estimated annual savings. The hospital’s workers’ compensation assessments decreased from $1.51 (per $100 payroll) in 1990 to $1.17 in 1995 - a 23 per cent reduction. The average rates in Manitoba decreased 7 per cent in the same time period. Accumulated savings for the hospital from 1990-95 were estimated at $2,866,000.

Yassi concluded that use of the databases permitted the analysis of departmental profiles of injury and health issues, systematic targeting of areas requiring attention, evaluation of the comprehensiveness, quality and efficiency of programs instituted, and appropriate allocation of resources. She described the use of databases as “invaluable” in effecting changes that resulted in reduced workers’ compensation assessments and other significant savings over the five years following implementation of the program.

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


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