Audit in Occupational Health: 13

Setting Audit in Context

So what is the brief of the audit: OHS or OH?

Can you think of a few topics in occupational health which would lbenefit from systematic audit of their quality?

Make a note of them.

The following are some ideas (but you should have thought of others too). They may not all be appropriate to you or your workplace but they should be amenable to criteria against which observed practice can be quantitatively assessed:-
 

Vaccination
 

•  identification of employees in target population
• participation rate of identified employees

• follow up for repeat vaccination if indicated

What matters of policy need debate and agreement on standards of practice in your organisation?

List a couple.

Then read on for examples.

Audiometry

Consider as a further example, the issue of industrial audiometry, as part of a hearing conservation and monitoring programme. Clearly it is important to help assure quality by establishing management systems for calling employees to undertake their audiometry, for regularly calibrating the audiometer, for recording and storing the audiograms, for recalling the employees after an interval, and so on.
 

But... good professional occupational health practice requires much more than that: the workplace needs to be assessed by suitable and sufficient noise surveys, appropriate advice must be given regarding reduction of noise at source, personal protection etc. Moreover the appropriate employees who need Health Surveillance must be clearly identified. If impeccable audiometry and systems management is applied to a poorly selected subset of employees (while others at equal or greater risk are overlooked) or if inadequate steps are taken to reduce exposure at source and/or implement personal protection, then sadly good occupational health standards have not been achieved.
 

Other examples

There are several others. can you think of any?.
 

What tools would you need to implement the above?

Staff time is the biggest resource needed to implement audit and quality improvement. Therefore careful planning and establishing of priorities is essential.
 

Increasing availability of computer facilities in occupational health services should assist considerably in the development of quantitative and ongoing methods of audit of process and of outcome. The data must be collected accurately, simply and prospectively. It must be retrievable for the purposes of the audit but otherwise securely kept. Strategic objectives and hence specific targets can be agreed upon and used as standards against which to audit observed practice, which is then analysed statistically.
 

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