Surveilling injuries: Why OHSN wants you to share your injury data
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July 13, 2017
Network expanded this year to include needlesticks and bodily fluid exposure
For nearly four years, the Occupational Health and Safety Network (OHSN) has been collecting traumatic injury data from hospitals on a voluntary basis. The initiative, which is part of an effort to identify persistent hazards and injury trends in healthcare settings, has in recent months grown both in its size and scope. And organizers are looking to sustain that steady acceleration.
When the network first launched in 2013, it dealt exclusively with three injury categories: slips, trips, and falls; workplace violence; and patient handling. Earlier this year, the network added two more modules: one for needlestick injury data and the other for incidents involving exposure to blood or bodily fluid. The team launched a recruitment campaign, and within a month, more than 50 additional hospitals asked to sign up, says Ahmed Gomaa, MD, ScD, MSPH, project officer for OHSN. As of mid-May, there were 170 hospitals enrolled across 28 states.
Why do hospitals put forth the effort to send their injury data to a subset of the U.S. Department of Health and Human Services without being required to do so? Perhaps because they see value in what they get back: information that is both actionable and timely.
“The difference between our surveillance and other surveillance is that we give the data to the hospital one week after they submit it to us, instead of waiting two or three years to get a generated report,” Gomaa says. “So they get the data right away.”
What’s more, OHSN ensures that the data it collects is standardized, making it much easier to measure changes over time—which is essential to testing whether a new solution is having any effect on the problem.
“We make it simple. We get the data in a standard way. You get it back in tables and graphs,” Gomaa says. “Anybody can understand and comprehend it in one minute and show it to the worker or supervisor or whoever, administrator or certification agency like [The] Joint Commission, or regulatory agency like OSHA.”
For each injury or illness, the data track the date, location, and impact of the incident, including the number of days affected employees spent away from work as a result of the mishap, among other data points. The OHSN team then processes the data and delivers reports to the hospital staff in about a week, with accompanying visuals. Since the data are recorded with standardized locations and job categories, the regular reports help to identify which areas and job titles are at greatest risk. That way, hospitals can craft solutions to improve safety, then measure whether those solutions are working.
“In our system, you submit the data every month. You get it after one week. Everybody speaks the same language. They can look at the historical data over time, and they can see trends, and they can see visual data. They don’t have to learn how to do analyses,” Gomaa says.
In mining, what sets an ore apart from a mere mineral is the fact that it can be extracted for a profit. Analogously, what sets a valuable data set apart from others is its utility—surveillance statistics are only as valuable as they are timely and actionable. So those running OHSN have built their entire operation with this in mind, seeking to provide data that are sufficiently granular to enable participants to test safety interventions on the local level.
“If you look at your data and find that you have a problem with violence against nurses, for example, the natural question after that is, ‘So what can I do about it?’ ” Gomaa says. The answer—actually, a number of possible answers—can be found on the OHSN website, where there are a number of proposed interventions listed by injury type.
Worried about blood and body fluid exposures? Review the four documents outlining universal precautions, engineering controls, PPE, and more. Looking to stop sharps injuries? There are eight resources on the topic. More links to workplace violence prevention strategies, safe patient handling refreshers, and advice on making slips, trips, and falls less likely are there as well, readily available for participants to review, adopt changes, then check their results.
Jennifer Beining, MSN, JD, RN, COHN-S, NE-BC, system manager of clinical services at Ohio Health Associate Health & Wellness, whose team has been using the OHSN system for about two years, says it has helped shift the conversation. Healthcare workers should not simply accept the risk of injury as part of their line of work, she said.
“I think in nursing the mindset is that there are some things that come with the job, and we spend so much time focusing on what’s right for the patient, we don’t necessarily take care of ourselves. That’s a culture that needs to change,” Beining said in a video testimonial for OHSN’s service, adding that the data-tracking system helps to reinforce best practices that can often be abandoned for the sake of convenience.
“There are a lot of tools out there that can be used to prevent our healthcare workers from lifting; however, we just aren’t using them,” Beining said. “With the Occupational Health and Safety Network, we can show the areas that we have been using the devices have lower rates of safe-patient-handling injuries. And that helps us spread that out to other areas and also convince the staff and the leaders that this is the right thing to do.”
Integrated and free of charge
When researchers with the CDC’s NIOSH devised the OHSN system, they did so because there was clearly demand for a standardized injury surveillance system—demand that has persisted after the system’s launch.
“An annual survey of OHSN users shows overwhelming support for a system that helps mitigate high-risk aspects of the healthcare industry and guides prevention efforts,” NIOSH Director John Howard, MD, said in a statement. “A commitment to a culture of safety that emphasizes continuous monitoring and improvement benefits not only the worker, but the employer as well.”
There’s a major incentive, Gomaa says, for hospitals to promote employee safety because promoting healthy workers helps to promote healthy patients and healthy hospital environments. But identifying an area in high demand is only half the equation. If a mineral is too difficult to extract affordably, then it’s not “ore,” which is why OHSN’s services are offered free of charge and designed to align with existing data-collection activity.
Participants who already collect incident reports and send them off to OSHA want to maximize the information they already have, Gomaa says.
“They don’t want to be passive partners sending data and receiving reports three to four years later when they don’t have to share the analysis and everything else,” he says. “They want to be active participants, and they want it to be easy, and they want it not to do double-entry.”
Importantly, the data OHSN collects is viewable only by the organizations that submit the information and those who prepare the reports. Information released to outside parties is done in aggregate, Gomaa says.
“We are not a regulatory agency. We are a public health agency,” he notes.
Gomaa’s team prioritized the five current modules because they address the most common, most serious, and most preventable injuries in the hospital setting. The team has identified other areas worth surveilling, but there is no timeline on when (or whether) the scope of the project will expand again.
“We would like to have a lot of other modules,” Gomaa says, “but I think that we are limited by the budget and time.”
Even if OHSN’s recently expanded scope remains constant, however, there is plenty of room for growth in membership. While 170 hospitals have enrolled thus far, there are more than 5,500 registered hospitals nationwide, according to the AHA.