Dear Lindsey,
Re: audit of OH Services and value for money.
The Institute has been involved in a number of audit / reviews of OH
services in recent years - sometimes because of concerns about
the services being provided, sometimes because the OH
professionals themselves value an extenal review as part of their
continuous quality improvement initiatives. We have also recently
been funded by the BOHRF to investigate cost-efficiency and cost-
effectiveness of OH services, in both public and private sector
organisations in the UK.
The former, audit activities, inevitably return to the thorny problem
of what are suitable performance measures for OH services that are
both sensitive and specific to the impact of providing OH services,
and what are performance indicators that are valued by both
customers / clients (and the OH professionals themselves). Many
OH services, as yet, do not have even rudimentary performance
indicators and this leaves them in a difficult position when trying to
demonstrate their effectiveness to purchasers of services.
There is an ICOH scientific committee on health services research
and evaluation (chaired by Prof. Peter Westerholm from Sweden - I
am on the ex. board) that examines these issues and there is
some really useful work being done by the Dutch (notably Frank
van Dijk, Carel Hulschof, Jos Verbeck - who have most recently
examined the use of customer satisfaction in OH). Last year we
produced a textbook on 'evaluation in occupational health practice'
(edited by Menckel & Westerholm, published by Butterworth &
Heinemann). We also published a report on 'guidelines on quality
management in multidisciplinary occupational health services' as
part of the WHO European Series (report no 1 - report no 3 is
'occupational medicine in Europe: scope and competencies that
might also be relevant, report no 4 - which I have just finished
writting - will be 'the role of the occupational health nurse in
workplace health management' that will be published later this
year) so all of these might be relevant.
In relation to value for money - a broader concept than cost-
effecitiveness / cost-benefit, it might also be worthwhile looking at
the report of a conference organised by TNO in the Netherlands
'cost and benefits of occupational safety and health (Mossink and
Licher) - although at the end of the conference they concluded that
there were, as yet, no good models for evaluating the cost benefit
analysis of OHS. Others who have written on this subject are
Jorma Rantanen from the Finnish Institute, Guy Ahonen (also from
the FIOH) and Oxenburgh ' increasing productivity and profitability
through health and safety' - although this model is largely based on
the Australian situation where, like the US, it is easier to identify
the costs and who pays for health care when it is delivered through
an insurance scheme.
Hope that is of help, but if you want to talk about the specifics give
me a ring.
Stuart
Dr. S.C. Whitaker
Senior Research Fellow
Head of Health Services Research Unit
Institute of Occupational Health
University of Birmingham
Birmingham B15 2TT
Tel (44) 0121 414 6010
Fax (44) 0121 414 6217
e-mail [log in to unmask]
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