Want to prove your value? Audit it!

An audit tool verifies performance

How do you prove the value created by the employee health service? Perhaps you can show a reduction in injury rates or workers comp claims. Or you report the number of TB screens performed and immunizations delivered. Or you demonstrate broader impact from a wellness initiative.

One systematic way to demonstrate your results is through an internal audit. You can check your services against compliance and performance goals and compare your policies with your actions.

Mary Asherbranner, RN, BSN, MSHA, COHN-S, director of client operations at CHD Meridian Health Care in Nashville, TN, a provider of contractual employee health services, conducts a comprehensive audit every two years and "mini-audits" once a quarter.

Audits are an effective way to validate what you are doing — and to uncover weaknesses that you need to correct, says Asherbranner. "We can show that we're providing the best care and that we're using not only industry standards, but best practices," she says.

For example, to check compliance with chemical safety, an audit would prompt you to verify the Material Safety Data Sheets for all chemicals. "When new chemicals or new products are introduced into the hospital, do they go to a safety group for approval?" says Asherbranner. "That would be one process that I would expect should happen automatically."

That review of the MSDS system would not just be a paperwork function. You would also make sure that employees have easy access to the information — for example, online — and that they know how and when to refer to the MSDS. The audit would verify that employees know how to respond to a spill and which chemicals they work with require special handling.

Identify risk potential

Here are some steps to take when setting up an audit:

  • Identify areas of the greatest potential risk. You can't include everything on a single audit, nor should you try. You want to have the greatest possible impact. Work with your risk managers to identify areas of potential liability for the hospital and review your injury data for risk of injury to employees.

Consider near-misses. "If you don't have a system in place to record a near-miss, you need one," Asherbranner says.

Reducing injury and risk may go hand-in-hand with demonstrating compliance. For example, you may audit compliance with the sharps safety program. In addition to looking for compliance with the Bloodborne Pathogen Standard of the U.S. Occupational Safety and Health Administration, you also want to make sure employees are following the specific policies and procedures of your institution. Are they properly using the devices you've provided?

  • Break the audit into components. Decide what specific items you need to verify. Set up a checklist on an Excel spreadsheet with each measure. When you conduct the audit, you may look at one area at a time, such as the respiratory protection program or management of the employee health clinic. (See sample.)
  • Don't try to conduct the audit all at once. "Look at it on a section-by-section basis," says Asherbranner. "That makes it more manageable."

Maintain a focus on the issues you've identified. It's easy to get sidetracked into other areas, but remember that you selected the items for their potential impact on your operations.

  • Validate your findings. If you are auditing compliance with bloodborne pathogen policies, for example, you'll want to talk to nurses and make sure they can explain the policy. Do they know how to report an injury? Do they know where the exposure control plan is?

By auditing your program, you can make sure that competencies are maintained and that safety procedures are followed on an ongoing basis.