A promising network of hospitals to track and prevent healthcare worker injuries and illness will shut down in September, the National Institute for Occupational Safety and Health (NIOSH) reports.

The NIOSH Occupational Health Safety Network (OHSN) ran afoul of the Office of Management and Budget (OMB), which must approve government data collection systems. The OMB determined the network data were not sufficiently representative of all healthcare facilities; thus, benchmarking and interfacility comparisons could not be made. OHSN collected information from hospitals on a voluntary basis.

After this decision, “OMB review indicated that because the information collected in this manner was not representative of healthcare facilities — that is, it would not capture a larger demographic of hospitals nationwide — we could not conduct interfacility comparisons,” says Teresa Schnorr, PhD, director of the NIOSH Division of Surveillance, Hazard Evaluations, and Field Studies. “Because the interfacility comparison was a main component of the OHSN model, NIOSH decided to end the data collection.”

OHSN was founded in 2013. NIOSH was trying to expand the OHSN system to as many as 300 hospitals as recently as 2017. Participating hospitals reported patient-handling injuries; slips, trips, and falls; workplace violence injuries; needlesticks; and other blood exposures.

Asked to clarify why the data between facilities were not comparable, Schnorr says “the [OMB] decision was based upon the voluntary manner in which the hospitals were enrolled. At this time, there are no plans to replace OHSN with another model. NIOSH is able to continue to accept data from actively participating hospitals through Sept. 30, 2019.”

Amber Mitchell, DrPH, MPH, CPH, is director of the International Safety Center, which has been tracking needlesticks and other exposures for decades through its Exposure Prevention Information Network (EPINet). The loss of the OHSN means there will be no national surveillance system that captures other types of occupational injury and illness incident data in healthcare facilities, she says.

“Healthcare occupational and employee health practitioners struggle with identifying how programs in their institutions compare to others in their specific industry and how to make them more robust with better and safer outcomes for workers,” she says.

Asked about the comparability problem, Mitchell says the OMB decision was “short-sighted” because occupational injury and illness incident data “does not need to be epidemiologically comparable across facilities to be useful.”

That said, there is nothing unique to occupational data in particular that makes comparison and generalization difficult.

“On the contrary, comparing occupational incident data is extremely straightforward,” she says.

As comparability relates to patients, there are large numbers of underlying and confounding factors related to their care and outcomes, including age, immune status, and comorbidities, Mitchell says.

“However, if it is identified that a worker is exposed to blood because they were not wearing eye protection, we know how to protect them from future exposures — increase accessibility and use of eye protection,” she says.

If a worker is injured by slipping on a wet floor because there was no signage, the intervention is equally obvious. “Put signs up,” she says.

“We can’t know how to intervene if we don’t know where or why workers are getting injured,” she says. “This doesn’t require complicated epidemiologic biostatistical facility-to-facility comparisons. It requires access to incident data, networks of resources and tools, a community of industry-specific professionals, and the ability to determine changes over time.”

A question-and-answer post on the OHSN website said this about using the system for comparison against other facilities and as a benchmark for users to look at their own past data:

“The system was designed for both purposes. The ability for a hospital to compare its performance against other hospitals was an overarching purpose of OHSN. While OHSN has shown it can be a helpful tool for individual participating hospitals, the OMB criterion and the resources required to maintain the system prevent us from continuing support, and so require a halt in enrollment.”1

REFERENCE

  1. Occupational Health Safety Program. Frequently Asked Questions. Available at: https://bit.ly/2VslyGF.