Guest Column

Increasing regulations could guarantee your job

EHPs face changes in the next millennium

By Kathleen VanDoren, RN, BSN, COHN-S, Paralegal
Executive President
Association of Occupational Health Professionals in Healthcare
Reston, VA

Nothing causes more apprehension among health care workers than an impending visit from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). A similar visit from the Occupational Safety and Health Administration (OSHA) can also cause rumors to fly and individuals to run for records to make sure they are in order. Unfortunately, agencies such as JCAHO and OSHA often are looked upon as an inconvenience, but that is not necessarily so.

Employee health professionals should embrace such agencies rather than criticize them because they can enhance the importance and status of employee health professionals (EHPs) in hospital settings and could help guarantee the EHP’s job in this era of downsizing, cost cutting, and mergers.

Several years ago as manager of employee health in an acute care facility, one of my goals was to transform the unit from a basic- into a full-service occupational health department. When discussing the need for pulmonary function, audio, and vision testing equipment with my director, I not only stated they were needed for employee surveillance and post-offer assessment, but also that OSHA regulations mandated the implementation of hearing conservation and pulmonary protection programs. My director, an individual who had the employee’s health and safety at heart (and the thought of an OSHA fine did not appeal to her either), made sure our department received the necessary funds for the equipment.

OSHA standards add urgency

One reason occupational health has become such a large specialty area is OSHA’s concern for the health and safety of workers. Issuing mandatory standards gives added urgency for support from the health care facility. And who better to implement those standards than the occupational health professional. Other national organizations that are not regulatory bodies may make excellent recommendations for various aspects of health care, but because they do not issue standards mandated by law, no health care facility is required to implement their recommendations.

Accreditation by JCAHO is the goal of many health care organizations and one that requires a great deal of record review, policy and procedure manual updates, and employee education for each department. If an institution is not accredited, it affects patient admissions and impacts the bottom line. In effect, accreditation helps to secure jobs, and that includes those in the employee health department.

Prospects for EHPs unclear

As we enter the new millennium, change will continue. Some hospital employee health departments will find themselves eliminated, while others will have added responsibilities. No one can seem to get a clear picture at this time. Health care in general will continue to face growing financial challenges that require an immediate response.

How can we ensure that we receive the assistance needed as professionals to make our departments as cost-effective and employee-friendly as possible?

Communication: We need better data reporting to identify problem areas and assist with decisions. We need to shorten response time from others to allow necessary changes and meet deadlines for our departments.

Cost containment: We need aggressive budget management to identify variances and make adjustments quickly. Working closely with upper management will assure that employee or occupational health departments are running at top efficiency while being sensitive to cost constraints.

Growth: We need to look toward expanding our areas and improving our facilities. We need to provide the services our customers (employees) want while managing expenses and resources. We must adjust today to department needs so that we can adequately function tomorrow.

Change is not a painless process. Regulatory agencies such as OSHA and JCAHO can be an asset for the employee health professional. Good management, sound financial decisions, and interaction with these agencies can assure the employee or occupational health department has a place in the health care facility’s structure well into the coming millennium.