Worker and Public Health and Safety

This book on "Worker and Public Health and Safety: Current Views" brings together current scholarly work and opinions in the form of original papers and reviews related to this field of study. It provides important and recent scientific reading as well as topical medical and occupational information and research in areas of immediate relevance, such as chronic and occupational diseases, worker safety and performance, job strain, workload, injuries, accident and errors, risks and management, fitness, burnout, psychological and mental disorders including stress, therapy, job satisfaction, musculoskeletal symptoms and pain, socio-economic factors, dust pollution, pesticides, noise, pathogens, and related areas

Evaluating information flow in medication management process in Australian acute care facilities: A multi-professional perspective

Over the years, various interventions have been introduced to improve the medication management process. While these interventions have addressed some aspects predisposing the process to inefficiencies, significant gaps are still prevalent across the process. Studies have suggested that the goal of optimal medication therapy is achievable when information flow integrates across the various medication management process phases, stakeholders and departments involved as the patient moves through the process. To provide a cross-sectional view of the process, this study utilised a systemic philosophy to evaluate the information flow integration across the process. The research approach adopted for this study takes a positivist paradigm, which is guided by the cause and effect (causality) belief. It explored numeric measures to evaluate the relationship between constructs that assessed information flow principles (accessibility, timeliness, granularity and transparency) within the medication process and the information integration. The research design was cross-sectional and analytical, and this ensures that findings are relevant to current situations across the Australian healthcare system. Data for this research was collected using an online self-administered survey and the data assessed information flow principles and technologies used in the medication management process. There were 88 participants in this study, including doctors, nurses and pharmacists. The questions and responses were coded for analysis and data analysis techniques used were frequency analysis, Pearson’s chi-square test and multivariate analysis. Findings from this study indicates that the constructs evaluating accessibility, transparency and granularity had moderate associations with the information integration in the medication management process. Further analysis highlighted accessibility as a significant principle in explaining an increase or decrease in information integration in the medication management process. The accessibility construct referring to information retrieval was significant across the two tests conducted. Accessibility is directly related to information sharing and the assessment and monitoring and evaluation phases in the medication management process were identified as having the highest challenges with information sharing. Furthermore, the hybrid (electronic and paper) channel was preferred to support information integration in the medication management process by the participants. Among the technologies evaluated for the medication process, computer-provider-order-entry was found to be statistically significant in explaining an increase in information integration. Overall, results from this study suggest that interventions for the medication management process in Australian acute care facilities should be directed towards improving accessibility, specifically information retrieval and the sharing of information with emphasis on the assessment and monitoring phases. Implementing strategies to address the gaps identified from this research can improve information integration across the process and thereby reducing medication errors, and improving patient care management. Furthermore, the technology adoption across the process highlights that technology adoption across participants’ facilities remains a challenge in Australia

Bibliometric Studies and Worldwide Research Trends on Global Health

Global health, conceived as a discipline, aims to train, research and respond to problems of a transboundary nature, in order to improve health and health equity at the global level. The current worldwide situation is ruled by globalization, and therefore the concept of global health involves not only health-related issues, but also those related to the environment and climate change. Therefore, in this Special Issue, the problems related to global health have been addressed from a bibliometric approach in four main areas: environmental issues, diseases, health, education and society

Impact of Quality of Work Life on Turnover Intention: A Study on Private Health Care Units in Odisha

The stakeholders of the health care systems are endeavouring to render effective, efficient, and equitable care in an environment that is enduring transitions in business, clinical, and operating models. In this scenario, the performance of the health care organisations is largely dependent on the knowledge, skills and motivation of the employees. However, health care organisations worldwide, including India are facing an acute shortage of skilled health care employees, which is further intensified by high employee turnover rates. Therefore, it has become crucial for organisations to explore the perceptions of health care employees regarding the factors that influence and shape their decision to quit, for developing effective strategies to reduce turnover and retain the workforce essential to achieve health care outcomes. Seminal works in developed countries have advocated that the turnover and turnover intention is mostly influenced by the extent to which the employees are satisfied with the facets of their work life. However, the past studies emphasising on the quality of work life (QWL) to address the turnover of health care employees are scarce in India. Thus, this research examines the impact of QWL on the turnover intention of the employees in the private health care units of India. Specifically, the study focuses on gauging the perception of health care employees on the job dimensions, human resource (HR) interventions, QWL, employee commitment, and turnover intention to build logical relationships among these variables. A survey was conducted among the health care employees (nurses, pharmacists, laboratory technicians, and radiology technicians) working in the private health care units (nursing homes, non-corporate hospitals, and corporate hospitals) situated in the major cities of Odisha (an Indian state), namely Bhubaneswar, Cuttack, Berhampur, Sambalpur and Rourkela. A structured questionnaire comprising of one hundred thirty three items was distributed to eight hundred employees by adopting the method of convenience sampling. In the process of opinion survey, six hundred nine useful responses were retrieved owing to a response rate of seventy six percent. The responses obtained were subjected to analysis by using SPSS 20 and AMOS 20. The preliminary analysis of data was conducted by using the descriptive statistics, correlation and regression analysis. Then, the hypothesised research model was validated by using statistical tools such as exploratory factor analysis and structural equation modelling. The findings reveal that the job dimensions have a significant association with QWL of health care employees. Further, the perceived QWL of employees is significantly and positively influenced by the operational HR interventions in the health care units. Subsequently, QWL was substantially linked with the commitment levels of the employees in health care organisations. Conversely, QWL and employee commitment were inversely related to the turnover intention of the employees. Besides, employee commitment partially mediated the relationship between QWL and turnover intention. The results also divulged that the job dimensions did not have a noticeably direct influence on employee commitment and turnover intention and both the relationship was fully mediated by QWL. Likewise, HR interventions did not have a substantial direct effect on employee commitment but had a direct and significant relationship with turnover intention. Moreover, QWL acted as a full mediator between the relationship of HR interventions and employee commitment and as a partial mediator between HR interventions and turnover intention. Thus, this research provides a holistic framework that may act as a blueprint for health care organisations to assess and improve QWL, commitment levels, as well as reduce employee turnover. Further, the study may also provide substantial evidence to the health care managers for improving structures and planning appropriate remedial measures to build employee-friendly workplaces as well as ensure a meaningful and value driven working lives for the employees. Finally, this work supports the crusade to enhance the QWL of the employees as the top priority of the health care decision makers of the country

Data infrastructures and digital labour : the case of teleradiology

In this thesis, I investigate the effects of digitalisation in teleradiology, the practice of outsourcing radiology diagnosis, through an analysis of the role of infrastructures that enable the transfer, storage, and processing of digital medical data. Consisting of standards, code, protocols and hardware, these infrastructures contribute to the making of complex supply chains that intervene into existing labour processes and produce interdependent relations among radiologists, patients, data engineers, and auxiliary workers. My analysis focuses on three key infrastructures that facilitate teleradiology: Picture Archiving and Communication Systems (PACS), the Digital Imaging and Communication in Medicine (DICOM) standard, and the Health Level 7 (HL7) standard. PACS is a system of four interconnected components: imaging hardware, a secure network, viewing stations for reading images, and data storage facilities. All of these components use DICOM, which specifies data formats and network protocols for the transfer of data within PACS. HL7 is a standard that defines data structures for the purposes of transfer between medical information systems. My research draws on fieldwork in teleradiology companies in Sydney, Australia, and Bangalore, India, which specialise in international outsourcing of medical imaging diagnostics and provide services for hospitals in Europe, USA, and Singapore, among others. I argue that PACS, DICOM, and HL7 establish a technopolitical context that erodes boundaries between social institutions of labour management and material infrastructures of data control. This intertwining of bureaucratic and infrastructural modes of regulation gives rise to a variety of strategies deployed by companies for maximising productivity, as well as counter-strategies of workers in leveraging mobility and qualifications to their advantage

Ergonomic interventions: comparisons between footrest and anti-fatigue mat in reducing lower leg muscle discomforts during prolonged standing

Ergonomics is a science focusing on the study of human fit, decreasing human fatigue and discomfort through the design of new product. Prevention related to workers injury and illness such as muscle discomfort is part of the main goals in ergonomics interventions. Thus, this present study investigates the effectiveness of ergonomic interventions such as footrest and floor conditions in reducing workers lower leg muscle discomforts during prolonged standing. The main objective of this study was to determine and compare the lower leg muscles discomfort (exertion percentage (%)) of Gastrocnemius and Tibialis Anterior among the respondents using the two ergonomic interventions (footrest and anti-fatigue mat). About 60 healthy subjects were recruited to stand for 2 hours (120 minutes) while using the two interventions in different session with one week interval between each test session. During standing, lower leg muscle discomfort of Gastrocnemius and Tibialis Anterior muscles were continuously monitored. Changes in lower leg muscle discomforts over standing time were measured using the surface Electromyography (sEMG). In this study, the sEMG readings showed that the percentage of exertion (%) were increasing with time (within 120 minutes) on muscles for both legs with the usage of the interventions (footrest and anti-fatigue mat). However, the percentage of exertion (%) from the sEMG readings were lower compared to previous studies. The independent t-test was used to find the mean changes on exertion percentage (%) between each muscles of both legs for the two interventions. Results found that there were significant exertion percentage at certain time with 15 minutes time period within the 120 minutes standing. This study showed that the ergonomic interventions (anti-fatigue mat and footrest) gives a low number of exertion percentage (%), showing a reduced muscle discomfort to the lower leg muscles compared to previous studies and interventions. In comparisons with footrest, this study showed that anti-fatigue mat is more applicable for the assembly workers in the industrial factory. The data produced by the comparisons between the two interventions can be useful especially to the Department of Occupational Safety and Health Malaysia (DOSH) in enhancing the safety and wellbeing of industrial workers in Malaysia

To convey, or not convey …? The effect and usefulness of the National Early Warning Score to support paramedics’ decisions to convey patients to hospital or treat closer to home.

Background: The ambulance service studied introduced the National Early Warning Score (NEWS) to help paramedics decide whether patients could be appropriately treated closer to home, via an alternative non-emergency care pathway, or needed conveying to hospital. I investigated the effectiveness and usefulness of the NEWS to support paramedics’ decisions to appropriately treat patients closer to home. Methods: I adopted a pragmatic approach and used mixed methods. I used an interrupted time-series design and autoregressive integrated moving average (ARIMA) methods to analyse ambulance data. My analysis focused on the change in outcome and trend in outcome, before and after NEWS was introduced. Primary outcomes measured were numbers and proportions of patients not conveyed to the emergency department (i.e. treated closer to home), which included those treated and left at scene and those conveyed to a minor injury unit or similar. Secondary outcomes measured were numbers and proportions treated and left at scene who recontacted the ambulance service within 24-hours. Numbers of 999-calls attended, patients treated and left at scene and life-threatening calls were also analysed to provide a baseline measure and enhance understanding about primary and secondary outcomes. A self-selected sample of paramedics participated in semi-structured interviews and a non-participant observation study. Semi-structured interviews were conducted to gain insight of perceived effectiveness and usefulness of the NEWS to support decision-making. Non-participant observations were conducted to observe how the NEWS was used in context. Results: Baseline measures showed no significant difference in the numbers of emergency calls attended to by ambulance, although numbers of life-threatening calls increased significantly. Despite the increase in life-threatening calls, the numbers and proportion of patients being treated closer to home remained constant. While a significant decline was found in the numbers of patients left at scene, the numbers and ii proportions of patients who recontacted within 24-hours did not differ significantly. Sixteen paramedics were interviewed. Those interviewed did not perceive the NEWS to have affected their decision-making or clinical practice. Other factors influenced their decision to convey or treat closer to home more than NEWS. They would use the NEWS to inform a decision only at times of uncertainty. NEWS was considered ineffective and not useful when assessing patients with complex conditions. NEWS was more readily adopted in localities where other healthcare providers were familiar and were using the NEWS. Eight paramedics were observed as they worked in the clinical setting. Those observed rarely calculated, documented or verbalised a NEWS. Half the NEWS documented, were calculated or documented incorrectly. There was no visible evidence of the NEWS tool being used; any scores documented were calculated from memory. Conclusions: The effectiveness and usefulness of the NEWS to support paramedics’ decision-making to appropriately treat patients closer to home was compromised by a lack of coherence between service providers and practitioners, and lack of accessibility to alternative care pathways. My findings will be of value to service providers seeking to achieve NHS England’s ambition to increase the uptake of the NEWS to 100%, and those responsible for redesigning and commissioning integrated care services

IFPOC Symposium:Discovering antecedents and consequences of complex change recipients' reactions to organizational change.

IFPOC symposium: Discovering antecedents and consequences of complex change recipients' reactions to organizational change Chairs: Maria Vakola (Athens University of Economics and Business) & Karen Van Dam (Open University) Discussant: Mel Fugate (American University, Washington, D.C) State of the art Organisations are required to continuously change and develop but there is a high failure rate associated with change implementation success. In the past two decades, change researchers have started to investigate change recipients' reactions to change recognizing the crucial role of these reactions for successful change. This symposium aims at identifying and discussing the complex processes that underlie the relationships among antecedents, reactions and outcomes associated with organizational change. New perspective / contributions This symposium consists of five studies that extend our knowledge in the field by (i) providing an analysis of change recipients' reactions going beyond the dichotomous approaches (acceptance or resistance) (ii) revealing understudied antecedents-reactions and reactions-consequences patterns and relationships (iii) shedding light on the role of contextual factors i.e team climate and individual factors i.e emotion regulation on the adaptation to change. This symposium is based on a combination of both quantitative (i.e diary, survey) and qualitative (i.e interviews) research methodology. Research / practical implications This symposium aims to increase our understanding of the complex processes associated with change recipients' reactions to change. Discovering how these reactions are created and what are their results may reveal important contingencies that can explain how positive organizational outcomes during times of change can be stimulated which is beneficial for both researchers and practitioners