Employee Health Service Research Articles

USER INTERFACE DESIGN FOR A HEALTH SERVICE AT PT UNITED TRACTORS

The EHS Department is one of the departments in PT United Tractors. The task of the EHS Department is to support the performance of employees working at PT United Tractors. One form of support provided by this department is health services for employees. To provide the best experience in supporting employee performance activities, the EHS Department has an idea to create a platform that is able to handle all activities to support employees in terms of health. The program is named "Hi Doctor". This program will later have features that make it easier for employees to access of health services at PT United Tractors. The stages of working on this application begin with designing UI / UX Design, this task was carried out by the author and his team during the internship. The method used in the UI/UX Design work is Design Thinking, Design Thinking is used as a method in designing the "Hi Doctor" application design. The Design Thinking method is a human-centered approach to solving problems and bringing about new innovations. The results of this study are application prototypes with UI/UX designs that have been developed and adapted to the problems and needs found. The use of the Design Thinking method will present a solution that meets the needs and can solve user problems when using the "Hi Doctor" application.

The use of digital health technology to provide mental health services for employees in Japan

The use of digital health technology to provide mental health services for employees in Japan

Create.Connect.Unwind: A creative response to the pandemic for NHS staff well-being

This article presents a reflection on the hurdles faced by arts and health organizations during England’s COVID-19 lockdown in 2020–21 through the work of the arts team at Manchester University NHS Foundation Trust (MFT), Lime Arts. As the pandemic hit, Lime risked being shut down, their premises reallocated and staff redeployed. Convinced that, more than ever, frontline health professionals might benefit from creative workshops, Lime piloted a six-month innovative programme of online creative workshops for MFT staff. Lime then partnered with the Employee Health and Wellbeing Service to take the online workshops across the Trust, creating a new project called Create.Connect.Unwind. The pilot phase ended in May 2022 with a Creativity and Wellbeing Festival at Manchester Royal Infirmary. The authors reflect on this two-year project, considering in retrospect the team response, the participant response and the artwork created as well as the creative perspective behind the project.

Hospital-onset COVID-19: Associations with population- and hospital-level measures to guide infection prevention efforts

Objective: To characterize hospital-onset COVID-19 cases and to investigate the associations between these rates and population and hospital-level rates including trends in healthcare worker infections (HCW), community cases, and COVID-19 wastewater data. Design: Retrospective cohort study from January 1, 2021, to November 23, 2022. Setting: This study was conducted at a 589-bed urban Midwestern tertiary-care hospital system. Participants and interventions: The infection prevention team reviewed the electronic medical records (EMR) of patients who were admitted for >48 hours and subsequently tested positive for SARS-CoV-2 to determine whether COVID-19 was likely to be hospital-onset illness. Each case was further categorized as definite, probable, or possible based on viral sequencing, caregiver tracing analysis, symptoms, and cycle threshold values. Patients were excluded if there was a known exposure prior to admission. Clinical data including vaccination status were collected from the EMR. HCW case data were collected via our institution’s employee health services. Community cases and wastewater data were collected via the Wisconsin Department of Health Services database. Additionally, we evaluated the timing of changes in infection prevention guidance such as visitor restrictions. Results: In total, 156 patients met criteria for hospital-onset COVID-19. Overall, 6% of cases were categorized as definite, 24% were probable, and 70% were possible hospital-onset illness. Most patients were tested prior to a procedure (31%), for new symptoms (30%), and for discharge planning (30%). Also, 53% were symptomatic and 41% received treatment for their COVID-19. Overall, 38% of patients were immunocompromised and 27% were unvaccinated. Overall, 12% of patients died within 1 month of their positive SARS-CoV-2 test, and 11% required ICU admission during their hospital stay. Hospital-onset COVID-19 increased in fall of 2022. Specifically, October 2022 had 16 cases, whereas fall of 2021 (September–November) only had 3 cases total. Finally, similar peaks were observed in total cases by week between healthcare workers, county cases, and COVID-19 wastewater levels. These peaks correspond with the SARS-CoV-2 delta and omicron variant surges, respectively. Conclusions: Hospital-onset cases followed similar trends as population and hospital-level data throughout the study period. However, hospital-onset rate did not correlate as strongly in the second half of 2022 when cases were disproportionately high. Given that hospital-onset cases can result in significant morbidity, continued enhanced infection prevention efforts and low threshold for testing are warranted in the inpatient environment.Disclosure: None

Symptoms Predicting SARS-CoV-2 Test Results in Resident Physicians and Fellows in New York City

Accurate prediction of SARS-CoV-2 infection based on symptoms can be a cost-efficient tool for remote screening in healthcare settings with limited SARS-CoV-2 testing capacity. We used a machine learning approach to determine self-reported symptoms that best predict a positive SARS-CoV-2 test result in physician trainees from a large healthcare system in New York. We used survey data on symptoms history and SARS-CoV-2 testing results collected retrospectively from 328 physician trainees in the Mount Sinai Health System, over the period 1 February 2020 to 31 July 2020. Prospective data on symptoms reported prior to SARS-CoV-2 test results were available from the employee health service COVID-19 registry for 186 trainees and analyzed to confirm absence of recall bias. We estimated the associations between symptoms and IgG antibody and/or reverse transcriptase polymerase chain reaction test results using Bayesian generalized linear mixed effect regression models adjusted for confounders. We identified symptoms predicting a positive SARS-CoV-2 test result using extreme gradient boosting (XGBoost). Cough, chills, fever, fatigue, myalgia, headache, shortness of breath, diarrhea, nausea/vomiting, loss of smell, loss of taste, malaise and runny nose were associated with a positive SARS-CoV-2 test result. Loss of taste, myalgia, loss of smell, cough and fever were identified as key predictors for a positive SARS-CoV-2 test result in the XGBoost model. Inclusion of sociodemographic and occupational risk factors in the model improved prediction only slightly (from AUC = 0.822 to AUC = 0.838). Loss of taste, myalgia, loss of smell, cough and fever are key predictors for symptom-based screening of SARS-CoV-2 infection in healthcare settings with remote screening and/or limited testing capacity.

Seroprevalence of SARS-CoV2 Infections in Health Care Personnel in a Long-Term Care Institution After the First Wave of the Pandemic: A Cross-Sectional Study.

At the time of our study, occupational health evidence specific for long-term care employees was mostly lacking. The purpose of this study was to determine the proportion of positive cases in employees after the first COVID-19 wave in May 2020. We also determined the prevalence of asymptomatic cases. The study population included all health care workers (HCW) employed at one mid-size long-term hospital in Spain (May 2020). A cross-sectional study design included an interviewer-administered self-reported questionnaire (including sociodemographic questions, risk factors for COVID-19 complications such as hypertension or diabetes, and previous polymerase chain reaction [PCR] results) and antibody determination (Biozek rapid test). Data were analyzed using Student's t, Fisher, and chi-square tests. Two multivariate logistic models were created to evaluate exposure factors and symptoms separately on the outcome of having had COVID-19. Of the 97% of workers who participated (580/596), 300 (51.7%) suffered symptoms of COVID-19, 161 (27.8%) of the rapid antibody tests were positive for IgM and/or IgG, 160 (27.6%) workers had at least one risk factor, and 32 (19.0%) of the 168 SARS-CoV-2-positive cases were asymptomatic. The proportion of negative or unavailable PCRs, with positive antibody, was 11.7% (56/477). Casual contact without protection (odds ratio [OR]: 1.9, 95% confidence interval [CI]: 1.1-3.4), doctor occupation (OR 3.3, 95% CI: 1.1-10.2), and nursing assistant occupation (OR 2.5, 95% CI: 1.2-5.8) were independently associated with SARS-CoV-2 infection. Physicians and nursing assistants in a long-term care setting were at a higher risk of SARS-COV-2 infection over other occupations in the first wave of the pandemic, especially when in contact with patients without protection. Almost one-fifth of the workers with a positive PCR test for SARS-COV-2 were asymptomatic and seroprevalence (27.8%) was well below the approximated herd immunity cutoff (60-70%). Essential workers in long-term care must be monitored frequently by Employee Health Service and should be required to wear personal protective equipment including a fit-tested N-95 while in close contact with patients and coworkers.

It's Complicated! Needlesticks in the Perioperative Area: How We Standardized the Process

<h3>Background Information</h3> Our needlestick process was confusing and outdated. Often when needlesticks occurred in the perioperative area, no one knew what forms to fill out, who to notify and what labs needed to be drawn. A simpler standardized process was needed to disseminate within our department. <h3>Objectives of Project</h3> Standardize the needlestick process to reduce miscommunication and confusion among the perioperative nurses. <h3>Process of Implementation</h3> The operating room (OR) and post anesthesia care unit (PACU) educators met with perioperative leadership, the nurse practitioner from employee health services (EHS) and a charge nurse from PACU to discuss a plan for standardizing the process. It was decided to develop a needlestick kit that had everything the nurse would need if an event happened. The outdated binder with multiple confusing steps was replaced with a one-page infographic to list step by step the process when a needlestick occurs. A Microsoft Teams in-service and multiple unit in-services were held prior to the roll out. An email was sent to all the perioperative staff attaching the infographic and informing them of the new process. The infographic was placed in each needlestick kit and delivered to each OR and PACU. <h3>Statement of Successful Practice</h3> After implementation of the needlestick kits and infographic, it has been noted that there has been less confusion among the staff and more collaboration between OR and PACU. We have seen less emails and phone calls on what to do in an event of a needlestick. EHS has noted there has been a decrease in missing documents since the implementation. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> By collaborating with OR and EHS and developing this needlestick kit and infographic, it has resulted in a more effective process with a positive impact within the department. The next step would be to have the paperwork digitized.

Management of a large tuberculosis contact investigation related to a contaminated bone graft product used in spinal surgery

Background: In March–April 2021, 23 patients at a 906-bed hospital in Delaware had surgical implantation of a bone graft product contaminated with Mycobacterium tuberculosis; 17 patients were rehospitalized for surgical site infections and 6 developed pulmonary tuberculosis. In May 2021, we investigated this tuberculosis outbreak and conducted a large, multidisciplinary, contact investigation among healthcare personnel (HCP) and patients potentially exposed over an extended period in multiple departments. Methods: Exposed HCP were those identified by their managers as present, without the use of airborne precautions, in operating rooms (ORs) during index spine surgeries or subsequent procedures, the postanesthesia care unit (PACU) when patients had draining wounds, inpatient rooms when wound care was performed, and the sterile processing department (SPD) on the days repeated surgeries were performed. We created and assigned an online education module and symptom screening questionnaire to exposed HCP. Employee health services (EHS) instituted a dedicated phlebotomy station to provide interferon-γ release assay (IGRA) testing for HCP at ≥8 weeks after last known exposure. EHS managed all exposed HCP, including nonemployees (eg, private surgeons) via automated e-mail reminders, which were escalated through supervisory chains as needed until follow-up completion. The infection prevention team notified exposed patients, defined as those who shared semiprivate rooms with case patients with transmissible tuberculosis. The Delaware Division of Public Health performed IGRA testing. Results: There were 506 exposed HCP in ORs (n = 100), the PACU (n = 87), inpatient units (n = 140), the SPD (n = 54), and other locations (n = 122); 83% were employed by the health system. Surgical masks and eye protection were routinely used during patient care. All exposed HCP completed screening by December 17, 2021. Furthermore, 2 HCP had positive IGRAs without symptoms or chest radiograph abnormalities, indicating latent tuberculosis infection, but after further review of records and interviews, we discovered that they had previously tested positive and had been treated for latent tuberculosis infection. In addition, 5 exposed patients tested negative and 2 remain pending. Conclusions: This large investigation demonstrated the need for a systematic process that encompassed all exposed HCP including nonemployees and incorporated administrative controls to ensure complete follow-up. We did not identify any conversions related to this outbreak despite high burden of disease in case patients and multiple exposures to contaminated bone-graft material and infectious bodily fluids without respirator use. Transmission risk was likely reduced by baseline surgical mask use and rapid institution of airborne precautions after outbreak recognition.Funding: NoneDisclosures: None

Smartphone-based active vaccine safety surveillance (SmartVax) at a Swiss adult vaccination clinic - a pilot study.

Post-licensure surveillance of adverse events following immunisation (AEFI) is critical for detecting rare but severe AEFI. SmartVax software, using smartphone technology, actively solicits reports of AEFI via automated, opt-out SMS surveys to vaccine recipients in the days following immunisation. We report on a pilot study to test the feasibility and acceptance of SmartVax in Switzerland. Between February and September 2020, consecutive subjects immunised at an adult immunisation clinic and the employee health service at the University Hospital of Basel were screened. Participants included three subgroups: healthcare workers (HCW), subjects with immune-mediated inflammatory diseases (IMID) and clients of the regular adult immunisation clinic. Three days after vaccination, participants received an SMS inquiring if they had any AEFI. In the case of an AEFI, subjects received an automated SMS with a link to an online survey assessing the type and temporal evolution of the AEFI. Descriptive statistics of response rate, time-to-response, frequency and type of AEFI by vaccine and clinical subgroup were performed. Of 293 subjects screened, 276 were included (46.6% routine vaccination check-up visits, 33.3% HCW, 20.1% IMID patients) receiving 625 vaccinations during 360 immunisation visits. The SMS response rate was high (90.3%), with a median time-to-respond of 47 minutes (interquartile range11-205). After 29.8% of immunisation visits at least one AEFI was reported. There were no differences in frequency or type of AEFI between the three clinical subgroups. The recombinant, adjuvanted zoster vaccine Shingrix® was associated with the highest rate of local and systemic reactions. Monitoring post-licensure vaccine safety using the active SMS-based surveillance system SmartVax is feasible in Switzerland. We observed a high acceptance in the diverse study population, including healthcare workers and IMID patients. High response rates in the elderly and reliable monitoring almost in real-time make SmartVax a promising tool for COVID-19 vaccine safety monitoring.

Utility of a Telephone Triage Hotline in Response to the COVID-19 Pandemic: Longitudinal Observational Study.

BackgroundDuring the initial months of the COVID-19 pandemic, rapidly rising disease prevalence in the United States created a demand for patient-facing information exchanges that addressed questions and concerns about the disease. One approach to managing increased patient volumes during a pandemic involves the implementation of telephone-based triage systems. During a pandemic, telephone triage hotlines can be employed in innovative ways to conserve medical resources and offer useful population-level data about disease symptomatology and risk factor profiles.ObjectiveThe aim of this study is to describe and evaluate the COVID-19 telephone triage hotline used by a large academic medical center in the midwestern United States.MethodsMichigan Medicine established a telephone hotline to triage inbound patient calls related to COVID-19. For calls received between March 24, 2020, and May 5, 2020, we described total call volume, data reported by callers including COVID-19 risk factors and symptomatology, and distribution of callers to triage algorithm endpoints. We also described symptomatology reported by callers who were directed to the institutional patient portal (online medical visit questionnaire).ResultsA total of 3929 calls (average 91 calls per day) were received by the call center during the study period. The maximum total number of daily calls peaked at 211 on March 24, 2020. Call volumes were the highest from 6 AM to 11 AM and during evening hours. Callers were most often directed to the online patient portal (1654/3929, 42%), nursing hotlines (1338/3929, 34%), or employee health services (709/3929, 18%). Cough (126/370 of callers, 34%), shortness of breath (101/370, 27%), upper respiratory infection (28/111, 25%), and fever (89/370, 24%) were the most commonly reported symptoms. Immunocompromised state (23/370, 6%) and age >65 years (18/370, 5%) were the most commonly reported risk factors.ConclusionsThe triage algorithm successfully diverted low-risk patients to suitable algorithm endpoints, while directing high-risk patients onward for immediate assessment. Data collected from hotline calls also enhanced knowledge of symptoms and risk factors that typified community members, demonstrating that pandemic hotlines can aid in the clinical characterization of novel diseases.

Partnerships to Care for Our Patients and Communities During COVID-19.

The Coronavirus disease 2019 (COVID-19) pandemic forced not only rapid changes in how clinical care and educational programs are delivered but also challenged academic medical centers (AMCs) like never before. The pandemic made clear the need to have coordinated action based on shared data and shared resources to meet the needs of patients, learners, and communities. Family medicine departments across the country have been key partners in AMCs' responses. The Duke Department of Family Medicine and Community Health (FMCH) was involved in many aspects of Duke University's and Health System's responses, including leadership contributions in delivering employee health and student health services. The pandemic also surfaced the biological and social interactions that reveal underlying socioeconomic inequalities, for which family medicine has advocated since its inception. Key to success was the department's ability to integrate "horizontally" with the broader community, thereby accelerating the institution's response to the pandemic.

Työterveyshuollon etänä toteutettavan neuvonnan ja ohjauksen käyttöönottoa edistävät ja estävät tekijät

Teknologiaa hyödyntämällä on mahdollista tarjota saavutettavia ja asiakaslähtöisiä työterveyshuollon tietojen annon, neuvonnan ja ohjauksen palveluita. Myös tarve etäpalveluille on kasvanut teknologian kehittymisen ja työterveyshuoltojen asiakasyritysten kansainvälistymisen myötä lisääntyneen mobiilin työn vuoksi. Tämän tutkimuksen tarkoituksena oli selvittää työterveyshuollon etänä toteutettavan tietojen annon, neuvonnan ja ohjauksen kehittämiseen ja käyttöönottoon liittyviä tekijöitä. Tutkimus toteutettiin kolmessa työterveyshuollossa vuosina 2016–2018. Tutkimus koostui työterveyshuoltojen neuvonnan ja ohjauksen nykykäytäntöjen määrittelystä sekä etänä toteutettavan neuvonnan ja ohjauksen yhteiskehittelystä, kokeiluista ja arvioinnista. Analyysissa hyödynnettiin realistisen arviointitutkimuksen menetelmää. Tulokset kuvaavat työterveyshuoltojen toimintaympäristöjä ja niissä syntyviä etäpalveluiden käyttöönottoa edistäviä ja estäviä tekijöitä. Tutkimus tuottaa tietoa työterveyshuollon etänä toteutettavan neuvonnan ja ohjauksen kehittämisen ja käyttöönoton tueksi.

Motion Graphic Media Informasi Edukasi Penyakit Tuberculosis(TBC) Pada Klinik Karawaci Medika Tangerang

Tuberculosis or better known as TBC disease is a disease caused by the bacteria Mycobacterium Tuberculosis. This disease can be suffered by anyone, both young and old. Karawaci Medika Clinic, located in the Karawaci area of ​​Tangerang, is a clinic that provides health services for individuals and company employees by providing basic and / or specialist medical services. Karawaci Medika Clinic has handled various diseases, one of which is TBC. Currently, people do not know much about the spread and consequences of TBC disease so that the number of people affected by this disease continues to grow every year. The current TB information delivery at the Karawaci Medika Clinic is still using banners and brochures. The delivery media did not make the public interested in knowing information about TB. The community only read briefly and then threw away the brochures that had been given by the clinic. Based on the existing problems, a motion graphic video about TBC was made so that it could help the Karawaci Medika Clinic in conveying information about TB disease. The method used in making multimedia-based information media is data collection methods, media design and the concept of media production. The applications used in this research are Adobe Premiere pro CS6, Adobe After Effects CS6, Adobe Photoshop CS6, Adobe Audition CS6, and Adobe Media Encoder CS6. The final result is a video information motion graphic health education about TBC.

How Did Occupational and Employee Health Services Maintain the Health Workforce During the COVID-19 Pandemic?

How Did Occupational and Employee Health Services Maintain the Health Workforce During the COVID-19 Pandemic?

How did Occupational and Employee Health Services Provide Strategic Input to Organizational Emergency Contingency Planning During the COVID-19 Pandemic? A Case Study.

How did Occupational and Employee Health Services Provide Strategic Input to Organizational Emergency Contingency Planning During the COVID-19 Pandemic? A Case Study.

How Did Occupational and Employee Health Services Innovate to Maintain Core Business While Meeting the Increased Work Demands of the COVID-19 Pandemic?

How Did Occupational and Employee Health Services Innovate to Maintain Core Business While Meeting the Increased Work Demands of the COVID-19 Pandemic?

No evidence of increasing COVID-19 in health care workers after implementation of high flow nasal cannula: A safety evaluation.

BackgroundInitial recommendations discouraged high flow nasal cannula (HFNC) in COVID-19 patients, driven by concern for healthcare worker (HCW) exposure. Noting high morbidity and mortality from early invasive mechanical ventilation, we implemented a COVID-19 respiratory protocol employing HFNC in severe COVID-19 and HCW exposed to COVID-19 patients on HFNC wore N95/KN95 masks. Utilization of HFNC increased significantly but questions remained regarding HCW infection rate.MethodsWe performed a retrospective evaluation of employee infections in our healthcare system using the Employee Health Services database and unit records of employees tested between March 15, 2020 and May 23, 2020. We assessed the incidence of infections before and after the implementation of the protocol, stratifying by clinical or non-clinical role as well as inpatient COVID-19 unit.ResultsDuring the study period, 13.9% (228/1635) of employees tested for COVID-19 were positive. Forty-six percent of infections were in non-clinical staff. After implementation of the respiratory protocol, the proportion of positive tests in clinical staff (41.5%) was not higher than that in non-clinical staff (43.8%). Of the clinicians working in the high-risk COVID-19 unit, there was no increase in infections after protocol implementation compared with clinicians working in COVID-19 units that did not use HFNC.ConclusionWe found no evidence of increased COVID-19 infections in HCW after the implementation of a respiratory protocol that increased use of HFNC in patients with COVID-19; however, these results are hypothesis generating.

Obstacles to the development of workplace health promotion in Poland - the perspective of companies' representatives

The aim of the paper is to present the barriers and difficulties faced by companies in Poland in their employee health promotion activities. The aforementioned obstacles were analyzed in terms of their quantity and quality. Quantitative data come from 5 nationwide surveys conducted in 2000 (N = 755), 2006 (N = 611), 2010 (N = 1002), 2015 (N = 1000) and 2017 (N = 1000), in companies employing ≥50 people. Qualitative data were collected from representatives of such companies by means of an audience survey conducted during a conference (N = 75), 8 focus group interviews (N = 64) and individual in-depth interviews (N = 14). Invariably, the most frequently reported difficulty has been the shortage of financial resources for health promotion, as well as the lack of real support (legal, fiscal) from the government. By 2017, the former was indicated by 53% of companies, and the latter by 48%. A detailed analysis has shown that they are interrelated, and the key barrier is the mentality of employers and managers, i.e., their reluctance to health promotion, the fact that they are convinced of its high costs, a poor knowledge about its importance and implementation methods, and fear of the unknown. Other difficulties include: culture and work organization not fostering health care, a poor preparation and limited opportunities for the staff to implement health promotion, employees' reluctance to employer's health-related activities, some drawbacks of offers addressed to companies by external service providers, and, to a lesser extent, other difficulties arising from the business environment. To effectively mitigate these barriers, it is necessary to involve the government in the implementation of a coherent strategy to support health promotion in companies. Its main directions would be: shaping employers' awareness, supporting health-related activities through fiscal mechanisms (tax and insurance), educating the managerial staff, and pursuing effective cooperation with external providers of health services for employees. Med Pr. 2020;71(5):569-86.

How did Occupational and Employee Health Services Strengthen Their Health System to Meet the Challenge Presented by the COVID-19 Pandemic?

How did Occupational and Employee Health Services Strengthen Their Health System to Meet the Challenge Presented by the COVID-19 Pandemic?

Pharmacy, employee health lead health system's exposure response.

At Baystate Health in Western Massachusetts, the pharmacy department and Employee Health Services (EHS) work together to provide a consistent response whenever there is an occupational exposure to pertussis, bacterial meningitis, or other infectious diseases. Erin Taylor, assistant director of acute care pharmacy services at Baystate Medical Center (BMC) in Springfield, said in early February that the response protocol was developed after the 5-hospital system performed a gap analysis to review recent exposure incidents. Before then, she said, “there just was no standard process.” “We were all scrambling at the last minute and really not providing a valuable service to our employees,” she said. The new process includes well-defined procedures and documentation to track the health status of employees who are involved in exposure events. Taylor said the intent was to meet the needs of BMC and the health system’s smaller regional hospitals. She said one of the problems the group had to address was how to bill for medications used in the exposure response.