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APHA Scientific Session and Event Listing

Ainat Koren, PhD RN¹, Monica Galizzi, PhD², Craig Slatin, ScD, MPH³, Kathleen Sperrazza, MS, RN⁴, Karen Devereaux Melillo, PhD APRN BC¹, Barbara Mawn, PhD RN¹, Carole Pearce, PhD RN¹, and The PHASE in Healthcare Research Team⁵. (1) Nursing Department, University of Massachusetts Lowell, 3 Solomont Way, Suite 2, Lowell, MA 01854, 978 934-4429, ainat_koren@uml.edu, (2) Department of Economics, University of Massachusetts Lowell, 1 University Ave., Lowell, MA 01854, (3) Department of Community Health and Sustainability, University of Massachusetts Lowell, 3 Solomont Way, Weed Hall, Lowell, MA 01854, (4) PHASE in Health Care Research Team, University of Massachusetts Lowell, 19 Maugus Hill Rd., Wellesley, MA 02481, (5) Center for Public Health Research and Health Promotion, University of Massachusetts Lowell, 3 Solomont Way, Lowell, MA 01854

Between 1985 and 1994, US healthcare industry injury rates went from being relatively low to higher than in most industrial sectors. The period witnessed industry expansion and neoliberal restructuring - shifting to a market-based orientation, reducing labor and other production costs, and limiting patient services. From 1994 to the present, occupational injury rates in healthcare leveled. Two hypotheses for this trend are that either OSHA and JCAHO regulations and pressure brought healthcare facilities to improve safety programs, or that significant barriers to reporting of injuries were successfully established. The PHASE in Healthcare study explored the magnitude and nature of underreporting in two community hospitals and two nursing homes, using different types of data: administrative records (OSHA logs and workers' compensation filings); surveys to analyze potential predictors of reporting activities and outcomes; and, case studies to understand the decision making, policies, and practices in place. We also conducted focus groups with nurses and CNAs. Survey responses and case study and focus group data highlighted different barriers to reporting: fear of jeopardizing future employment or career advancement; patient's needs exceed workers' needs; claim filing burdens; and, concern about coworkers' and supervisors' reactions. Managers generally reported satisfaction with the facility's injury reporting system and with the general containment of workers' compensation costs. Reporting mechanisms were both formal and informal. We also found that reporting of hazardous conditions, near misses, and threatening incidents was rarely done. In no case was reporting part of a comprehensive occupational health and safety program.

Learning Objectives: At the end of the presentations, the audience should be able to

• Understand the complexities and added value of using mixed data sets and research designs when studying injury reporting issues.
• Identify some different ways that managers and workers perceived a common set of occupational health and safety problems.
• Discuss the injury prevention limitations of injury reporting mechanisms put in place in the absence of comprehensive workplace health and safety program.

Keywords: Health Care Workers, Occupational Injury and Death

Presenting author's disclosure statement:

Any relevant financial relationships? No