Employee Health & Safety Tracking
Business
problem
Health care organizations must ensure that workers directly involved
with patient care are tested for tuberculosis exposure (PPD test).
These workers must also have a respirator "fit test" to
ensure that they know how to use the appropriate mask. Other immunizations,
such as influenza, are joining the list of things that must be tracked
for various groups of workers. The employee health department needed
a tool to manage this process.
PPD
Testing
There are three basic types of PPD tests:
- Initial
- Annual
- Post-exposure
follow-up
Each
type of test follows the same basic work flow, but with some differences,
as described below. The first step is to look up the specific worker
(not shown). Documenting the initial test
begins as shown below.

The
"Plant" and "Read" dates may be input or selected
from a calendar
(shown below).

The
date is selected by clicking on the
correct date on the pop-up calendar (shown below).

If
the initial test is negative and a
two-step
test is not used, the documentation process is complete (shown
below).

If
a two-step test is used, and both results
are negative, the documentation process is complete (shown below).

If
either test is positive, additional
fields are displayed for that test (shown for second test, below).
If the X-ray result is normal, documentation process is complete.

If
the X-ray result is abnormal, additional
fields are displayed to document follow-up steps (shown below).

Annual
PPD tests
follow the same workflow as initial tests (positive test with abnormal
result shown below).

Post-exposure
follow-up
also follows a similar workflow. The only significant difference
is the addition of a two-month follow-up after the first test (shown
below).

A complete
history of PPD tests for the selected worker is displayed
with one click (shown below).

Fit
Testing
Respirator fit testing
documentatin is handled in much the same way, by looking up a specific
worker and either adding a new test or viewing prior tests (shown
below).

All
prior fit tests may be viewed with
a single click (shown below).

When
adding a new fit test, if the worker
passed the medical evaluation, the tested respirator is selected
(shown below).

If
the worker passed the standard N95 fit test,
the fit test date field is exposed (shown below) and can be completed
either by inputting or selecting from pop-up calendar.

If
the worker failed the standard N95 fit test,
s/he was instead trained on the PAPR
(Powered Air Purifying Respirator), and the training date is recorded
(shown below).

If
the worker failed the medical evaluation,
the reasons are selected and the date input (shown below).

Department
Eligibility
Not all departments need to have PPD or Fit testing. Only departments
directly involved with patient care are required to have staff tested.
Those departments are identified from a list of all departments
in a maintenance page for this application (shown below).

Reporting
Selecting the eligible departments (shown above) makes it possible
to run compliance reports listing the workers who need testing.
A sample PPD testing report is shown below.

[Click
the image above to see the full size image]
Exposure
Tracking
Exposures of workers to infectious diseases occur at every health
care facility. When an exposure occurs, it is essential to identify
all exposed workers and track their health status and double-check
immunizations.

The
first step in adding a New Exposure (shown above) is to select the
type of exposure (shown below) and
the date of the primary exposure.

The
second step is creating a list of exposed workers. One method is
to look up individual workers by name
(shown below).

This
displays fields to record details about the
exposure and follow-up for each worker (shown below).

Very
often, multiple workers in one department are exposed. In that case,
selecting the department from the list (shown above) displays a
list of all workers in that department. All
exposed workers from that department can be selected (shown
below) and added in a batch for tracking.

Updating
details about any previous exposure
is simple. Just select the exposure from the list of previous exposures
and add, delete or edit the details about the exposure and any exposed
workers.
- Note:
E-mails are sent to the supervisor of any worker with "Expected
Followup Date" in the past and null "Follow-up complete,"
reminding the supervisor to have the worker contact employee health.

The
list of exposure types can be maintained
using a maintenance page in the application (shown below).

Permissions
There currently are four roles in this application:
- PPDTest-user
has read-only access to PPD testing and Exposure Tracking.
- PPDTest-superuser
has edit access for PPD data, Exposure Tracking, and department
eligibility.
- FitTest-user
has read-only access to Fit testing.
- FitTest-superuser
has edit access for Fit testing and department eligibility.
Outcomes
- All
three tracking modules (PPD, Fit and Exposures) work well. However,
resource constraints have slowed full implementation by employee
health.
- A
new module to track flu immunizations for workers is planned.
- Automated
reports showing compliance for the enterprise and by department
are produced and loaded into the intranet every night.
Lessons
learned
- Do
what it takes to make an implementation successful. Employee health
lacked the resources to input existing data into the new application,
so IT arranged for a temp to input all existing data, removing
a barrier to implementation.
Posted 9 August 2008
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