Measuring the occupational health and safety performance of construction companies in Australia

Many facility managers are now required to deal directly with small firms engaged in the maintenance, alteration and cleaning of physical infrastructure. Increasingly the performance of small firms reflects on the manager of the facility, and so an understanding of their operation is required. It is mandatory for all firms to provide a safe working environment for their workers and subcontractors. Consequently, occupational health and safety (OHS) is a major issue for companies mainly due to the fear of prosecution. The introduction of Zero Tolerance by the Victorian government WorkCover Authority in 1999 provided even higher OHS safety standards for the construction industry. This has placed an increased burden on construction and maintenance companies especially small firms that are not in a position of financial strength. The size of the company has been found to be a major contributing factor to the OHS performance of construction contractors. This research is based on a benchmarking study of 44 construction companies in Victoria, Australia. The results show that the major factors influencing safety performance were; company size, and management and employee commitment to OHS.

Effect of company size on occupational health and safety

It is mandatory in all Australian jurisdictions for construction companies to provide a safe working environment for their workers and sub-contractors. Consequently, occupational health and safety (OHS) is a major issue for construction companies mainly due to the fear of prosecution. The introduction of zero tolerance by the Victorian government “WorkCover Authority” in 1999 provided increased legislative OHS standards for the construction industry. This has placed an increased burden on construction companies especially small firms that are not in a position of financial strength. This research is based on benchmarking study of OHS performance of 44 construction companies in
Victoria, Australia. The results show that the size of the company is a major contributing factor to their OHS performance. Small companies employing less than 25 employees have comparatively low levels of OHS performance compared to larger firms. Company size is a limiting factor that impacts on the ability of small firms to implement comprehensive OHS plans. This research calls into question that notion that increasing legislative requirements will improve OHS outcomes.

Nonpharmacologic interventions need outcomes for evaluating complex interventions in rheumatic diseases

Introduction. Nonpharmacologic interventions are themselves complex and are often combined with drugs and other interventions in the treatment of rheumatic diseases. Therefore, overall strategies for treatment are complex interventions. These should be evaluated regarding their processes and outcomes.
Methods. The CARE network, an international organization of health professionals (physicians and nonphysicians) and patients conducted a survey in 2008 to identify core outcomes in the ICF perspective, completed with a second survey (2009–2010) with patients in routine practice. These surveys have provided new information about domains to investigate as a basis for evaluating complex interventions.
Results. Outcome Measures in Rheumatology Clinical Trials (OMERACT) participants in this Special Interest Group agreed that current outcomes used in pharmacological research are not sufficient if the nonpharmacologic independent or combined contributions are to be assessed; other domains need to be addressed. This is an area of interest for further development.
Conclusion. Recommendations are proposed to develop research in the area of outcome for evaluation of complex interventions in rheumatic diseases.

Health system costs of diseases and injury in Australia 1993-94 : an analysis of costs, service use and mortality for major disease and injury groups

Provides a systematic analysis of the health system use and costs associated with specific disease and injury groups in Australia in 1993-94. The estimates are presented in a consistent format and are derived using a methodology that ensures the results add across disease, age and sex groups to total Australian health expenditures for 1993-94.

The Australian burden of disease study : measuring the loss of health from diseases, injuries and risk factors

This is an overview of the first burden of disease and injury studies carried out in Australia. Methods developed for the World Bank and World Health Organization Global Burden of Disease Study were adapted and applied to Australian population health data. Depression was found to be the top- ranking cause of non-fatal disease burden in Australia, causing 8% of the total years lost due to disability in 1996. Mental disorders overall were responsible for nearly 30% of the non-fatal disease burden. The leading causes of total disease burden (disability-adjusted life years [DALYs]) were ischaemic heart disease and stroke, together causing nearly 18% of the total disease burden. Depression was the fourth leading cause of disease burden, accounting for 3.7% of the total burden. Of the 10 major risk factors to which the disease burden can be attributed, tobacco smoking causes an estimated 10% of the total disease burden in Australia, followed by physical inactivity (7%).

Shared care for chronic eye diseases : perspectives of ophthalmologists, optometrists and patients

Objective: To report the perspectives of optometrists, ophthalmologists and patients on a model of shared care for patients with chronic eye diseases.

Design, setting and participants: Qualitative study of a model of shared care between optometrists and ophthalmologists for patients with stable age-related macular degeneration, diabetic retinopathy and glaucoma, trialled by the Royal Victorian Eye and Ear Hospital in Melbourne during 2007–2009. Semi-structured interviews were conducted with optometrists, ophthalmologists and patients at completion of the project to obtain their perspectives on this model.

Results: Seventeen optometrists submitted expressions of interest to participate, and 12 completed web-based training modules and clinical observerships and adhered to specified examination and reporting protocols. All five participating ophthalmologists and 11 of the optometrists were interviewed. Ninety-eight patients participated and 37 were interviewed. Optometrists not only met ophthalmologists’ expectations but exceeded them, appropriately detecting and referring patients with additional, previously undetected conditions. Patients reported savings in travel time and were satisfied with the quality of care they received. Optometrists, ophthalmologists and patients indicated a general acceptance of shared care arrangements, although there were some issues relating to interprofessional trust.

Conclusions: Shared care between local optometrists and hospital-based ophthalmologists can help to reduce patient waiting time for review and offers an opportunity for these two groups of eye care professionals to collaborate in providing localised care for the benefit of patients. However, trust and relationship building need to be further developed.