Arm yourself for the information revolution
Arm yourself for the information revolution
Computerization essential for recording, managing data in the EHS
Forty percent of hospital employee health departments are not computerized, according to the Hospital Employee Health annual reader survey. Computer-literate practitioners and other experts attribute this surprising statistic to two causes: either many hospital administrators are unwilling to allocate the money, or a large percentage of EHPs still are computer-phobic.
"Many employee health practitioners don’t have computers because they’re not computer-literate and they’re afraid of computers," says Kathleen VanDoren, RN, BSN, COHN-S, executive president of the Reston, VA-based Association of Occupational Health Professionals in Healthcare (AOHP). "There’s a resistance, because if they’re not computer-literate, they don’t see the importance or the convenience of computerization."
Keeping records on paper and writing reports by hand are relics of the past, VanDoren maintains. Although creating a computerized database can be time-consuming at the outset, it saves countless hours in the long run.
"If you take the time to put in the proper information, all you have to do is push a few buttons and out comes a report. For yearly reports, it takes just a few minutes to categorize all of the [injury] incidents that happened during the year and to get percentages and costs of the incidents. You can automatically know when employees are due for immunizations and tuberculosis screenings, and when you push a button, up comes the delinquent list. That saves hours over doing it by hand," she says. "It is such an advantage to have an employee health department computerized."
Only a few years ago, "I didn’t know how to use the on-off switch of a computer," VanDoren admits, but she learned by taking free classes offered by the information systems department at her hospital and by using a home computer. Other EHPs can do the same, she suggests.
Sometimes the lack of a computer is due to administrators’ reluctance. Because employee health departments often are perceived as non-revenue-producing, they can be overlooked for computerization. VanDoren advises EHPs who want computers to list all the tasks they have to do by hand, how many hours those tasks require over a year’s time, and then apply a dollar figure to those hours based on the EHP’s salary. (For cost justification and cost-benefit analysis information, see insert in this issue.)
Another strategy is to remind administrators that information required by regulatory agencies such as the U.S. Occupational Safety and Health Administration (OSHA) requires computer tracking, and that the cost of an OSHA fine can greatly exceed the cost of a computer system. "If you have to pay a $70,000 fine, how many computers could you have bought for that?" VanDoren remarks.
Be self-motivated to learn’
Nevertheless, the two possible reasons for remaining in a technological void may not be mutually exclusive. Many EHPs may not be actively lobbying for a computer system due to lack of computer literacy.
"You have to be self-motivated to learn," VanDoren says. "If you’re not self-motivated, you will be left behind. Everything is computerized these days, so there just isn’t room for anybody who wants to do reports by hand."
Many of the reasons given for not having a computerized department no time to learn or not being able to get administrative approval are nothing more than excuses, says Patrice L. Spath, a health care quality and resource management consultant with Brown-Spath & Associates in Forest Grove, OR.
"People use all sorts of excuses for not getting into [computerization], and it all comes back to, I’m afraid of computers and that’s why I’m making up all these excuses, and I’m hoping I retire before I have to use one,’" she says. "They need to sit down with someone in their own organization who can respond to all their concerns."
Spath also recommends that computer-shy EHPs use a home computer to gain familiarity and feel more comfortable operating the machine. Classes also are offered at most community colleges, as well as at many hospitals, such as the classes VanDoren attended.
Computerizing the employee health department is not the ordeal that some practitioners might dread.
"Be aware of what information systems are available in your facility," Spath advises. "People in occupational health should get their hospital’s data management plan and find out what information is already computerized. They may find there are existing systems within their organization that they can append to, that there already are occupational health modules in their hospital’s mainframe system."
If you’re considering buying a prepackaged software system, be sure the system specifically fits your needs, she adds. (See list of software packages for the EHS, p. 29.)
EHPs who are recording and managing data for more than 100 employees would benefit from computerization, Spath says. Using paper records works only for very small numbers of less than 100, but is unwieldy and inefficient for greater numbers.
"It has to do with the amount of records you’re trying to maintain," Spath explains. "For 100 or less, the time it takes to input and update the data is an additional step that probably doesn’t add any value to using a computer. When you have more than 100 records, though, then the return on your input investment becomes greater. You have the ability to generate reports, to manipulate data, to track infections among groups of employees, and to see relationships between different variables that you couldn’t recognize if the information was all on pieces of paper."
In addition, computers that are connected to the Internet give EHPs the ability to send electronic mail to colleagues across town or around the world, as well as to obtain OSHA standards and other federal regulations in minutes, she notes. (See related story on the World Wide Web, p. 27.) Like the telephone and fax machine, e-mail has become a standard of business communication without which department managers are left out of the organizational loop.
Scared to death at first’
Phyllis K. Stebbins, RN, employee health manager at Huntsville (AL) Hospital, says computerization is "invaluable" to providing services for more than 4,000 employees. Her EHS staff has been reduced in the past year, but the department’s responsibilities have not.
"Keeping up with our work manually would be a nightmare," says Stebbins. "It would be frightening to have to go back to that."
While Stebbins now uses her computer system for workers’ compensation management, employee leave, immunizations, needlestick tracking, post-exposure follow-ups, and monthly reports, among other functions, she lacked computer confidence at first.
"I’m from the old school. It scared me to death at first, but I had free instruction from our information services department. They have ongoing classes to teach everything you really need to know but were afraid to ask," she says. "Do you really need a computer? Yes, you do."
Most EHPs who are resisting technology are doing so out of fear of the unknown, Stebbins adds.
"If you don’t have one at home to play with, it can be very frightening. Nurses don’t want to look stupid. We’re supposed to know everything. It’s hard to say, I don’t know how to do that.’"
At 3,500-employee Tampa (FL) General Hospital, employee health manager JoAnn Shea, MSN, NP, has been using computers in her department for six years.
"It amazes me that [all EHSs] don’t have computers," she says. "It’s essential; I don’t know how anyone survives without a computer. I can’t even imagine it anymore."
Shea’s computer system is used for managing immunizations, clinic visits, and the wellness program. She also gives frequent presentations on topics such as bloodborne pathogens, substance abuse, and AIDS, and uses the computer to generate graphics and overheads. Reports that formerly took five or six hours a month to produce manually now take only five minutes.
In addition, OSHA requires having a database for TB screening, she points out, and Florida workers’ compensation law also requires a database. Both would be extremely difficult to produce and maintain without a computer.
It’s beneficial to careers to learn’
Some EHPs may not use computers because "they’re so strapped for time that they don’t have time to sit and learn and input the information," Shea says. "I’m fortunate to have a secretary who helps with that, but I have a computer at home so I’ve become a lot better at it. I can relate to not having the time to learn the programs, but in this day and age it’s beneficial to careers to learn."
But having a secretary is not a prerequisite for successful computer use. At Hendricks Community Hospital in Danville, IN, employee health nurse Marian S. Seib, RN, MS, COHN, inputs and maintains the data for 800 employees by herself.
Seib has been using the computer for three years, but as a novice, "I ran a paper list for the first month because I thought, I don’t know if I trust this.’ Now I’m working completely off the computer," she says.
She admits to thinking she couldn’t operate a computer initially, but after purchasing one for use at home, taking continuing education classes at a local university, and doing "a lot of self-teaching," she rarely has to ask anyone for help.
Convincing administrators of the need for a computer was not a problem. "Our executive vice president knew what computerizing an office could do," she says.
Now Seib keeps track of all regulation-required information, employee immunizations, TB skin testing, employees’ lab reports, and medical surveillance with her department computer.
"Our employee population has almost doubled, so I could no longer use index cards. I can be my own secretary. Before I was computer-literate I had to turn information over to human resources and wait until they had time to generate it back to me. Now I can do it all myself when I have time," she says.
Her advice to those who fear trying? "Dig in. It just involves logical thinking. You have to get beyond the fear because this is where the future is."
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