[MCOH-EH] Annual health evals for hospital employees

[Sampson, Deborah]

We only do annual eval of employees positive for TB (symptom questionnaire), chemo exposure (labs and questionnaire), and respiratory fit test for those who need it.  We also do random UDS on select high risk department personnel on an ongoing basis.

There is little to support such annual screenings in any literature that I have seen, although I do share your concerns about our aging employee population.

It is important, however, to avoid actions that could be considered age discrimination and you would also need to have job descriptions and policy/procedures in place that back up the testing/screening activities.

Before thinking about what tests should be done, it is perhaps important to think deeply about whether this process is the best course of action in the first place and how would it be operationalized in an appropriate way.

You would have to be very clear, specific, and on what you plan to do with the information in a screening beyond a 'Dear Doctor" letter. For example, if you find something that is potentially a problem in the workplace, do you restrict the worker? If so, how long and what criteria do you use for return to work? If you find something and don't restrict the worker, how will that influence any subsequent quality of care, patient safety and patient liability concerns?

Can your decision one way or the other both in process and in outcome hold up in court and will you apply the same process/criteria for everyone in a safety sensitive positions? How will you define a safety sensitive position? Will you also test physicians who are employees? How will this type of process effect your employee relations?

I do share your concerns as I also move into the 'aging employee' population. But I think annual screening could be a very slippery slope.

Deborah A. Sampson, PhD, APRN, COHN-S, FAANP
Director
Employee Health and Wellness Services
Southern New Hampshire Health   P.O.Box 2014   8 Prospect Street   Nashua, NH 03060
p(603) 281-8583  f (603) 577-5665
deborah.sampson at snhhealth.org<mailto:deborah.sampson at snhhealth.org>

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From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Galaid Edward I
Sent: Thursday, March 24, 2016 5:26 PM
To: mcoh-eh at mylist.net; Occ-Env-Med-L at listserv.unc.edu
Subject: [MCOH-EH] Annual health evals for hospital employees

XPosting MCOH and OEM-L.

We are re-evaluating our annual health eval for hospital employees.  Currently it's just the minimum that we have to... just the TST and symptom survey.

There are a couple of things that I think would be worthwhile to be checked on an annual basis, because they aren't static determinations, and our employee population is aging.  I'd would be interested in the lists' thoughts.

Looking at those involved in direct patient care and others here in safety sensitive positions.   Considering annual checks of near and far visual acuity, a BMI, and a med list review.  The vision is pretty straight forward...being able to properly perform essential job functions.....  The other two focus on impairment of situational awareness, executive functioning, judgement and vigilance.   Get a BMI (as arguably a rough screen) for OSA, and do a med reconciliation for sedating meds or polypharmacy.  Based upon findings, encourage going back to personal MD for further assessment with a "Dear Doctor" letter.

Shared ideas or experience with these issues appreciated.

Ed Galaid

Edward I. Galaid, MD, MPH
ABIM, ABPM
Medical Director, Occupational Health Partners
Roper St. Francis Healthcare   Charleston, SC
Member, ACOEM Task Group on Medical Guidance for Law Enforcement Officers
Member, NFPA 1582 Writing Group - NFPA Technical Committee on Fire Fighter Safety and Health
843-906-0519


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