Evaluation of occupational health and safety services of the hospitals in İzmi̇r

INTRODUCTION The aims of this study are to determine the quality and quantity of occupational health and safety (OHS) services for the healthcare professionals in the inpatient treatment facilities and settings in İzmir, appointing the application level of OHS Law and other law provisions, finding encountered problems and deficiencies while offering OHS services, detecting areas related to, which are open to improvement. In recent years there have been significant rapid changes in the concept of OHS. OHS has been more important for healthcare professionals than other professionals or occupations. The majority of healthcare professionals are working at the hospitals, where they are being continously posed with most dangerous category. National Institute for Occupational Safety and Health has identified 94 risk factors under five sub-headings at the hospitals, especially biological and psycho-social risks. The regulations supporting healthcare professionals to benefit from OHS services against these risks are carried out in recent years in Turkey. While Labor Law includes binding provisions for private health institutions, OHS Law enacted in 2012 contains provisions related to all public and private healthcare facilities and institutions. MATERIAL-METHOD 56 inpatient treatment facilities in İzmir constituted the study population. The study contains all the population and extra samples were not chosen. Our study consists of two parts; 1) quantitative and 2) qualitative. The quantitative part of the study was planned cross-sectionally. The qualitative section was intended to explain the results, which were obtained from the quantitative section and grounded theory method was used. Data collection had been completed between May 2015 and September 2015. FINDINGS 49 out of 56 hospitals participated in the study. OHS services evaluated collectively by giving individual points for each service and calculating an OHS score from these points. Mean OHS score was 75,8±10,5 for these hospitals. 26 hospitals were under mean score and evaluated as 'insufficient'. The number of hospitals above the mean score was 23. While the best hospitals OHS score was 97,9, the lowest-rated hospitals score was 50,3. OHS score was higher at special hospitals, which has no white/blue-collar union and at hospitals which have accreditation study (except Quality Systems in Healthcare of Health Ministry). In correlation analysis, it was found that OHS score has a negative correlation with hospitals age, subcontractor employee rate and the number of physical and verbal violence rate reported by employees. Positive correlation found for OHS score and the duration of the OHS service offering. RESULTS According to logistic regression analysis, the most important variable affecting the results of the OHS services was ownership type of hospital (public / private). Public hospitals were worse than the private sector by OHS service provision. Qualitative part pointed out the possible causes of differences were following; 1)OHS legislation which was not compatible with the public sector, unnecessary bureaucracy in the public sector and the problematic of the bids, 2) Inadequate employment and problematic employment of OHS professionals in public sector; and 3) Inadequate control of OHS in the public sector. Moreover, other problems encountered in the provision of services were; 1) Failure of employer / management support, 2) Lack of participation of occupational physicians to OHS service provision, reluctance in recruitment OHS service of health workers -especially doctors-, 3) Requirement for developing location-time-content of OHS educations, 4) Quality units are still the most effective unit about OHS at hospitals, and 5)The lack of notification in occupational accidents and sharp injuries. CONCLUSIONS The government is only the most important representative on daily-basis grounds that it is an employer and it has an inspection, a supervision and a regulation mission.