Determining the Function of an Occupational Health Advisor and How to Evaluate Success
Those responsible for the management of health, environment and safety matters should consider the following guidance when determining what function the occupational health nurse specialist will fulfill within the company. There may well be variation in the function of an occupational health nurse between different organizations depending on the needs and priorities of the working population and the health care system in which they are operating. Some useful questions to consider are:Has a comprehensive health needs assessment been performed recently to identify the needs of the organization and to help with setting priorities for action?
Has the workplace health management policy been reviewed and agreed in light of the needs assessment, taking into account both legislative demands and voluntary agreements?
Have the goals of the occupational health service been defined clearly and communicated throughout the organization?
Does the occupational health service have adequate resources to achieve these goals, including staff, expertise, facilities and management support?
Is it clear how the performance of the occupational health service or of individual professionals within that service, is to be evaluated and are there clear, objective criteria agreed?The answers to each of these questions will help to shape the discussion about the role and function of the occupational health nursing specialist within a specific organization.Workplace health management is most effective when there is:Commitment from senior management
Active participation of employees and trade unions
Integration of company policies and clear targets for HES (health, environment and safety management)
Effective management processes and procedures
Adequate resources
A high level of management competence, and
Rigorous monitoring of company performance using the principles of continuous quality improvement.Policy making should be based on legislation and on a voluntary agreement between social partners at work, covering the total concept of health, safety and wellbeing at work.Evaluation of PerformanceEvaluation can take place on three levels:Company performance in the area of workplace health management
Contribution of the occupational health and safety service
Contribution of the individual occupational health nurseAll review procedures should be based on the principles of continuous quality improvement or audit. The criteria and indicators against which performance is to be measured should be defined clearly as a part of the initial planning and contracting process so that everyone is clear about what performance indicators are being used. Some caution is required if health measures are to be used as performance indicators for the occupational health service as much of the work of an occupational health service is orientated primarily towards the prevention of disease or injury or the reduction of risk. The success or failure of preventative strategies can be difficult to measure using health data on its own as it is sometimes uncertain to what extent a single intervention or programme of interventions can claim responsibility for preventing the effect. Furthermore, many health effects only become apparent a long time after initial exposure and sometimes only become apparent in particularly vulnerable individuals. Where prevention is dependent upon the employee, the line manager or the organization following the advice of the occupational health professional, where this is not followed the adverse event may not necessarily indicate a failure on the part of the occupational health service, but rather a failure of the individual, manager or organization to respond appropriately to the advice they were given.Evaluation can be based on the structure, input, process, output and outcome indicators, and both direct and indirect effects, positive or negative, can be taken into account when judging the relative success or failure of the service. It is often useful to consider two inter-related aspects of occupational health practice in the evaluation process, the professional standards that underpin professional practice and the delivery or services within the organization. Professional practice can be evaluated by, for example, evidence of participating in continuing professional development and adapting practices to take account of new knowledge, self-assessment of compliance with current best practice guidelines, regular internal and external peer review, or systematic audit of compliance with standards. The criteria used to evaluate professional practice should also take account of ethical standards, codes of practice and guidance from the professional bodies. Evaluating service delivery can be done by, for example, comparing the delivery of services against predetermined service level agreements or contracts, including meeting agreed quality standards for services, through customer or client satisfaction surveys, or by assessing the adequacy of access to and level of uptake of services.
The Global Financial Crisis and Its Repercussions
The global financial crisis of 2008-2009 is an ongoing major financial crisis. It became prominently visible in September 2008 with the failure, merger, or conservatorship of several large United States-based financial firms. The causes leading to the crisis had been reported in business journals for many months before September, with commentary about the financial stability of leading U.S. and European investment banks, insurance firms and mortgage banks consequent to the subprime mortgage crisis.Beginning with failures of large financial institutions in the United States, it rapidly evolved into a global credit crisis, deflation and sharp reductions in shipping resulting in a number of European bank failures and declines in various stock indexes, and large reductions in the market value of equities (stock) and commodities worldwide.The credit crisis was exacerbated by Section 128 of the Emergency Economic Stabilization Act of 2008, which allowed the Federal Reserve System to pay interest on excess reserve requirement balances held on deposit from banks, removing the longstanding incentive for banks to extend credit instead of hoard cash on deposit with the Fed. The crisis led to a liquidity problem and the de-leveraging of financial institutions especially in the United States and Europe, which further accelerated the liquidity crisis, and a decrease in international shipping and commerce. World political leaders and national ministers of finance and central bank directors have coordinated their efforts to reduce fears but the crisis is ongoing and continues to change, evolving at the close of January into a currency crisis with investors transferring vast capital resources into stronger currencies such as the yen, the dollar and the Swiss franc, leading many emergent economies to seek aid from the International Monetary Fund. The crisis was triggered by the subprime mortgage crisis and is an acute phase of the financial crisis of 2007-2008.Russia’s economy hitThe Russian financial crisis of 2008-2009, part of the world Economic Crisis of 2008, is an ongoing crisis in the Russian financial markets which stemmed from the US sub-prime mortgage crisis and has been compounded by political fears after the War with Georgia, and by the plummeting price of Urals heavy crude oil, which has lost more than 70% of its value since its record peak of $147 on 4th July 2008. While according to the World Bank, Russia’s strong short-term macroeconomic fundamentals make it better prepared than many emerging economies to deal with the crisis, its underlying structural weaknesses and high dependence on the price of a single commodity make its impact more pronounced than would otherwise be the case. Swift fiscal management and substantial financial reserves may have protected Russia from deeper consequences of this shock.Reasons Why Gold Will Rise In 2009Secretary of the Treasury Paulson talked of the current crisis being potentially worse than the Great Depression. Alan Greenspan told Congress that the financial meltdown had left him in a “state of shocked disbelief.” Reputable economists are saying “this looks an awful lot like the beginning of the second Great Depression.”U.S. consumer confidence has fallen more sharply than in any period since records began in 1978. Since September 9, we have seen the nationalization of Fannie Mae, Freddie Mac and AIG; the socialization of the auto industry; the disappearance of the investment banking industry; a $700 billion Bailout with another stimulus plan approved recently; the bankruptcy of Lehman Brothers; the “breaking-of-the-buck” of the supposedly rock-solid money market funds; the largest bank failure in history; the implosion of global stock markets; the collapse of home values, retail sales and consumer sentiment; the biggest fall in industrial production in 34 years; and an unprecedented shattering of confidence in both commodities and financial assets. It is increasingly apparent that fear predominates. Individual investors are abandoning anything with the slightest hint of risk. Last year was the worst year for global equity markets since the Great Depression, with the Dow suffering its worst annual decline since 1931. Investors are pulling huge amounts of money from hedge funds, stock mutual funds and bond mutual funds in one of the biggest flights to safety the financial industry has ever seen. Defensive Asset Class have assets that have similar risk/return characteristics, are positively correlated with each other and are traditional inflation hedges that are negatively correlated with stocks – they do well when stocks do poorly. Historically, the principal Defensive Asset has been gold. Of the major assets, only Treasuries and gold have escaped the selling panic that has gripped the markets. Gold rose 5.4% over 2008, ending the year above $850 a troy ounce. Gold bullion reached $1,030.80 in mid-March and Mints around the world ran out of popular gold coins and small gold bars after the collapse of Lehman Bros. in September. The U.S. rate cut to virtually zero lowers the opportunity cost of buying gold and gold ETF holdings have exploded from 7 million ounces to over 30 million ounces in less than four years Gold is different from other precious metals such as platinum, palladium and silver because the demand for these precious metals arises principally from their industrial applications.Gold’s value rise arises from its use and worldwide acceptance as a store of value and a safe haven. Other precious metals have also been classified as Defensive Assets, but have not performed as well as gold during this crisis. For example, investment accounts for about 90% of the demand for gold, while investment makes up only one-third of the total demand for platinum. Therefore, although gold has done well, platinum’s demand from industrial uses has fallen rapidly, particularly because of the high concentration of uses of platinum in new automobiles – an endangered species in an economy in which automakers are begging for funds from Washington just to keep them afloat. Gold’s price has been bolstered by the view that it is a safe haven in times of economic or political uncertainty, while platinum’s industrial demand has fallen precipitously. Platinum reached its all-time high of $2,267.00 per ounce in March, but fell like a rock from there, as did silver. Platinum fell nearly 60% from its March peak, while silver fell 47%. The last time that gold traded for more than platinum was January 21, 1994, when gold closed at $381.70 and platinum at $380.90.