The review process was extensive and aimed to build on prior research and reports and reflect well the needs and advice of system stakeholders from both the OHS system and the HC system. We are grateful for the thoughtful and engaged input of all involved.
Important principles that emerged include:
- Strengthen connections between the OHS and HC systems (strategic linkages).
- Inform and empower workers at each step in the prevention and healthcare journey (agency).
- Build trust in data collection, integration and use in both systems (informed decision-making).
- Prioritize prevention services for smaller workplaces and industries most at risk (equity).
We strongly recommend that action be taken on the recommendations within. We experienced a strong interest in the OHS system to take action but little consensus on what, how and who. Without making decisions and articulating a comprehensive OD plan, partners will continue to move ahead on their own. While with good intent, the results are not optimal. Pulling back to basics and proceeding together in both an organized and comprehensive way is required.
OD system design considerations include:
- Get clear on purpose first.
- Clarify roles and strengthen accountabilities.
- Leverage and build on current expertise and activity.
- Centralize development of core activities and customize as required.
Set performance standards and monitor results from the start.
Finally, connecting the two OHS and HC systems in more fundamental ways is needed. This will require leadership and engagement from within the HC system and an OHS system sensitivity to the many challenges facing healthcare providers today. Supporting providers (specialists, primary care) most likely to see patients with occupation related disease and facilitating their diagnosis and care planning is the best place to start.
System redesign is a journey. Advancing our collective understanding of the connection between workplace exposures and disease and where and when to intervene is the goal. Worker health is the outcome.