1. Evaluation of Selected Processes in Regional Occupational Health Care Centers Jacek Michalak, Nofer Institute of Occupational Medicine, Łódź, Poland

2. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Structure of OHS in Poland Primary units Primary units  authorized doctors,  different forms,  private or public organizations  prophylactic examinations Secondary units – Regional Occupational Health Care Centers Secondary units – Regional Occupational Health Care Centers  Public organizations only,  Responsibilities – OHS in the region  Consultations, education, control etc.

3. 10 th Congress on OHS, Amsterdam 13-16.11.2002 7 out of 23 ROHC were invited and their following functions were evaluated: Re-examination of employees Re-examination of employees Consultation Consultation Diagnosing of occupational diseases Diagnosing of occupational diseases Supervision and control of primary units Supervision and control of primary units Health promotion Health promotion Post-graduate education and training Post-graduate education and training

4. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Methods: Questionnaires for nurses and doctors Questionnaires for nurses and doctors Processes divided into steps Processes divided into steps Each step assessed or measured Each step assessed or measured Health promotion and educational programs were evaluated separately from other activities Health promotion and educational programs were evaluated separately from other activities

5. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Results (1) Majority of ROHCC assessed time schedules Majority of ROHCC assessed time schedules Two out of 7 performed measurements of each step of 4 procedures Two out of 7 performed measurements of each step of 4 procedures Two „rapid ROHCC” – all procedures were remarkable shorter Two „rapid ROHCC” – all procedures were remarkable shorter Five „slow ROHCC” – assessments with caution Five „slow ROHCC” – assessments with caution

6. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Process - total Examination Occupational physician 34 - 90 min. 10 - 45 min. Laryngologist 10 - 70 min. 5 - 20 min. Neurologist 14 - 120 min. 4 - 40 min. Orthopaedist 16 - 70 min. 5 – 20 min. Results (2) - re-examination

7. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Nurse 19 – 40 min. Nurse (at specialistic clinic) * 18 – 10 2 min. Occupational physician: 69 – 450 min (examination 11-60 min.) Dermatologist 24 – 140 min, Laryngologist 12 - 100 min Neurologist 24 - 150 min Results (3) diagnosing an occupational disease * different functions in different clinics

8. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Results (4) Consultation Procedure Medical examination Nurse 10 – 35 min - Occupational physicians 30 – 90 min. 5 - 30 min Neurologist 5 * - 115 min. 2 - 15 min. Ophtalmologist 8 - 75 min 4 - 20 min Pulmonologist 4 – 115 min. 1 -10 min. measured

9. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Results (5) Control of a primary unit Different extend and scope of controls in different ROHCC Different extend and scope of controls in different ROHCC Time spent on a control by occupational physician from ROHCC varied from 1 to 68 hours Time spent on a control by occupational physician from ROHCC varied from 1 to 68 hours

10. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Conclusion Two „rapid ROHCC” – all procedures were remarkable shorter (realistic scenario) Two „rapid ROHCC” – all procedures were remarkable shorter (realistic scenario) Five „slow ROHCC” – assessments with caution (pessimistic scenario) Five „slow ROHCC” – assessments with caution (pessimistic scenario) The differences were caused mainly by different time spent on the evaluation of documents and filling the forms by the doctor(s)

11. 10 th Congress on OHS, Amsterdam 13-16.11.2002 Thank you for your attention