The client of occupational health services is, for example, an enterprise, an individual employee or a group of employees, the management, personnel administration, line management, and the work safety organization. Cus- tomer-orientation means that the client’s needs for occupational health serv- ices are determined together with the client enterprises, and the set goals are based on these needs. The clients of occupational health services ex- pect tailored services, i.e. services that suit their individual needs. The oc- cupational health personnel’s expertise as regards the content of the servic- es is used in interpreting the needs into procedures, priorities, and choice of service options. Complying with the needs of work places may also re- quire development of the occupational health services and the skills of the personnel.
In Finland, good occupational health practice emphasizes the needs of the work place and the employees in the implementation of occupational health services. Often the needs vary, depending on the point of view:
w the visions of the enterprise management: development plans,
experiencedproblems, e.g. bottlenecks in production, and turnover of the workforce related to the employees’ health and work ability
w needs of the employee (in the role of an employee and a private person)
w needs of the work community
w needs observed by the occupational health personnel (from sickness and accident statistics, work place surveys, findings in health check- ups, work atmosphere surveys, etc.)
w needs reportedby the safety representatives and stakeholders
How to determine the client’s needs?
The contract negotiations with a new client form a sound basis for client- oriented planning in occupational health services. Questions may be pre- pared beforehand to get a client-oriented discussion started. The answers to these questions should give a picture of the enterprise’s visions for the fu- ture, goals and policies in personnel, administration, recent changes in pro- duction or plans of change, bottlenecks in production, key personnel groups, problematic situations, etc. Examples of such questions are given in the following list. A picture of the enterprise’s occupational health service needs and goals is formed on the basis of the discussion.
Example 1
Questions to the management of the enterprise to help launch the planning of the occupational health services:
What kind of changes have been made recently in the production? Are changes planned in the future?
How do the changes affect the personnel policy? Will there be a need for more employees, or will cut-backs have to be made? Will the need for training increase?
What is the enterprise’s personnel policy? What kind of goals regarding the personnel’s health are in line with the enterprise’s public image? How could the work environment be improved?
How can the work content be improved? How could the work organization be improved? Which of the needs are most urgent?
What is the time schedule that can be agreed on by the enterprise and the occupational health services as regards the implementation, cost estimate
The occupational health personnel and the representatives of the client en- terprise should meet in person at least every 1–3 years. The results of the activity are discussed during the meeting, and further measures are agreed on. If it is not possible to arrange a meeting with the representatives of all the work places, information on needs and wishes can be collected with a questionnaire. The following examples of activities can be recommended as solutions to the needs of the work place.
Example 2
Questions that are helpful in charting the occupational health service needs of a work place
“How important is it that the occupational health services offer the following services to your enterprise/personnel?” The level of importance can be marked with numbers, e.g.:
1 = very important, 2 = important, 3 = difficult to say, 4 = rather unimportant, 5 = not needed, and 6 = I would like to know more about the service.
Service 1 2 3 4 5 6
w Work place survey (walk-through)
w Assessment of accident risks
w Ergonomic inspections and guidance
w Participation in the planning of the work environment and work content
w Participation in the teaching of new employees
w Information to groups about the risks at work, safe working methods, self- care, e.g. stress management, weight problems, how to quit smoking, etc.
w Assessment of first-aid readiness and participation in planning it
w First aid courses
w Support to the work community in times of change and development
w Support to the work community in their efforts to solve problems
w Health examinations
w Individual follow-up of work ability and referral for rehabilitation
w Individual support in coping with problems
w Activities to maintain work ability
w Instructions to individuals by an occupational health physiotherapist
w Curative treatment of acute illnesses
w Curative treatment and follow-up of chronic illnesses
w Neck and back ‘schools’
The client’s wishes, as expressed in the questionnaire, often require further handling, specification, and prioritization. Wishes can also be heard during work place walk-throughs, and at events organized by occupational health services. They may be voiced at feedback discussions of, for example, work atmosphere surveys, at individual meetings (health examinations, group check-ups), and at meetings of co-operative bodies (e.g. safety commit- tee).
The goal of the planning is to ensure that the occupational health services answer an actual need, and that they are grounded on a realistic basis, i.e. that the necessary resources are available (Figure 9).
Figure 9.
Starting points for planning occupational health services, and the limits set by the resource. An action plan can be part of an enterprise’s occupational safety action plan
▲ ▼ ▼ ▼ ▲ ▲ ▲ Work environment
Work and health Work capacity Knowledge on work and health
The goals
w in the work environment
w in health
w in work capacity OHS PLAN,
priorities agreed on by the client and the OH personnel Concrete action plan
w for about 3–5 years
w for the next year
NEEDS Cost/benefit to the enterprise General plan and budgeting made by the OHS