PubMed · 7249642
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J T Lynch, M L Silverman, K M Delaney. 1981. Emergency room utilization: an initial look.. https://pubmed.ncbi.nlm.nih.gov/7249642/
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Shared Governance is the administration and deployment of the organization's services through a partnership model of managers and staff. A system is said to "live" where it provides service. In a health care organization this is the point of service known as the patient care unit. In that arena staff nurses engaged in a partnership model of governance should be acknowledged as the rightful owner of their clinical practice and the systems that support the delivery of patient care. This manuscript describes an acute care hospital's experience in the evolution of its governance structure that enabled staff nurses to assume greater levels of autonomy and control over their practice.
BACKGROUND: Reports of occupational disease using the Bureau of Labor Statistics (BLS)/OSHA survey have shown increasing rates with larger establishment size. The literature is divided on whether this pattern is an artifact of under-reporting in smaller businesses or is the result of differences in underlying risk factors. METHODS: A population-based survey [the Connecticut Upper-Extremity Surveillance Project (CUSP)] assessing prevalence of likely work related musculoskeletal disorders (MSD) in CT, coded by establishment size, is compared to CT MSD incidence rates based on the BLS/OSHA survey. RESULTS: When analyses were controlled for age, gender, physical risks, and occupation, there was a marginally significant association between business size and the rate of MSD [odds ratio (OR) = 0.91, CI 0.82-1.01], but in the opposite direction of the BLS/OSHA rates, with larger businesses having somewhat lower rates of MSD. Reported risk factors varied in a similar direction, though with mid-sized companies having the highest physical risks. CONCLUSIONS: The increased rates of occupational illness in larger businesses reported in the BLS/OSHA survey does not appear to be due to actual incidence or distribution of risk factors, but appears more likely to be due to under-reporting in smaller businesses. Estimates based on the assumption that the ORs based on size are actually similar to the CUSP population survey results suggest that MSD incidence is approximately 3.6-times the reported rates.
OBJECTIVE: To quantify the magnitude and patterns of occupational disease in Connecticut. METHODS: Collecting and standardizing data on occupational diseases from the Bureau of Labor Statistics Survey, workers' compensation reports, and physician reports for the 2001 calendar year, and using capture-recapture analysis to estimate unreported cases. RESULTS: The rate of occupational illnesses dropped to 35.1 cases per 10,000 workers in 2001 (from 6,396 cases reported in 2000 to 5,514 in 2001). Musculoskeletal disorders (MSD) accounted for more than half of the cases. There was a low proportion of cases that were reported to both workers compensation and the Department of Public Health, indicating widespread under-reporting of cases; it is estimated that there are actually over 30,000 cases of occupational disease each year. CONCLUSIONS: Occupational disease is one of the highest incident conditions of any type of medical condition, and there is a high level of under-reporting.