The development of evidence-informed clinical quality indicators for generic occupational health practice

Introduction
Our aim was to develop generic quality indicators (QIs) to improve the quality of clinical occupational health (OH) practice in promoting the health of the workforce and reducing the duration of long-term sickness absence.

Methods
A hand search of relevant literature was conducted, followed by a systematic search of the Cochrane Database. Studies were analysed for evidence of interventions that led to a reduction of incidence or duration of sickness absence, or improved vocational rehabilitation and return-to-work rates. The studies were categorised thematically to produce draft QIs.
A pilot study asked volunteer OH departments to collect data for each QI over one day in one week, and fill out a questionnaire on whether the indicator was clear, whether it was feasible to collect data for that indicator, whether they would recommend any changes, and questions relating to the specific QI.

Results
1065 reports or papers were retrieved and eight met the inclusion criteria for inclusion as evidence for the development of QIs. Four QIs were developed based on temporary modification for work for those off sick for >4 weeks; timeless of appointment and advice to manger; high level of patient satisfaction and the production of informative reports. Five OH departments piloted the draft QIs. The pilot sites made useful suggestions and asked for clarification for the indicators, help notes which accompanied them and the patient and manager satisfaction surveys. The pilot indicated that the QIs were feasible to use in practice and easy to implement in a busy OH clinical environment.

Discussion
We used the best available research evidence of high quality OH care to develop four QIs. The pilot study demonstrated that the indicators are both feasible to use and easy to implement by clinical OH departments.