Hanna Barbara Rasmussen

Occupational accidents in the Danish merchant fleet and the nationality of seafarers

BackgroundThe aim of the study was to examine occupational accidents reported from non-passenger merchant ships registered in the Danish International Ship Register in 2010-2012, with a focus on analysing nationality differences in the risk of getting injured in an accident.MethodsData about notified occupational accidents were collected from notifications sent to the Danish Maritime Authority and from records of contact with Danish Radio Medical. Events were matched by personal identification and accident data to create a unified database. Stratified cumulative time spent on board by seafarers was used to calculate accident rates. Incidence rates of different nationalities were compared by Poisson regression.ResultsWestern European seafarers had an overall accident rate of 17.5 per 100000 person-days, which proved to be significantly higher than that of Eastern European, South East Asian and Indian seaman (adjusted incidence rate ratio 0.53, 0.51 and 0.74, respectively), although differences decreased over the investigated period. Smaller but in most cases still significant discrepancies were observed for serious injuries. The back injury rate of Western European employees was found especially high, while eye injuries seem to be more frequent among South East Asian workers.ConclusionsThe study identified substantial differences between nationalities in the rate of various accidents reported from merchant ships sailing under the Danish flag. The differences may be attributed to various factors such as safety behaviour. Investigation of special injury types and characterisation of effective elements of safety culture can contribute to the improvement of workplace safety in the maritime sector.

Safety Representatives’ Roles and Dilemmas in the Danish Oil and Gas Industry

Abstract Safety representatives are supposed to play a crucial role in ensuring safe and healthy workplaces in the oil and gas industry, but the role is marked by dilemmas and constraints. This paper analyses how safety representatives in their daily practice develop a role that can create the necessary recognition from management and the manoeuvring space to fulfil their role. It is based on a study of three firms in the Danish oil and gas industry. The results indicate that safety representatives are marked by dilemmas between the rather extensive legislative demands and the conflicting expectations from colleagues and management, and constraints on the day-to-day fulfilment of the role. Danish legislation and Danish industrial relations focus on the collaborative aspect of the safety representative role, which impacts on the view of the role. The primary role of the safety representative is to solve small problems rather than protect the interests of colleagues. The focus on problem solving is caused not only by legislation, but by the policies of the individual companies-in the three companies studied, there were considerable differences between them, with one company including its safety representatives to a much larger extent than the others.

Municipalities Collaborating in Public Health: The Danish Smoking Prevention and Cessation Partnership

This study explored the Smoking Prevention and Cessation Partnership (SPCP) which builds upon a collaboration between two Danish municipalities targeted at the prevention of tobacco smoking. The aim of the study was to describe the processes of SPCP, to examine the difficulties this collaboration faced, and to assess how these experiences could be used to improve future partnership collaboration. We employed qualitative methodology comprising 12 semi-structured one-to-one interviews with SPCP’s stakeholders and an analysis of the partnership documents and reports. The findings suggested that the main potentials of the partnership were the personal relations between the members and stakeholders with the possibilities of the creation of new connections with other actors. Barriers to successful partnership building were the implementation of the new Local Government Reform as a competing task, and that the two municipalities were heterogenic in respect to organizational issues and working methods. Other impediments included the lack of continuity in leadership, the lack of clarity regarding the form of collaboration and roles, as well as different expectations of the stakeholders. We conclude that four factors remain critical for partnerships. The first is the clarity of the collaborative effort. Second, partnerships need to take into account the structural circumstances and culture/value systems of all stakeholders. Third is the impact of contextual factors on the development of the partnership; and the fourth factor is the bearing of personal/individual factors on the partnership e.g., personal engagement in the project. Early attention to these four factors could contribute to more effective partnership working.

Identification of Success Factors for Green Shipping with Measurement of Greenness Based on ANP and ISM

Green shipping as an emerging concept which aims to mitigate the negative environmental impacts caused by shipping activities has received more and more attentions recently. However, there is a gap in knowledge how to take the efficacious measures, which makes it difficult for the stakeholders of shipping activities to promote green shipping. In order to fill this gap, this chapter proposed a generic methodology for establishing a criterion evaluation system for greenness assessment of shipping, including the identification of the success factors, the development of some strategic measures, and the analysis of the measures for enhancing the greenness of shipping. A criterion evaluation system which consists of multiple criteria in five aspects including: technological aspect, economic aspect, environmental aspect, social aspect, and managerial aspect has been firstly established. Subsequently, Analytic Network Process (ANP) has been employed to determine the relative importance of these factors in green shipping with the consideration of the interdependences and interactions among these criteria for evaluating the greenness of shipping, and they have been ranked from the most important to the least. Accordingly, the key success factors for green shipping have been obtained. Then, some strategic measures for helping the stakeholders enhance the greenness of shipping have been proposed. Finally, Interpretative Structuring Modeling (ISM) has been employed to analyze the cause-effect relationships among these measures and the features of these measures.

Using patient experiences as an outcome of integrated care. How to measure it

Introduction : When is integrated care successful? Many studies have focused on clinicians’ perspective whether initiatives to sustain integrated care are successfully implemented and whether the initiatives have an effect. One of the primary aims in integrated care is to deliver a person-focused and population-based care. The foremost to assess whether integrated care initiatives enhance clinical integration, are the patients themselves. The Region of Southern Denmark has initiated a project focusing on the patient perspective, so that clinical integration is based on both patient and clinical perspective on the micro level. Moreover, the project deliver important knowledge to both the meso level and the macro level enhancing normative integration. In this project, clinical integration is composed by health care being hospital admissions and outpatient treatments, and social care being home care and rehabilitation. The purpose of this project is to identify how patients conceptualize clinical integration and how this resembles key features for clinical integration identified by clinicians. Further, we want to develop a patient questionnaire measuring their experience of clinical integration. Method : We performed a qualitative literature review to identify articles and reports concerning patient experiences in clinical pathways entailing clinical integration in-between health care and social care. Based on the literature we developed a semi-structured interview guide and conducted 12 patient interviews. Inclusion criteria for respondents were, ≥ 18 years, able to read and speak Danish, and having experienced a clinical pathway that included services from both health and social care. The study population include patients being admitted to hospital acute or scheduled, patients in outpatient clinical pathways, and patients with chronic and transitory conditions. Data from the semi-structured interviews will be analyzed using grounded theory identifying themes that are important to patients in inter-sectorial clinical pathways. The identified themes will be compared to themes identified in the literature and the three subscales of the Nijmegen Continuity Questionnaire (NCQ)(2). Based on the comparison of themes, we will develop a questionnaire and do a pilot test. Progress report : We searched the literature for articles and reports surveys measuring different aspects of patient experiences on clinical integration. Several questionnaires measured patient experiences on selected themes such as hospital care coordination, patient education, or for selected patient groups. We found a number of reports describing qualitative studies of patient experiences in clinical integration in-between health care, social care and primary care. These reports provided the background for the interview guide together with the NCQ. We choose the NCQ as inspiration for the development of the survey because it had elements general to all patients in inter-sectorial clinical pathways. The NCQ is translated from Dutch to Danish in a forward-backward procedure(3). Patients for the qualitative semi-structured interviews were recruited from hospital departments specialized in orthopaedic surgery, neurology, cardiology, general medicine, and pulmonary medicine. From social care, we recruited patients with clinical pathways related to diabetes and oncology. Discussion : It is challenging to identify themes that are sensitive to changes in clinical integration involving health care and social care. In other surveys of patient experiences, the quantitative data often provide a picture of general high patient satisfaction. We will try to take into account that some item must be very specific to be able to detect differences. In future assessment it would be beneficial to use both quantitative and qualitative data of patient experiences. There is a risk of selection bias in the population that we wish to interview. However, in the selection process, we tried to included a population that reflects the general population with regard to age, socio-economic level and gender. However, the interviewed patients are in general older and do have comorbidity. The data analysis is ongoing and results will be presented at the conference.

Key aspects in managing safety when working with multiple contractors: A case study

Working with multiple contractors in a shared workplace can introduce and increase safety risks due to complexity. The aim of this study was to explore how safety issues are recognized in a specific case and to identify whether clients and contractors perceive problems similarly. The safety issues are explored through a brief survey and a workshop in the maintenance department of a logistics company. The results indicate that culture and behavior are recognized differently by clients and by contractors. The contractors and client had different perceptions of involvement of contractors by the client. The contractors complained on lack of involvement, which was not fully recognized by the client. The case study used a practical approach to show differences in perception of safety within a project. The study illustrates the need for more applied studies and interventions on contractor safety.