Program Setup I - Occupation Health Shift Rules

This article describes the shift rule settings that are used for occupational health and hearing conservation programs. For a description of the shift rules used for clinical and research settings, see Program Setup I - Clinical and Research Shift Rules.

You can find the settings for shift rules, scheduling rules, and automatic triage under Settings > Program Setup in the side menu of the Data Management Portal.

In this article:

• Shift rules
• Shift standard
• Hearing conservation calculation standards
• Averaging label
• Creating new rules
  • To create a new rule

Shift rules

The Shift Rules page is where you can configure rules for shift/averaging calculations and assign them to projects. Shift reports and the automatic triage process rely on the correct configuration of these rules. Clicking the Pencil icon will allow you to configure rule settings.

The settings you can select in this section are the shift standard and the averaging label.

Shift standard

Shift standards are shift calculations or grading scales used to evaluate hearing changes. Here, you can set which calculations are used in your organization. These calculations are used for Patient Analysis, Summary Reports, and Automatic Triage.

Shift standards use the results of a patient's audiogram to automatically calculate things like recordable shifts in a patient's hearing ability, or measurable grades of hearing that are given to a patient based on their audiogram results.

During your testing, you may be required to use different calculation standards, based on your specific use case. Listed below are examples of the different calculation standards offered within SHOEBOX, and the industries they apply to.

Hearing conservation calculation standards

OSHA (Occupational Safety and Health Administration)

As a part of the Department of Labor, OSHA is the regulatory and standard body for occupational health in the US. The specific standard that applies to occupational hearing conservation is 29 CFR 1910-95. Note that this is a national standard but that more than 25 states have their own state-specific OSHA guidelines in place for hearing conservation which take precedence over the national guidelines.

This calculation standard is used in compliance with OSHA to determine if there has been a measurable shift in a patient's hearing ability. While performing hearing conservation testing, you may be required to provide an indication of a recordable shift as a part of a patient's final test results.

OSHA With Age Adjustment

The same as above, with the addition of automatic adjustment to the calculation based on the patient's age. This variant of the OSHA calculation standard is not required, but optional in 48 states, and is not permitted at all in Oregon and Washington.

MSHA (Mining Safety and Health Administration)

Similar to OSHA and FRA but for the mining industry. MSHA works cooperatively with industry, labor, and other federal and state agencies to improve safety and health conditions for all miners in the United States.

A calculation standard used in compliance with MSHA to determine if there has been a measurable shift in a patient's hearing ability. While performing hearing conservation testing, you may be required to provide an indication of reportable shift as a part of a patient's final test results.

MSHA With Age Adjustment:

The same as above, with the addition of automatic adjustment to the calculation based on the patient's age. This variant of the OSHA calculation standard is not required, but optional in 48 states, and is not permitted at all in Oregon and Washington.

Averaging label

During your testing, you may be required to calculate the PTA (Pure Tone Average) or AHL (Average Hearing Level). The Averaging Label determines which value (PTA/AHL) displays in the Analysis section of a patient's Summary Report, and can also be selected as an averaging model when building a report.

The frequencies that you select here will be used to calculate the average.

AHL (Average Hearing Level) is typically used in Hearing Conservation and is required for the following shift standards: OSHA, OSHA with Age Adjustment, MSHA, and MSHA with Age Adjustment. It is the average threshold across 2 kHz, 3 kHz and 4 kHz.

PTA (Pure Tone Average) is typically used in Audiology to determine hearing sensitivity in the speech frequencies. It is the average across your selected frequencies, most commonly 500 Hz, 1 kHz, 2 kHz, and 4 kHz.

Creating new rules

You can create additional program rules that differ from the default rule and assign them to specific projects. Take note that while you can create new rules, the available options are based on predefined standards and you cannot customize their settings.

A good example of this is if you are performing occupational hearing testing on patients in Oregon or Washington state, where shift calculations without age adjustment are required by law. In this example, you would group all patients from these states into a separate project, create a new rule that uses the OSHA shift standard without age adjustment, and apply that rule to all patients contained within that project.

To create a new rule:

1. Click on the New button in the top-right corner of the page.

   

2. Give your new rule a title, assign it to a project(s), and select the shift standard and averaging label you would like the rule to use.

   

3. Click Save to save your new rule.

   

Your new rule will then appear above the default rule. Rules can be edited at any time by clicking on the Pencil icon .