Table 1 APHIRM toolkit stages in relation to the WHO toolkits framework [48] and a Quality Implementation Framework [47]

Stage 0.

Getting started

PLANNING AND IMPLEMENTATION:

1. Purpose of the toolkit

2. Defined target audience

3. Description of the working context … and content of the toolkit as outlined by the risk management cycle. …

4. How to get started:

a) How to ensure management commitment; provide the rationale/business case

b) Reinvigorating or setting up Labor/Management Committees and defining the role of safety committees in quick identification, communication and intervention …. in terms of structure and distribution of responsibilities

TRAINING:

1. Models for training to cover requirements, recognition and continued good work practices.

2. Training modules on assessment, planning, implementation, evaluation and maintenance of prevention and control strategies.

3. Description of measures/indicators of success in implementing training.

4. Training recordkeeping, such as attendance records, course participation records, evaluation summaries

Phase One: Initial considerations regarding the host setting Assessment strategies

1. Conducting a needs and resources assessment

2. Conducting a fit assessment

3. Conducting a capacity/readiness assessment

Decisions about adaptation

4. Possibility for adaptation

Capacity-building strategies

5. Obtaining explicit buy-in from critical stakeholders and fostering a supportive community/organizational climate

6. Building general/organizational capacity

7. Staff recruitment/maintenance

8. Effective pre-innovation staff training

Phase Two: Creating a structure for implementation

9. Creating implementation teams

10. Developing an implementation plan

Stage 1.

Identify main hazards and assess current risk

A. Identify potential workplace hazards and/or high exposure work tasks or jobs and assess the extent of risk stemming from identified hazards, taking account of the severity of the hazard(s), and the duration of exposures to hazards and potential interactions between hazards.

Phase Three: Ongoing structure once implementation begins

Ongoing implementation support strategies

11. Technical assistance/coaching/supervision

Stage 2.

Identify local causes of main hazards

B. For each significant hazard or combination of hazards:

1. identify possible means of eliminating the hazard(s)

2. where elimination is not possible, identify possible means of reducing the risk, often referred to as control options.

Stage 3

Form action plan

3. devise an action plan to reduce risks as much as possible, taking account of the following factors:

a. for each particular hazard or group of interacting hazards, the level of risk presented (assessed at step 1 above)

b. for each possible means of risk control (identified at step 2 above):

• its probable effectiveness in eliminating or reducing risk

• the practicability of implementing it

• possible effects of its implementation on other hazards that lead to the same or different health outcomes

4. the perceptions and priorities of those who are at risk, concerning both the hazards that are most important to control and preferred means of managing them.

5. determine how it can best be evaluated.

Stage 4. Implement action plan

C. Implement the action plan

Stage 5. Review – process evaluation

12. Process evaluation

13. Supportive feedback mechanism

Stage 1 – REPEATED (start of next risk management cycle)

D. Evaluate its impact

E. Discuss the result of the evaluation and determine what can be learned from the successes and failures of the action plan.

Revise and improve the action plan to target previously unaccounted risks and repeat the cycle.

Phase Four: Improving future applications

14. Learning from experience