In contrast to the situation in schools, business and financial needs drive the design and operation of employer attendance systems. Further, successively higher levels of the business hierarchy are concerned primarily with operational status. They ask, "Is our business unit functioning properly today?," and not "Who is absent today and why are they absent?" In general, tracking attendance serves human resource and compensation needs, and departments that track attendance design their work processes and information systems around those needs, which do not include the real-time absence or health status of a given employee.
An employer-run attendance system must cope with two classes of employees: essential and nonessential employees. All employers have essential employees, regardless of their size. Essential employees are those who contribute to activities where staffing must be maintained at specific levels for safety and efficiency. The law requires some kinds of facilities to adhere to specific minimum staffing regulations, especially where the facility cannot operate without the presence of a licensed or certified employee. Examples include procedure-certified nurses in hospital intensive care units, licensed reactor operators in nuclear power plants, and licensed brokers in a real estate office. Other employees are nonessen-tial, and a given business unit may continue to operate without them.
Intuitively, the presence or absence of essential employees represents an opportunity for a biosurveillance system to monitor attendance; in practice, this opportunity is often lost because the organization's hierarchy is focused on performance, not individuals. This principle extends to the U.S. military's current attendance-taking policy. A record of absence because of illness is registered when a member of the service presents to a military health facility; those records may be electronic or manual. Personnel records, however, will reflect simply whether a service member is on duty or on leave and may not be completed in a timely way. The reasoning is quite straightforward: The captain of a U.S. Navy warship needs to know and must be able to report to superiors the state of readiness of that warship. For this purpose, he/she needs to know the state of readiness of all the ship's departments. The identities or even (to a point) number of service members absent is a secondary matter, so long as all departments are functioning properly, the ship is fully fueled and armed, and all sensors and weapons systems are ready for combat (Medina, 2005).
Employer-run attendance reporting at most large employers is computerized, with a wide variety of systems in place. Newer systems use relational databases, facilitating the creation of different views of these data. Moreover, vendors such as Peoplesoft and SAP have created web-based systems that can take attendance daily and make lists of absentees available in real time to authorized users. Whether these systems are actually used to maintain daily attendance records varies from employer to employer based on business practices. Other clients using older systems with proprietary networking or hierarchical database technologies may pose additional challenges.
For many employers, attendance is a more local problem. Employees call in sick to a supervisor who may not formally track absences. This reporting would typically be supplemented by payroll-based attendance recording using a time card. Employers generally do not enter absenteeism information into the electronic database until the end of the pay period, to determine monthly salary and eligibility for benefits. This practice might result in delays of days to weeks between events and data entry into computer systems. Many employers use a category known as "PT," or personal time (or a similar classification), which represents an absence on the employee's request for any reason, including a short-term illness, to identify periods of absence.
Even though as much as 10-15% of all absenteeism is due to influenza outbreaks (O'Reilly and Stevens, 2002), there is minimal evidence for the effectiveness of employment-based efforts for absenteeism surveillance. Early work by Quenel and coauthors demonstrated linkages between sick leave requests and influenza outbreaks; however, subsequent work has not confirmed or expanded this relationship. For example, Nguyen-Van-Tam et al. (1999) were not able to find associations between outbreaks of influenza and hospital employee absenteeism.
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