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Workplace Factors
A people oriented culture creates a safer workplace

At a glance:
  • A safer workplace, with lower injury rates, can be created by a positive workplace culture and good organisation regarding workplace safety. The following factors have been found to have a positive impact on reducing work absence:
    • Active safety leadership (executive leadership by example)
    • Safety training
    • Safety diligences (awareness of safety)
    • Ergonomic solutions (reducing risk of injury)
    • Disability case monitoring (communication)
    • Proactive return-to-work (partnership)
    • Wellness orientation (healthy workplace)
    • People-oriented culture (respect and communication) 
  • Employee surveys can provide a reliable measure of how positive a workplace's culture and organisation is
Perspectives:
Employee
A company's organisation has an effect on workplace safety and injury rates.

  • A workplace that has a strong focus on the people will be a safer workplace.
  • A workplace with well thought-out safety practices and with workstations designed to minimise strain
    strain
    Injury to a muscle in which the muscle fibres tear or become irritated as a result of overstretching or wrenching
     for workers will have a lower injury rate.
  • A workplace that has a policy for helping workers recover from injury and return to work will also have lower injury rates.
  • When employers communicate well and involve employees in decisions that affect them it creates a better workplace.
If you can choose your workplace, choose one with good organisation regarding safety and workplace injury, and with good communication practices. If you can't choose your workplace, try to improve the above practices in your company.  This will improve your own and others' safety and prospects for recovery after injury.
Employer
This study showed that a company's approach, to safety and workplace injury, and also to their general relationship with their staff, makes a significant difference to work absences after work injuries.

Work disability
disability
A condition or function that leaves a person unable to do tasks that most other people can do.
 is a result of complex interactions between the work environment and individuals within it. This study suggests that the company's organisational environment influences injury rates and duration and therefore costs from claims and work absence.

A people-oriented culture helps make a workplace safe. The implementation of ergonomic
ergonomic
Designing activities and the workplace in a way to minimize discomfort. i.e. Adapting work tasks, hours, or workstation to accommodate people. An ergonomic computer workstation allows the person to work in the best position to relieve load on the muscles of the neck and arms.
 practices reduces risks and, in turn, fosters a productive and positive partnership for rehabilitation
rehabilitation
The process of helping a person back to their former abilities and quality of life (or as close as possible) after injury or a medical condition.
 with injured workers.

  • A workplace that has a strong focus on the people will be a safer work place.
  • A workplace with well thought-out safety practices and workstations designed to minimise strain for workers will have a lower injury rate.
  • A workplace that has a policy for helping workers recover from injury and return to work will also have lower injury rates.
Comprehensive programs for managing work disability include:

  • a system of early contact and case management as soon as injuries or work disabilities are identified
  • an organised process and appropriate services to help disabled workers return to work in a safe, timely, and productive manner
These policies and practices encourage management to view people as important. Valuing people through safety, health, and modifications to the workplace is a strategy for success, increasing productivity and reducing costs from injury and improves profits.
Treater
Organisational behaviours in the workplace are a predictor of injury rates and rehabilitation success.

A positive, people-focused workplace is likely to have lower rates of injury and better rates of return to work after an injury.

When trying to assist patients to return to health and work, you will find progress slow if the patient's workplace does not have a people- and safety-focused culture.

Improvements in workplace culture are likely to lower injuries and improve the likelihood of return to work after injury.
Insurer
Work disability is a result of complex interactions between the work environment and individuals within it. This study suggests that the company's organisational environment can influence injury rates, the duration of work absence and the cost of disability claims.

It is likely that a people-oriented culture helps make a safe workplace. The implementation of ergonomic practices reduces risks and, in turn, these enable a productive and positive rehabilitation program.

  • A workplace that has a strong focus on the people will be a safer work place.
  • A workplace that has well-defined safety and ergonomic practices will have a lower injury rate.
  • A workplace that has a positive rehabilitation policy will also have lower injury rates.
These policies and practices fit with a management view that people are as important as productivity and finance. Valuing people through safety, health, and modifications to the workplace is an important corporate strategy for success.
Original Article, Authors & Publication Details:
B. C. Amick III1,2,   R. V. Habeck3, A. Hunt4, A. H. Fossel5, A. Chapin6, R. B. Keller7, J. N. Katz5,8 (2000). 

Measuring the impact of organizational behaviors on work disability prevention and management. Journal of Occupational Rehabilitation; 10(1):21-38

1School of Public Health, University of Texas-Houston Health Science Center, Houston, Texas.
2Institute for Work and Health, Toronto, Canada.
3Michigan State University, East Lansing, Michigan.
4W.E. Upjohn Institute, Kalamazoo, Michigan.
5The Robert Brigham Multipurpose Arthritis Research Center, Boston, Massachusetts.
6Maine Health Information Center, Augusta, Maine.
7Maine Medical Assessment Foundation, Augusta, Maine.
8Harvard Medical School, Boston, Massachusetts.
Background, Study Objectives, How It Was Done:
The study suggests: “Work disability arises from complex interactions between the work environment and the individuals within it'. Therefore, to prevent work disability we need to consider issues beyond traditional considerations like safety measures and claims handling techniques. We should also include company attitude, workplace culture, policy and communication as factors that can help prevent disability.

The authors of the study indicate, however, that there has been limited evidence that a company's management approach and culture plays an important role in disability prevention. The objective of this study was to present research findings on the topic. 

The specific objective was to evaluate the effect of workplace organisational factors in preventing and resolving work disability, in order to assist companies to improve their disability rates by better management, and to provide researchers with information that can be used in further study of rehabilitation after injury.

The factors of workplace organisation investigated were:

A.       Health and safety management, safety management leadership, effective safety controls, training and evaluation to anticipate and manage hazards, integration of safety programs into company operations to balance human and economic priorities.

B.       Disability management, or management of the return to work process once an injury has occurred, a system of early contact and case management as soon as injuries or work disabilities are identified, an organised process and appropriate services to enable the safe, timely and productive return to work of the disabled worker.

C.    The organisation of the company.

This paper presents the findings of research projects that had two different aims, these were: 

Two studies that were undertaken in Michigan between 1987 and 1989, and looked at disability claims in different industries. Companies with high and low numbers of claims were included, to assess whether employers could accurately judge their own organisational policies and practices.

A study of surgical patients with Carpal Tunnel Syndrome
Carpal Tunnel Syndrome
A condition characterized by pain and numbness in the hand and sometimes the forearm. It is caused by pressure on the nerve which connects the arm to the hand (through the carpal tunnel) and gives sensation to the hand, thumb and three fingers
 compared the employees' assessment of their company's organisational policies and practices with their likelihood of returning to work six months after surgery.

1)      The Michigan Studies (employers)

 Analysis of workers' compensation claims in the state of Michigan (USA) showed a tenfold difference in the lowest and highest rate of claims in companies from 29 different industries. 

Two studies were performed. For the initial study four industries (food production, fabricated metals, transportation equipment, and health care services) were selected for in depth investigation. A questionnaire was mailed to companies, asking them to evaluate their performance in a range of relevant areas.  The company was asked to rate the strength of their systems in each area on a scale of 0-5, with 5 being excellent.
 
This was followed up by a larger study, which included 220 employers within seven industries. The questionnaire tried to provide a more complete picture of the company's organisational policies. The study adjusted for factors such as the company size, wage level, and length of employment of the workers. 
 
For both of these studies, the companies' responses to the questionnaires were compared to information about their number of claims, and the relationship between them analysed.
 
2)      Carpal Tunnel
Carpal Tunnel
A tunnel at the wrist made up of the wrist bones and a strong ligament.
ligament
fibrous tissue
tissue
Collection of cells that perform a similar function. e.g. epithelium (skin), connective tissue (blood, bone), muscle
 that connects bones to other bones
  See carpal tunnel syndrome.
 Syndrome Study (employees)
 
The last study discussed in this paper was a study of workers with carpal tunnel syndrome. The study wanted  to assess whether worker's beliefs about their employer's approach influenced their likelihood of returning to work. Each employee completed a questionnaire asking them to comment on their company's approach to health and safety management, disability management, and the company's organisation. These results were compared to the person's work status six months later.
 
Study Findings:
1.       The Michigan studies - employer assessment of company organisational factors compared to claim rates

Initial study:

124 companies responded to the survey (44% of those contacted). Company policies and practices were compared to their disability claims rates, in companies with high and low numbers of claims. The study found the following practices were significantly different between the companies that had low and high claim rates:

Workplace Policy or Practice High claim companies Low claim companies
Average score on questionnaire
Unsafe behaviours of employees are monitored and corrected on a systematic basis. 3.3 3.8
Safety training occurs as a regular part of orientation for new and transferred employees. 3.4 4.2
Company leaders' model and pay attention to safe behaviours. 3.5 4.0
Information and communication travels both from the top down and from the bottom up within the organisation. 3.5 3.9
Employees participate in problem solving and decision making as a regular part of company operations. 2.6 3.2
A profit-sharing or gain-sharing program is used to stimulate and reward productivity of employees at all levels. 1.8 2.6
Light duty assignments and /or modified work are used to help restricted workers come back to work. 3.2 4.0
An employee assistance program is used to help employees who are showing signs of problems that may interfere with work (e.g., alcoholism, stress, and personal problems). 2.4 3.1
Procedures are used to monitor and encourage individual supervisors to assist the return of injured workers to their departments (e.g., incidence and costs of claims are assigned to departments). 2.1 3.0
The company provides wellness programs and fitness resources to promote employee health. 1.5 2.4
Employees are screened for job-related health or disability risks on a continuing basis. 2.3 3.0
That is, companies that had low claim rates reported higher average scores for safety training, involving employees in decision making, providing restricted duties, and the other areas listed.

Follow up study:

In the second Michigan study eight organisational policy and practice scores were compared to claim outcomes, after adjusting for the effects of other factors such as company size, wage levels, and union status. 46% of those sent the questionnaire completed and returned it.

The results from the 220 companies who responded demonstrated similar findings:

  • A 10% higher rating on management of safety matters was associated with 17% lower rate of lost workdays from injury.
  • A 10% better rating on proactive return to work strategies was associated with 7% fewer lost workdays.
2.        Carpal Tunnel Syndrome study – employee assessment of company organisational factors compared to return to work outcomes

The third study discussed in this paper explored outcomes of return to work for employees with carpal tunnel syndrome,
syndrome
A group of symptoms that together are characteristic of a specific disorder or disease
 compared to their own report of their company's workplace policies and practices. 

The results are listed in the table below.   The study found that the person was more likely to have returned to work six months after injury if they had rated their company as having a people-oriented culture and good safety strategies, ergonomic practices, and disability management.  

The “odds ratio' is a measure of the likelihood that the employee's rating of their company's policy or practice affected the person's work status six months after injury. The employee's assessment of the company's disability management has the highest odds ratio,
odds ratio
Measure of how much more likely one group is to have a condition or event than another group. It is defined as the ratio of the odds of a condition occurring in one group to the odds of it occurring in another group. An odds ratio of 1 indicates that the condition or event under study is equally likely in both groups. An odds ratio greater than 1 indicates that the condition or event is more likely in the first group. Also called a measure of likelihood.
 and therefore is the most important factor studied affecting work status six months after injury. The “P- value' is a statistical term, and is a measure of the likelihood the result has occurred by chance. For these results, a P-value of less than 0.05 is significant, so the employees' rating of each organisational factor does affect their return to work (i.e. each factor is statistically significant).

Workplace Policies and Practices Odds ratio P -Value
People-oriented culture 1.9 0.01
Safety climate 1.6 0.03
Ergonomic practices  1.8 0.02
Disability management 2.2 0.00
Conclusions:
The following 11 organisational policies and practices were found in companies with the least workers compensation claims:

  • Unsafe behaviours of employees are monitored and corrected on a systematic basis.
  • Safety training occurs as a regular part of orientation for new and transferred employees.
  • Company leaders' model and pay attention to safe behaviours.
  • Information and communication travels both from the top down and from the bottom up within the organisation.
  • Employees participate in problem solving and decision making as a regular part of company operations.
  • A profit-sharing or gain-sharing program is used to stimulate and reward productivity of employees at all levels.
  • Light duty assignments and/or modified work are used to help restricted workers come back to work.
  • An employee assistance program is used to help employees who are showing signs of problems that may interfere with work (e.g. alcoholism, stress, personal problems).
  • Procedures are used to monitor and encourage individual supervisors to assist the return of injured workers to their departments (e.g. incidence and costs of claims are assigned to departments).
  • The company provides wellness programs and fitness resources to promote employee health.
  • Employees are screened for job-related health or disability risks on a continuing basis.
If companies with poor records of disability claims made improvements in the following organisational policies and practices, their claim rates were reduced:

  • Active safety leadership (executive leadership by example)
  • Safety training
  • Safety diligences (awareness of safety)
  • Ergonomic solutions (risk reduction)
  • Disability case monitoring (communication)
  • Proactive return-to-work (partnership)
  • Wellness orientation (healthy workplace)
  • People-oriented culture (respect and communication)
The study therefore concludes:

  •  “A people-oriented culture facilitates the development of a strong safety climate'
  •  “Organisational attempts to reduce the number of work-related disabilities and reduce their consequences for the employee and for the company can be successful.'
References:
No PubMed Abstract
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