A few weeks ago during the EHS Daily Advisor’s Safety Culture Week, we provided a wide array of content to help you build a safety culture that is effective all year round. But to maintain a healthy culture, it’s important to constantly check in on it. So, how is your safety culture? You might begin by asking yourself, “What does ‘safe’ look like?” Is it a low recordable incident rate? Is it a lower number of workers’ compensation claims?
Measuring outcomes is important, but you may need to dig deeper to understand how those outcomes affect your business and the underlying hazards, risks, and risky behaviors that lead to accidents and incidents.
The most obvious sign of a troubled safety culture is workers who fail to comply with safety rules, policies, and procedures. Worse than mere disregard for rules is risky worker behavior. You need your employees to fall in line, especially now.
Worker compliance is even more critical during the ongoing coronavirus disease 2019 (COVID-19) pandemic, starting with the risk of a sick employee showing up for duty. There are engineering and administrative controls you can put in place to help prevent infections, like installing plexiglass shields where distancing of 6 feet or more is impractical, staggering shifts and installing additional time clocks to prevent close contact at shift changes, and removing chairs and tables in break rooms. However, preventing infections relies heavily on individual behaviors, from social distancing and the proper use of cloth face coverings to hand-washing, cough and sneeze etiquette, and staying home when sick.
Where duties can be performed remotely, an effective telework policy can help ensure workers do not show up sick at your workplace, but you may want to add start-of-shift screening that includes temperature checks and symptom assessments.
Resuming operations following state-imposed shutdowns and continuing operations during the uncontrolled spread of COVID-19 may require new approaches specific to a pandemic response. You should begin by assessing how the pandemic has affected your organizational culture.
You may need to communicate new operational objectives to your employees and update how you deliver safety training to your employees in addition to incorporating infection prevention into your training programs. You also may need to add resources to reinforce safety training for employees who have been away from the workplace. Some states have new regulations with COVID-19 training requirements.
You also need to communicate your new policies and practices with your employees to counter any reentry anxiety.
Patient and Worker Safety in Health Care
The impact of safety culture can extend beyond employees themselves, as researchers at Imperial College London recently found. A positive safety culture in a healthcare facility can result in improved patient safety and better patient health outcomes. Training and support for redeploying healthcare workers during the onset of the COVID-19 pandemic resulted in better safety attitudes and a reduced number of reported safety incidents.
The Occupational Safety and Health Administration (OSHA) years ago acknowledged the benefits of linking patient and worker safety after the release of an Institute of Medicine (IOM) report, “To Err is Human: Building a Safer Health System.” IOM concluded that a safer environment for patients would also be a safer environment for workers and vice versa. Several studies have shown a correlation between a strong safety culture and the safe handling of sharps and bloodborne pathogens.
According to the IOM report, a strong safety culture in a healthcare facility is created through:
- The actions management takes to improve both patient and worker safety,
- Employee participation in safety planning,
- The availability of appropriate protective equipment,
- The influence of group norms regarding acceptable safety practices, and
- The organization’s socialization process for new personnel.
An effective safety and health management program can help employers find and fix workplace hazards before workers are hurt, according to OSHA. Many healthcare facilities may already have a safety and health management program in place to conform to Joint Commission standards. Joint Commission certification usually is a prerequisite for insurance, Medicaid, and Medicare reimbursement.
OSHA has identified management leadership, worker participation, hazard identification and assessment, hazard prevention and control, education and training, and system evaluation and improvement as key elements to an effective safety and health management program.
The National Institute for Occupational Safety and Health (NIOSH) even has a National Occupational Research Agenda (NORA) for the healthcare and social assistance sector. As part of the healthcare and social assistance research agenda, NIOSH developed a “Stop Sticks” Campaign focused on the knowledge, behaviors, and attitudes of healthcare workers surrounding the use of devices with sharps injury protection (SIP).
Safety Rules Compliance
Even in the best of times, employees “bending” or breaking workplace safety rules and procedures can have serious consequences—even the loss of a limb.
For example, evidence emerged in a lockout/tagout case at a Wal-Mart distribution center that company and contract employees regularly circumvented company procedures for entering an Electrified Monorail System (EMS) consisting of trolleys to move pallets of merchandise within the warehouse. Employees for Wal-Mart and its contractor, Swisslog Logistics, crossed over fixed conveyors to enter the EMS. Employees also had placed pieces of cardboard over the light curtains between loops of the EMS—an employee tripping a light curtain normally would stop the trolleys in that section—resulting in the light curtains being in a muted state. Employees could walk from one loop to another without tripping a light curtain, even where trolleys operated in full-speed mode. An employee servicing trolleys was struck by one, and a piece of machinery penetrated his leg.
Rank-and-file employees aren’t the only challenges to your safety culture, and the threat can be hard to spot if it is one of your managers and supervisors. A research study last year found that abusive behavior among managers and supervisors degraded safety behavior and led to poor safety outcomes among workers.
Bullying bosses can make workers become more self-centered, causing them to forget to comply with safety rules or ignore opportunities to promote others’ safer work behaviors. It even can create circumstances in which other people are likely to become injured.
You should intervene with abusive managers and supervisors, researchers suggest, by utilizing training programs to improve managers’ and supervisors’ skills in interacting with the employees they supervise so they have the skills to provide discipline and feedback in ways that are not offensive or threatening. Researchers also recommend that you promote a civil and engaged working environment, strengthening social bonds among employees to create a buffer that limits the negative consequences of their boss’s bad behaviors. You may even want to institute a transparent performance evaluation process so employees have no question about their social status in the workplace.
You also need to ensure that “safety first” is more than a motto and that all your managers and supervisors are steeped in safety culture.
You can get real-world results from a strong safety culture when supported by emerging safety technologies. Researchers found that trucking companies that have strong safety cultures and take advantage of advanced safety technology have seen better safety outcomes than motor carriers that don’t.
Best practices in a strong trucking safety culture require a consistency that includes:
- Having zero-tolerance policies for hours-of-service violations;
- Implementing improvements in hiring policies and training protocols and modifying driver scheduling to reduce fatigue;
- Informing drivers about the carrier’s safety culture during orientation and including all employees—not just drivers—in safety training and education; and
- Sharing carrier wide safety indicators with managers and drivers.
Training can be critical. Researchers have found strong evidence that training affects worker safety and health behavior, especially behavior surrounding ergonomic hazards.
Training needs to be geared toward the intended audience, taking employees’ cultural and educational backgrounds into consideration, including literacy levels. In some instances, training may need to be delivered in a language other than English.
The American Society of Safety Professionals (ASSP) has suggested looking at safety training at a higher level and integrating it into an overall safety and health management system. Safety and health management programs also include safety observations, safety audits, job hazard analyses, and incident investigations.
These elements can help reinforce a strong safety culture in your facility or at your jobsites.
‘Hidden’ Safety Culture
You also need to be aware that there may be a “hidden” safety culture, like the one among the employees at the Wal-Mart distribution center. This hidden safety culture may be starkly different from your stated policies and procedures. It cannot be found in the safety manual sitting on the safety manager’s desk.
First, you will need to embrace a certain amount of discomfort. Issues with your safety culture may not be obvious, and you will need to persist until you get to the underlying issues.
Next, look below the surface for hidden “mixed” messages, picking up on the internal forces that can lead to unsafe actions. Develop consistent messaging that reinforces how workers should perform their duties safely.
Develop your pattern-recognition skills. Look for common threads in incident investigation reports. Look, too, for employees’ jury-rigged solutions for challenges to safety and comfort, like padding adhered to sharp workstation edges. There may be issues with your current equipment, and replacing some of it may offer you low-cost solutions.
Continue asking the right questions, but realize you may not be able to “see the forest for the trees” and may need to bring in outside help.
While fostering a strong safety culture among a diverse, multigenerational workforce has its challenges, older workers still in the workforce can offer a model of safe workplace behaviors that younger workers can emulate. Older workers tend to become injured less often, although their injuries may be more severe when they do become injured. They may have knowledge about hazards in the workplace picked up over years of experience.
Your safety culture also may need to adjust to cultural differences in an increasingly diverse workforce. You need to become aware of your own biases, as some workers may not have grown up receiving the same cultural messages as you and other employees. Do not let your assumptions hinder your safety efforts.
While you and some of your employees may perfectly understand American sports metaphors like “team” and “teamwork,” workers raised in other cultures may be more accustomed family metaphors when referring to work colleagues.
Check your assumptions so your safety policies and procedures do not become “lost in translation.” Encourage a free exchange of ideas. Different is not necessarily better or worse.
You need a safety culture that works for you today during a pandemic and every day after the outbreak.