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Measuring for success - performance indicators and executive reporting

Musculoskeletal Disorders Symposium 2017

Karen Wolfe

Presented by: Karen Wolfe (Australian Nuclear Science and Technology Organisation)

Run time: 44:58

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Presentation 3: Measuring for success - performance indicators and executive reporting

Presented by: Karen Wolfe (Australian Nuclear Science and Technology Organisation)

[Start of transcript]

Karen Wolfe:

Good morning everybody. Look, I'm not here to tell you how to suck eggs. I've found in conferences it's really annoying to have people stand up and pontificate on things, and you sit in the audience and you go, 'Yeah, like I've never thought of that'. That's not what I'm about today.

What I want to do is I want to tell you my journey of discovery over the last 25 years, and I hasten to add I was five when I started working. And back from the old days when I used to use LTIFRs as the be all and end all, I had a CEO who said, 'Reduce my LTIFR. I don't like it'. So I would ring up HR and say, 'Surely we've employed more people and we can actually cut the numbers a little bit and get the figures down'.

That's where I started. I want to take you on my journey.

We have not picked an easy job. If we take William Tell as an example, he started with a long bow, he trained on it, he knew his tool, and he was really, really good. But we've learnt this morning that we've got to have an eye to the future of work, and we've got to look at the potential impact of work health and safety, on what that might mean, on the technology, the workplace, the supply chain. So poor old William Tell, really good on a long bow, somebody develops a cross bow. So all of a sudden he's got new skills to learn, he's got new technology, a new piece of equipment he's got to understand and maintain.

And then when we get new technology we've got to look at change management. We've got to look right across our organisation at the impacts of that change. Will it work as well as the old way? How long before the change is accommodated, and what new training do we require? And for goodness sake, let's not forget about the psychosocial effects that we might have on the workplace when that comes in.

And once we've thought of all this, we have to ensure the business integration of work health and safety into all aspects of our business process, as well as consider total worker health as we heard this morning from Chase, with the integration of safety in health into the DNA of job design. Success for us is measured in people's lives and wellbeing.

So how do we tell decision makers how they are going? On the other hand, how do we know when we are doing well? It's fairly easy for us to identify when something has gone horribly wrong, but how can we identify what actions that we are doing actually makes a difference? Well this is what's exercised my brain for over 15 years.

Some of you might want to leave now, because the key message I want to deliver to you today is you can't get your measures out of a textbook, and what works for one organisation is not guaranteed to work for you. The secret on how to measure your success is actually in the questions you ask. What is actually your objective? What is it you want to improve? Who are you getting the information for, because the measure you get needs to meet their needs? What are you actually assessing and what change do you want to see? What activities will influence this so you can see if you are making a difference? Then you've got to measure and evaluate, and probably from that point you then need to start all over again.

The Safety Institute of Australia has spent a lot of time developing a body of knowledge for the safety professionals, and in that body of knowledge it tells us that the scientific knowledge that can be used to prevent work-related fatality, injury, disease and ill health is often well known long before we seriously apply it. We know the impact of gravity on the body, and we know the injury over time of continuous and repeated movement. The time has passed when prevention of work-related injury and ill health can be considered a matter of common sense. When we ignore or don't clearly understand the scientific basis of work health and safety, safety practice defaults to a superficial common sense or the flavour of the month/year approach. What did we hear at the conference? Let's try that.

Ergo if safety is a science, then we the people working in safety are scientists. Dr Google says that a scientist is a person engaging in a systematic activity to acquire knowledge that describes and predicts the natural world or one who uses a scientific method. Now by a scientific method it is that you make observations, you think of interesting questions, you formulate hypotheses, you develop testable predictions, you gather data to test those predictions, then you might refine or alter those hypotheses and then you develop a general theory and take it forward.

Well I say we are scientists. We just haven't lent into that aspect of our work enough. One way of measuring performance and testing activities has been developed outside of our discipline, and that's mainly by the accounting and the insurance world where the goal has always been subtly different to ours. We need to rectify this.

Ann Rowe, whose quote is up on the screen there, was an American clinical psychologist and researcher who studied creativity – and we heard this morning how important that is – and occupational psychology, so it seems appropriate that she sets the tone for the discussion. A good part of the trick of being a first rate scientist is in asking the right questions, or asking them in ways that it is possible to find the answers. It is in the asking of these questions that we should be discovering what we can measure in our workplace.

The importance of identifying how best to measure performance in safety was driven home to me at a conference I attended in 2008. There were a number of AMP alpha investors speaking at that conference, and they spoke about how they would look at a company's safety performance in making a decision on whether to invest or not. They had found that the companies that performed well on safety outrode the GFC in 2007.

From that point onwards I became really interested in looking at how to use measurement and reporting to reflect success in safety. My initial conviction that safety could be used to indicate the overall health of a company was confirmed in an article in the Harvard Business Review by Michael Malbeson. He referenced a study by accounting professors Christopher Itna and David Larka, who found that companies that bothered to measure a non-financial factor like safety, and to verify that it had some effect, earned returns on equity that were about 1.5 times greater than those of companies that didn't take those steps.

My need to understand how to apply measures that would indicate if my efforts were making any difference in safety, as well as getting it integrated into the organisation's business model, led me into an unholy alliance with, of all people, an accountant. Dr Sharon O'Neil and I embarked on a voyage of discovery to bring the discipline of accounting measures to the world of safety. This voyage of discovery is the foundation for this presentation.

Performance KPIs for safety are a form of business intelligence that provides information to inform decisions. Financial and organisational objectives and processes can influence safety, so it's important that safety is integrated into the business model and thinking. However it's important for us to realise that there is a difference in the role that executives and boards play and that management plays. Boards are there to set strategic direction and manage business risk. They need work health and safety information that will provide assurance that risks are being managed and appropriate resources are available. Managers on the other hand manage the day-to-day business operations. They need safety information that indicates how they are performing at an operational level. The reports that we provide them are not the same, nor should they be, as the decisions that are required to be made are different.

The phrase on the screen that you're looking at is a phrase that I think most people are familiar with. It's the earliest instance of the phrase that was put in a letter to the editor of the British Newspaper the National Observer in 1891 commenting on national pensions, although Mark Twain also used it to very great effect. 'Sir, it has been wittily remarked that there are three kinds of falsehood. The first is a fib, the second is a downright lie, and the third and the most aggravated is statistics.'

To take your reporting from just a statistic to a meaningful measure, you have to be very clear on what your objective is in doing the measure and what you want to change. Once you get your measure you need to understand what the data is telling you, otherwise you'll be taking the wrong actions.

I've taken advice along the way from the very best, and I'd like to share with you a statement from Professor Dennis Else. He said the whole performance measurement area is about trying to get people to think in terms of moving it from just data through to information, from information up to knowledge, and then up to wisdom. That is how do you get individual data items and datasets to the point where they can inform wise decisions? Also there's the other corollary that is we don't really want to be collecting data unless there's some decision point at the end of it. What's the point of burdening our businesses with more and more things to measure unless you can actually show how the information can be used to decide something? Our role is to identify what to report, who to report it to and why.

I think the first challenge that we have is to understand exactly where our organisation is at. There is no point suggesting anything like a qualitative measure if your organisation is just focusing on the absence of injuries and the cost of them. If all they're thinking of is in terms of LTI, it's going to be just a waste of your time to say, 'Hey, let's do a safety culture survey to check and see if everyone thinks we have a just culture embedded in it'. I'm thinking it just won't work.

A useful way to approach this challenge is to think of where your organisation sits on the maturity model. Now Patrick Hudson suggested a five level maturity model, but there have been many suggestions utilising a three level model. Personally I like three. I think five is a great academic model with subtle nuances. But I'm a very practical person. I like to think of it in the terms of, 'I'm no good'. 'I'm getting better'. 'I'm great, with a continuous improvement agenda.'

Five or three, this will help you to really understand where your organisation's thinking is at. But be aware that this is not a reflection on you but it does provide a focus for understanding the challenge you face. I'm not suggesting for one minute that we're on that continuum. I know we're all on the very top. Our challenge is to understand where our organisations are at, because then we as safety professionals have to identify where we want to take our organisation and then come up with the performance indicators that will help them move in the direction we want.

When setting up your KPIs you need to think through who needs the data and what decisions they will be making based on the data. This will frame what you report. The KPIs should help you understand what is happening and should be able to be measured. What is important to measure you need to make easy to measure, otherwise you'll just be collecting KPIs that are the ones that you can get, not necessarily the ones you want, and what a waste of time that is.

We'd all be familiar with this. Lost time injury rates have an undeserved reputation as being a useful measure used to compare your organisation with other organisations. The reality is that they do not give an indication of a fatality as shown in this diagram, and that's been proved in a study by … in 1998. LTIs reflect high frequency, low consequence events, but provide little insight into disabling injury or illness.

Andrew Hopkins has said about LTIs they are at best a measure of how well a company is managing minor hazards. They tell us nothing about how well major hazards are being managed. Moreover firms normally attend to what is being measured – we found that out this morning as well – at the expense of what is not. Thus a focus on LTIs can lead companies to become complacent about their management of major hazards.

As a consequence of focusing on relatively minor matters, the need for vigilance in relation to catastrophic events was overlooked. Clearly the LTI rate is the wrong measure of safety in an industry which faces major hazards. Now I work in nuclear, so LTI for us would be just so the wrong way to go. We need to think outside that box.

We would all be aware of the fine LTI scores that preceded some of the catastrophic events that have happened in the past few years – point in case is Deepwater Horizon who were receiving an award for a great LTI record on the day that they had the catastrophic failure. However it may be prudent for us to keep reporting what is expected. It is a good idea to lean into what is already being measured and then add in the performance indicators that will drive improvement. If LTIs are expected, then it is easier to keep them and introduce others to replace them over time. Same, same, slightly different, really different.

Case in point is my daughter. She hated broccoli. Would never eat broccoli. As a result for five years she ate green carrots and was very, very happy.


KPIs should be informing across different levels of the organisation how effective the controls are in place to manage the risk to health and safety. There are broadly three types of controls. There's the technical controls, cultural and governance controls. These come together to underpin effective management of work health and safety by ensuring a hazard identification and risk management is in place at the operational level for workers and supervisors, and you've probably got more down at that level because they need to have more. Leadership with a robust safety culture goes right across your organisation, and effective oversight and control is required at the executive board and board level.

So how do you gather this information? Identifying potential hazards and risks can come from many sources, and these may identify some areas that should be measured. Hazards can be measured proactively or reactively. Ideally you'll use a combination of both. To go about identifying hazards proactively, you can look for risks that your organisation has already identified and has in their risk register. You may have identified them through audits and inspections, or you can look outside your organisation and see what's happening across your industry or through other organisations, or what you pick up at conferences when you're talking to people.

Sometimes hazards are identified the hard way, after an illness or an injury. Identifying hazards reactively may be through injuries and illness, through a review of investigation reports to gain information on uncontrolled risk, or heaven forbid lessons learnt from regulatory activities, whether they be investigations, prosecutions or fines.

What you're seeing there is our radio pharmaceutical production area, and this has probably been the driver for everything I've wanted to do in my life. This was a very, very old facility. It was created more as a research facility that turned subtly over time into a full production area, and it creates boutique radio pharmaceuticals for the diagnosis and the treatment of cancers.

When I took on my role there, you knew by talking to people and by finding out what was going on that we had a long history of musculoskeletal disorders coming from this area. Because the equipment was very old, it has remote handling manipulators, because the radiation is inside a lead bricked case as you can see, and it has a lead brick window. Now the windows were little. If you were tall enough to look in the window, it meant you used the manipulators like this. If you were short enough to use the manipulators properly, it meant you couldn't see in the window. So the equipment wasn't really ergonomically designed.

Now when you looked at the data that we provided to management, there was absolutely no picture of the damage that had been done to people, because what would happen – we had a saying that we had a two-year shelf life – we'd get fresh blood in, we'd work them to death and then we'd find them another job somewhere else in the organisation, and they would just disappear off the statistics. They'd be a blip and then they're gone. So management had absolutely no idea of the kind of catastrophic damage that was actually happening in this area.

So we had a great reliance on LTIs. Didn't peer into the LTIs because they weren't on lost time, they were either on restricted duties, and so they were at work, or they'd been moved on to another role. So I introduced a couple of different metrics. I started reporting on the number of people on restricted duties and how long they'd been on restricted duties. And then I started reporting on the number of people who had to be moved into a different role. All of a sudden we had a very different report. All of a sudden we had a very different conversation. I had to go and report to management. 'Where did this problem come from?' 'How long have we known about it?' 'Why hasn't anybody been told about it?'

So the upshot of that was we also introduced priority reporting. So we would say to the people, 'Don't wait until you've actually got an injury. We want to know as soon as you've got a niggle. You report a niggle. Report every niggle you've got so we can actually start to see the trending data, and that way it's actually starting to appear early'. So what this all led to was a capital investment on new equipment. We got great big lead glass windows so everybody could see in them. We got brand new manipulators. We got a very comprehensive preventive maintenance program, because one of the problems that we had was the toggle balls wouldn't work properly either, and that was just another thing.

And we also introduced a preventive health program, and that brought an ergonomic physiologist into the organisation to look at the range of movements that were going on and then introduce exercises. Then they would analyse the people working at the manipulators and introduce core strengthening exercises that they could work. And we also established a gym, and there was an expectation that the workers would have to go and do gym work every day for a certain period. They had to sign in. We'd check that and make sure that they did it. The end result of all this is that our issue has disappeared and we do not have a problem with the injuries occurring anymore. If we get an immediate niggle, we get them to a physiotherapist. And all the equipment has made the issue disappear, and we've got the preventive health program.

So identifying and finding out how you can make people aware is really, really important.

Using the traditional approach to classification of injuries has a number of limitations. LTIs lump high frequency and low consequence events in with low frequency, high consequence events, and that restricts your knowledge of how you are progressing with injury prevention. Using the LTI approach, the focus is on the frequency of the occurrence – that is how many have happened – rather than the consequence – that is how bad it is. And it doesn't recognise impairments that may not involve lost time but result in long-term damage, things like your hearing loss. It happens over time and that doesn't appear. And that was certainly my experience in our production area.

An alternative approach to classifying injury and illness is by severity. This provides a far greater validity and reliability, and the measure of both the financial and human injury and illness costs. What you get from this is improved information to inform your organisation a work health and safety strategy. The severity classification focuses on the consequence of the illness and injury from the perspective of the injured person rather than the employer organisation. Impairment is therefore a reflection of the time until a full recovery is achieved, and whether a full recovery is achieved rather than simply the time taken to return to work.

The severity categories draw attention to the high consequence class one injuries rather than the low consequence class two and three injuries. This work for me has been a real 'aha' moment, and I'm really indebted to the work of Geoff McDonald here for the thinking and the work he did on it. And you might be interested to know that he was actually a Queensland boy too.

As I've stated, there's a real danger in focusing on the highly aggregated LTI or recordable injury rates when monitoring injury and illness and performance, because the number of low consequence injuries – that's 'I've got another paper cut' – tends to far exceed the number of high consequence injuries – 'I've actually chopped off my hand' – changes in fatal and permanently disabling outcomes are relatively insignificant components of LTI and are therefore rendered – 'poof' – statistically invisible.

An analysis state-based workers compensation data for a ten-year period was undertaken by Sharon O'Neil, and what she looked at was over 400,000 workplace injuries. And when she analysed these they showed a downward – which is an improving trend in LTIs. That's great. However when she put an impairment analysis over the same data, what it showed was a rising increase of permanently disabling injuries. And this is an important measure when we're looking at musculoskeletal disorders where the potential for ongoing disability is very high.

Using the approach of classifying injury and illness by severity, you can start to allocate your investigation resources in a much more strategic way as well that's aligned with the impact or the potential impact of the incident. None of us have unlimited resources, and it's important that we know where to focus our efforts to make the most impact. A change of approach can also lead to an improved focus on controls to prevent any further injuries or illness where it's most needed.

Having improved the quality of reporting based on everything we've discussed, is your method of reporting making the impact you've hoped for? So here's the latest reporting for the body location of injuries. Back 11, fingers five, shoulders three, arms three, legs three, heads three, chest two, hand two, psychological two, knee two. Is anyone still awake?

And did you notice how I slipped in psychological injuries into that? Second last, so it kind of just slips in there.

Can you make it become more exciting? If you want to get attention from the decision makers, you need to make it real for them. They get so many reports across their desk, that numbers and pieces of paper just disappear. If you put it into a picture like this, you can also add in the severity classifications and it aligns everything straight away in a picture. Suddenly all that data just pops, 'What's our issue?' I've got to acknowledge – because none of this happens on your own. You leapfrog off people. Kurt Warren originally came up with the concept of using the body for classification and Maria Prior superimposed the category of the injuries on it. And you've got a dialogue straight away that you can have with the decision makers about where you're having the big impacts.

The next thing to think about is are your KPIs lead or lag? Dr O'Neil says that it's all in the timing. It can be a lead or it can be a lag, depending on when you're measuring. For example if we're going to measure our training, training conducted is a lead indicator and training effectiveness is a lag indicator. However if there's been an incident, training effectiveness then becomes a lead indicator and the injury is the lag indicator. Now this way of thinking really did my head in when we started talking about this, because this is accountant speak. And I want to challenge you to start to try to lean into this as well. It's important to understand how the business parts of your organisation think and understand, because how often do we go in to talk to accountants and they just go, 'But that's not real in my terms'. We have to understand and speak in the business terminology if we actually want to get our message across and make an impact.

A useful way to think of this is to consider lead indicators as the useful aspects of the implementation of the control process. Lag indicators reflect the outputs or the outcomes of a process and provide information on the effectiveness on a control. One example of this is we take consultation, and again Chase told us this morning how it's important that we consult with people. We know that. It's in our legislation. But to make people own what you're going to put in place. The number of staff consulted is a lead indicator, as it gives us information about the implementation of the consultation we're doing. The number of staff suggestions that we actually adopt is a lag indicator, as it gives us information about how effective that consultation was.

Identifying KPIs in this way is also useful for integrating and indicating organisational responsibility for work health and safety, and the consequence of the decisions that are made across the organisation. For example you can highlight the impact of HR resourcing decisions by looking at rosters that identify safe staffing levels and the number of shifts that are actually operating below these levels. You can look at the impact of procurement decisions by looking at the percent of contracts that actually state we have work health and safety criteria, and then look at the number of contracts that we award based on costs instead of work health and safety criteria.

How do we manage the risk? It's important that safety professionals talk the language of the business. Most businesses' risks are managed by using one of four strategies – avoid, reduce, transfer and accept. Work health and safety risk is different. There are legal requirements that mean two considerations distinguish our risk management from the practices used to manage other forms of business risk. First, the choice of strategy available for controlling work health and safety risk is limited by law. Second, the role that cost benefit analysis plays in decision making processes is significantly reduced in our space. So if we look at the four strategies used by business to manage risk and apply it to the world we know – avoid. We actually like that, because that equates to the level one of the hierarchy of controls. Reduce – we like that too. It equates to the level two and three. Transfer – for us that's just not possible. Accept – so not possible.

So how far do we take it? That will depend on where your organisation is at on the maturity scale, or the risk profile that you do for your organisation may tell you that you need to expand the scope of what you're reporting. You may need to start to report across a supply chain. You may need to look at organisational decisions if they're continually impacting on work health and safety. You might need to introduce psychosocial.

The factors you need to consider depends on your organisation and where it operates. Do you have national or international considerations that bring with it the variations in legislation and standards? What industry factors do you need to consider? What is your sector profile? What's the nature of work and the risk it brings? Then there are your organisational factors – the maturity level of your people and your management, the organisational infrastructure, your resources – there never really are enough of them – and your structure. The number of KPIs you require will change as you move through the organisation too. There will be more KPIs at the operational level, and remember that different roles require different information.

To be useful a KPI needs to have some certain attributes. It needs to be robust and well-chosen to inform the effective design and management of safe and healthy work. You need the right tool. Don't rely on generic work health and safety indicators. I am afraid to say you can't be like the lady in the café in When Harry Met Sally and say, 'I'll have what they're having'. It just doesn't work. Another organisation's maturity level may not be yours. Their industry may be different. I would say weigh the desire for benchmarking against your need to have KPIs that are useful for informing sound work health and safety strategy and practices in your organisation. Consultation is essential, and not just because the legislation tells us to do it. If you understand the use and likely impact of the KPI, you will ensure that the KPIs you adopt are both relevant and valid.

And finally, you need to provide scope for continuous improvement of the quality of evidence relating to both work health and safety position and performance. It is our role to take our organisation on a journey whether they want it or not.

So it all starts with the right questions. What knowledge do I need? What controls need to be in place? What will drive performance? How do I know it is working?

I started my quest many years ago with a question. How can I measure my success in making my workplace safe? My talk has taken you through my journey to find the answer, the new questions I have asked myself and the wonderful brains that have provided me some answers. I let a scientist open my talk, and it seems appropriate to let a scientist have the last word.

Albert Einstein said, 'If I had an hour to solve a problem and my life depended on it, I would use the first 55 minutes determining the proper question to ask'.

Thank you very much.


Madonna King:

Thank you Karen. So many thoughts there too, and what a wonderful turnout we've had for this session. So can I just put it straight out to you, who has a question that they would like to ask Karen? We've got ten minutes. Thank you sir.

Audience member:

I'd like it if you could go back to the slide that you had the options for I guess risk management, accept, transfer. Yeah, that's what we're kinda used to. In your experience and in your experience with accountants, what's different to the way that a non-safety person?

Karen Wolfe:

For example some organisations from an accounting perspective might say, 'Look, I'm going to transfer that risk. I'm going to put something in the contract for my supplier that they can do, that they can take that risk off me, because I don't want to accept it'. And they will do that. They might say also from an accepting point of view, 'Look, I'm such a big organisation. The risk of somebody ripping me off is so miniscule that I'm just going to carry that risk myself'. So across the accounting firm they will actually make those sorts of decisions, but we just can't make those final two decisions in the safety perspective. I would hazard a guess that there's some organisations that actually do the transfer part because they haven't got the knowledge. If you look at some of the contracts that are established across a supply chain, I think there's a degree of ignorance at the business level about how they still own those safety risks but they put them into contracts and push it out to truck drivers to say, 'You will deliver from Melbourne to Townsville in three hours,' and they go, 'Well, yeah we'll do it'. And then they push their drivers. So it's those sorts of things are taken.

Madonna King:

Who's next? Thank you.

Audience member:

Can you go back to the slide about … you're talking about short-term, and something like a laceration or suture, where would that be classified?

Karen Wolfe:

So I think I've got a little thing here.

Audience member:

So what's defined as temporary, you know, versus…

Karen Wolfe:

So a class three is not life altering. So the way it thinks of it, it's not a life altering one. So it could be I've got a laceration, I've got stitches, I've got some time off, but it's not life altering. I'm still fine. Now if you were a concert pianist and you got a laceration on your hand, that could be life altering and that could actually escalate it up. So those sorts of things might come into it. It depends on the role that the person's playing. So if you've got a person, say a doctor for example who cut a scalpel across his hand, now if it was any other industry it might just be a minor injury because they'll just go back to their full-time work. But if you rely on your hands and you rely on your skill and that creates a problem with that, that would escalate the injury up through the triangle.

Madonna King:

Thank you. Our next question thanks.

Karen Wolfe:

If that didn't answer, speak to me later and I'll go through it with you. Sorry.

Audience member:

That's alright. Lori Deakin from the health industry. I'm interested in you setting up I suppose the core strength classes and the gym. I think we've tried to do that a bit in our workplace, but I suppose the organisation, whether it's a public organisation, is worried that The Courier-Mail will see us, you know, taking time off with the public purse to give our workers time off work to do their exercises.

This conversation is around that, but I'm just interested in how you got that into your workplace where your workers are allowed to take time as opposed to being productive and being gizmos to actually investing in themselves. Obviously you have a bit of injury history, but that happens in a lot of places, and certainly it hasn't convinced our organisation to change.

Karen Wolfe:

We're also a public organisation. We're a Commonwealth Government organisation. But this was a core program that we needed for this body of work, and we actually made it a mandatory thing. So it wasn't kind of like if you'd like to do it, it was actually a core business part of their work. They had to do it so many times a week for a period of time over that. They had to sign a logbook, and that was checked and that was measured and looked at. So we did it that way.

Madonna King:

But if someone was looking in from outside…

Karen Wolfe:

If they were looking in? We just said this is part of our safety program. This is part of our fitness program for these people to do their job. We had it in. We had the data to prove it. And that's what we did.

Madonna King:

Just based on that can I just ask a follow up? You said a couple of things. Your daughter doesn't mind green carrots but hates broccoli. You said that firms that value safety have a commercial return on that, which would suggest communication and how you communicate this internally and externally is vital. Are we experienced enough or getting the training in that area to further our advocacy?

Karen Wolfe:

Look, that's always going to be a work in progress I think, and you need to do that. We're not perfect, and so we had a lot of people who wanted to actually access the gym and, 'Why can't we use it,' so we actually did make the gym available to people for lunch time so that they could go there and do that. We're very lucky at work that we have a strong sporting culture that's supported by our social club, so we have an exercise minded staff as well. So there were facilities for people to do things, but we did make that area available to staff and we started looking at sort of maybe extending that program out to other areas where they were experiencing the same sorts of injuries.

Audience member:

Thank you very much Karen. That was very informative. I come from remote Queensland where I've got a lot of workers that already come to us with underlying conditions and long-term employment. So how does that blur what you've got there, that model?

Karen Wolfe:

How does it blur?

Audience member:

Yeah. How is going to change?

Karen Wolfe:

If they come to you with injuries do you do any premedicals so you're aware of what they come with?

Audience member:

Yes. Yes. We are, and we're doing all those sorts of things, but because you've got a limited amount of workers available to you, you've got to often take on more risk than you would if you've got the choice, and we often don't have the choice.

Karen Wolfe:

So what would I do with that? Just thinking off the top of my head. Maybe you could sort of have a line of where they are and then start to see what – if you're doing another impact on that. So you accept people might bring injuries and know where they are on the scale, but then you don't actually want to exacerbate that. Hopefully you might improve it, but you don't want to exacerbate it.

Audience member:

I have on a number of occasions – we've discovered underlying conditions because of an injury. They didn't know they had it or didn't say they had it, and it's been discovered because of injury. So yeah, there's a lot of other information I get around those sorts of reports, but yeah, it's a little bit more complicated. It's not quite as clear as that.

Karen Wolfe:

Everything's going to be complicated. Don't take this as nirvana. This has been 20 years I've been grappling with it and I'm still not where I really want to be. But you've got to start somewhere, and I think for every question you find there's another couple of questions you haven't, and then exactly like you're saying, you'll find other things that you haven't even thought of and you've got to start to think what's the answer to that.

Madonna King:

Yes? The lady and then the man behind you. Thank you.

Audience member:

I work for a labour hire company. We've got 2,500 injured workers in many different industries across Australia. One of the things we find challenging is that we actually don't know the workplace and find it very difficult to assess workplace where our workers are placed. We do a range of things proactively, but one of the challenges we have is trying to influence clients on how to better measure safety and also make improvements when our workers are injured. Do you have any suggestions or ideas about the best ways to influence other businesses…

Karen Wolfe:

Yeah. Well that's – gees.

Do you go in and do inductions into the workplace? Do you have a look and see what's going on?

Audience member:

Yeah. So we do agility tests, physical agility tests for our workers to find out any pre-injuries that they might have. We do system checks and site checks and a lot of interactions with our clients from a safety perspective on a proactive basis, but we often find our clients can be quite resistant…

Karen Wolfe:

I mean that's a breaking down the cultures and I think it's a drip, drip, drip process. I mean I'll tell you an extreme story that I was regaled by a construction company. And this construction company had a value at the corporate level of valuing their workers and looking after them, and then when the executive were actually doing the looking at the data of the injuries and the high consequence injuries that they were getting, they found that it was always occurring in one country – because they were multinational. They went everywhere – always occurring in one country. Always occurring in one country. And finally they kind of went, 'You know what? We said that people are really important. We just won't work there anymore'. And they just made that call. And so that's really a walk on the wild side, and that's your organisational maturity. And I suppose for us all we can do is provide the data, and the decision makers have to make the decision.

Madonna King:

Very telling story though. So quick question and then a final quick answer. Thank you.

Audience member:

When we look at lead indicators, I think of the classic one of trainee's musculoskeletal workplace ergonomic training where we take two groups of workers and train one group, don't train the other group, and we end up with similar injury rates. Have you come across any lead indicators which are more concrete than those?

Karen Wolfe:

Around training or around musculoskeletal…

Audience member:

Around what we do. Lag indicators are very concrete.

Karen Wolfe:

Yeah. Yeah. You've got them.

Audience member:

We've got them. What lead indicators have you come across which give you a fair indication you're on the right track?

Karen Wolfe:

Look, all I can tell you is go back to my example, and what I did with that is I just said I want the niggles. I don't want it when you've got to go to the health centre. I want if you've got a pain, if you've got a squiggle, if you've got – I just tried to collect as much data as I could starting right at the beginning, and then that helped me sort of identify when I should be fine tuning and where I had to go. And then I knew what to measure. So did a big pool, preventive health. One of my measures was doing the core program and then seeing what came from that, and then we extended out from that and then we found that we're still getting some things so then it was back to the equipment, which it should have been in the first place but it was a huge capital investment. But we took the low hanging fruit.

There's no easy answers, and your organisations are all different and I think you've just got to sort of throw it in – a bit like Harry Potter's Pensieve. Throw it in the Penseive and hope the right thing bubbles to the top.

Madonna King:

Okay. Thank you Karen. Ladies and gentlemen, please put your hands together for Karen Wolfe.


And the number of questions there just showed the impact of your talk Karen.

Now you have the opportunity in this room to hear from Anna Clarkson on the role of safety leadership in preventing MSDs. If you're wanting to attend The Anatomy of an MSD, go to P9. And if you would like to attend Diversity in good work design, you'll find that in P10. I'll just give two minutes for a change of personnel.

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