dr Marija Molan University Medical Centre Ljubljana Slovenia

dr. Marija Molan University Medical Centre Ljubljana Slovenia

Key lecture 1: Psychological Stress and Risk Assessment dr. Marija Molan University Medical Centre Ljubljana EASOM - European Association of Schools of Occupational Medicine Bled 2015

Psychological stress at the workplace (something new or heritage from the past): Perception of strain Perception of stress What is more important at the workplace? dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Issues 2

• Evaluation • Reduction of environmental risk Experiences in identification Safety management • Due to health and safety legislation • Due to the obviousness of the environmental risk dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Risk assessment 3

Reality of the working places in the 21 st century Poor psychosocial environment (what does it mean? ) Less obvious (hidden) Depends on individual perception Depends on expertise of evaluators (health physicians, psychologists, safety engineers) dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Psychosocial risk 4

How to do this? Is this evaluation as precise as evaluation of environmental Is it possible risk? to evaluate psychosocial risk? Is reduction of psychosocial risk possible? dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Evaluation of psychosocial risk 5

Different approach compared to environmental risk Decision limited on symptoms of poor psychosocial environment Decision on the top dr. Marija Molan, Bled 2015 Step-by-step approach EASOM - European Association of Scools of Occupational Medicine Main issues 6

Original Flanagan’s CIT from 1954 Modification of the method Description of stressful situations by workers reporting stress and strain dr. Marija Molan, Bled 2015 Write or report (better is to write) EASOM - European Association of Scools of Occupational Medicine First step: Critical Incidents Technique (CIT) 7

Legend: w 1. . . w 2. . . w 3. . . w 4. . . What When Who Where dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Graph of the CIT 8

Description of the critical situation as precisely as possible (causes, environment, crew, time, outcomes) Changes (if any) in worker’s future behavior (consequences fear…) Individual feelings and perceptions Actions taken during an incident dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Obligatory elements of report 9

Original method developed for NASA Flow chart and timeline of the incident Identification of event’s critical points dr. Marija Molan, Bled 2015 Identification of event’s causes Reduction of the problem EASOM - European Association of Scools of Occupational Medicine Second step: Root Cause Analysis (RCA) 10

Legend: O. . . Organization T. . . Technology E. . . Environment M. . . Man dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Graph of the RCA 11

Proportion of workers reporting the same event Number of workers reporting the same incident defined in advance Depends on the seriousness of the problem dr. Marija Molan, Bled 2015 More workers report the same incident – higher probability of indentified risks EASOM - European Association of Scools of Occupational Medicine Third step: definition of critical limits 12

Collection of well being data from the workplace Matching of well being data with indentified risks Identification of correlations between both kinds of data dr. Marija Molan, Bled 2015 Identification of most exposed workplaces or positions Indentified root causes (step 2) connected to poor well being EASOM - European Association of Scools of Occupational Medicine Fourth step: evaluation of identified risk 13

Identification of possible elimination intervention for each particular root cause of perceived strain or stress Elimination intervention defined as humanization measures dr. Marija Molan, Bled 2015 Collection of the best humanization measures with participation of workers EASOM - European Association of Scools of Occupational Medicine Fifth step: elimination of main root causes 14

Cost estimations according to AH model Decrease of well being evaluation (costs of sick leave, absence, decrease of functions) Costs of humanization measures evaluation (costs of recruitment, education, training) dr. Marija Molan, Bled 2015 Comparison of all costs (estimated cost of humanization interventions and estimated costs of well being decrease) EASOM - European Association of Scools of Occupational Medicine Sixth step: Availability Humanization (AH) 15

16 dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine Graph of the AH-model

All interventions need some investments Psychosocial risk should be managed Identification of possible eliminations Identification of problems root causes dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine The most important outcomes 17

Critical incident technique (CIT) Availability humanization model (AH model) Root cause analysis (RCA) dr. Marija Molan, Bled 2015 EASOM - European Association of Scools of Occupational Medicine The overview: Integration of proposed methods 18

dr. Marija Molan University Medical Centre Ljubljana Slovenia