Recently we were involved in a project meeting between contractors and site employees during a maintenance shutdown (called a “turnaround”) where an open discussion of safety and production activities takes place. The purpose of the meeting is to facilitate knowledge sharing and problem solving, to be proactive and identify issues before they turn into disasters. During the meeting one of the contractor supervisors volunteered that one of his employees was bitten by what they think was a mosquito, seemed to have an adverse reaction, and was sent to a clinic as a precautionary measure. The employee was looked at by a doctor and was quickly cleared to go back to work. The contractor spoke with his site contact about this at the time, but the meeting was the first that the rest of the group heard of this incident.
Quickly a few folks from the plant, including a corporate safety representative who was visiting, objected that we need to know about these sorts of incidents much more quickly. The corporate safety representative explained that site employees need to examine employees before they are sent to receive any medical care, so they can evaluate their treatment needs and make recommendations to the doctors.
For the record - no one at that site has any formal medical training beyond first aid training. Yet, somehow we feel qualified to make decisions regarding treatment. Why? Because there is one area that many “safety” professionals are well versed in – regulations. In the US, where this plant is, if an employee receives certain types of medical treatment for any injuries it becomes what we call a “recordable” injury, something that is recorded on a log that OSHA has created. Over time, an organization’s number of recordable injuries has become the standard way of measuring how “safe” an organization is. The logic is that the more injuries you have, the less safe you should be. Whole systems have emerged around this method of measurement. Contractors are awarded or denied contracts on the basis of their recordable injury rates. Organizations compare themselves to others based on this rate. It’s the way we keep score in safety.
In the case of this plant, the corporate incentive was to reward employees with a bonus based on safety performance. And safety performance, in this case, is measured by, you guessed it, the number of recordable injuries you have (which includes recordable injuries suffered by contractors and site employees). So, if the contractor employee who got bitten by a bug received a certain level of medical treatment it would cost people real money and would make the site and the organization look bad. The corporate safety rep was simply trying to avoid this.
This is all reasonable until we take a step back and realize that, to paraphrase Newton, for every action there’s a reaction. We just told the contractors that every single injury is a big deal that will be evaluated by site employees who are not medical professionals, who will subsequently guide treatment options. The question then becomes, although these actions are designed to help the site look good, how does it make us more safe?
Could it make us less safe?
We contend that it will, and here’s why – we just incentivized people to hide injuries and we just made the injuries that we do see more severe. Minor injuries will be driven underground, not because people don’t care about safety, but because they want to avoid having people make a big deal about it (the same reaction happens when someone avoids calling for emergency medical help when they are having heart attack symptoms). Further, minor injuries that are reported are less likely to be sent for precautionary reasons, which means the only medicine that will be provided will be reactionary, i.e. the condition gets worse to the point where it’s severe enough that it’s unbearable. So, by attempting to ensure that the organization looks good we created a situation where the organization will, on average, learn less about what’s really happening on the ground floor and we, on average, increased the overall suffering our employees face.
In the safety profession we have to understand that our choices are often not ones where we face choosing between a good choice and a bad one. Often we have to choose between two options that have benefit our organization in some way, but that have negative consequences as well. In this case, we have to choose between increasing organizational learning or making the organization look good. (Of course, we can remove this choice by changing the way safety is measured, but that’s beside the point for now). Both are laudable goals in a vacuum. But we don’t live in a vacuum. We live in a world with finite resources, which means we have to make tradeoffs, which means we have to have a clear understanding of what our priorities are in different situations. There are always side effects to our decisions. We have to identify those side effects and evaluate whether they make our intended decision “worth it” or not. Sometimes what seems like a very good decision actually makes things much, much worse. Our job is to identify that as early as possible. It’s not as easy as some would make it sound. Our world is not mechanistic and linear. It’s complex and impossible to fully understand. But that’s why they pay safety pros the big bucks, right?