Broad comprehensive plan to manage the human resource. Broad comprehensive plan to manage the human resource. Integrated and Interdisciplinary approach to managing manpower, fatigue and quality of life issues. Safety & Health Priorities. Evidence-based
Risk Management Model Risk Management Model - Identify, measure and prioritize risk and develop and implement controls
Addresses Critical Challenges - 24/7 Operations & 24/7 Society
- Unsupervised TE&Y workforce
- Aging/new workforce
- Unhealthy workforce
Scientifically based “toolbox” approach
Policy Policy - Corporate & Local Policies
Training and Education Ensuring adequate average sleep opportunity - Company responsibility
- Software analysis & Measurement (FAID)
Ensuring employee preparedness: ensure that individuals who received an adequate average sleep opportunity have achieved sufficient sleep to ensure safe level of alertness [SLA] Ensuring employee preparedness: ensure that individuals who received an adequate average sleep opportunity have achieved sufficient sleep to ensure safe level of alertness [SLA] - Education on signs & symptoms
- Education & policy regarding minimal sleep and reporting
- Shared Responsibility partnerships with employee, labor organizations and government
Additional Countermeasures (Toolbox) Additional Countermeasures (Toolbox) Research - ongoing process of pertinent research to ensure FRMS is evidence-based.
10-hour Undisturbed Rest/AM Mark-Up 10-hour Undisturbed Rest/AM Mark-Up Proactive Notification - Completed
- Ongoing Enhancement
Work/Rest Cycles & Call Windows - Magic bullet mentality not justified -- Comprehensive and integrated process
- More than just Crew Scheduling
- Example - Seattle
- Example - North Platte/Marysville
FAID Process FAID Process - FAID Analysis -- Software package to identify the extent of any fatigue problems (i.e. locations or times of reduced average sleep opportunity)
- System identification of where reduced sleep opportunity may lead to work-related fatigue
- Assess whether interventions have increased sleep opportunity
- Used in conjunction with the Board Game software for simulating the impact of changes at the board/pool level
Level 2 controls are designed to ensure that individuals who received an adequate average sleep opportunity have achieved sufficient sleep to ensure safe level of alertness [SLA] Level 2 controls are designed to ensure that individuals who received an adequate average sleep opportunity have achieved sufficient sleep to ensure safe level of alertness [SLA] This requires a high level of shared responsibility This will require significant cultural change and time and is likely to be the most difficult element to implement effectively Labor will play an important role in shaping the employee attitudes. Labor/management consultation will be essential Implementation: Employee, Management and Family education and awareness.
Stage 1 - Initial Awareness Stage 1 - Initial Awareness - Minimum Sleep/Wake Needs - 5/12 rule
- Commenced -- Q1 2004
Stage 2 - Personal Management tool - Introduce Prior Sleep/Wake Model and behavioral scale
- Used to manage personal behavior and ensure SLA
- No reporting requirement
- Proposed Completion
Stage 3 - Organizational Integration - Introduce Scoring System
- Reporting of non-zero scores
- Develop local decision matrices
- Mark off
Industry collection of US Sleep/Wake Data Industry collection of US Sleep/Wake Data - Ensure Level One Models are valid
- Link L1 -> L2 -> L3 frequencies to ensure evidence-based policy
- Establish industry benchmarks/policy guidelines for Sleep/Wake behavior
Research projects - Projects collecting Work/Rest, Sleep/Wake, Behavioral data
- Kansas City [WR,SW, Actigraphy, PVT]
- Des Moines/St. Paul [WR,SW, PVT]
- San Antonio [Diaries, Actigraphy]
These reflect a general organizational shift in philosophy and policy These reflect a general organizational shift in philosophy and policy - Increased focus on employee involvement in fatigue hazard identification and self-management of fatigue
- i.e. self and peer education leading to self assessment
- Clear policy guidelines on managing pre-defined unacceptable levels of fatigue-related behavior)
- Example: Alternative to Discipline
- Discipline vs. Peer Intervention
Physiological Monitoring Systems Physiological Monitoring Systems - Ongoing internal technological review process
- No current systems with acceptable Cost/Benefit Analysis
- Generic symptom checklists (developed)
- Task-specific symptom checklists
Sleep Disorders Screening - Certification process
- FRA/UP Assessment Research Project
- Voluntary Program (OHNS)
- Education and Awareness
- Related Health Issues
Identifying fatigue as a cause of errors or incidents Identifying fatigue as a cause of errors or incidents - Evidence of L1-3 data consistent with fatigue
- Nature of incident is consistent with fatigue-related error
Needs to be an industry initiative to ensure level playing field Model and Boardgame Analysis
Assess the relationship between safety and risk factors such as: fatigue, sleep disorders, stress, depression, obesity, etc. Assess the relationship between safety and risk factors such as: fatigue, sleep disorders, stress, depression, obesity, etc. Part of UP FRMS Partnerships with Labor and Regulators Bottom-line Implications: Improve employee health and safety while reducing medical costs, absenteeism and presenteeism.
Behavioral Health: 2003 WHO study (Wang, et al) suggests that depression most highly significant factor in accident and injury. Behavioral Health: 2003 WHO study (Wang, et al) suggests that depression most highly significant factor in accident and injury. Depression expected to become #1 cause of disability world-wide. Wellness Inventory (Pfizer) UP studies indicate behavioral issues (depression, stress, anxiety) are most costly in presenteeism, absenteeism and medical costs. Fatigue: Sleep Deprivation & Sleep Disorders are a societal issue impacting the work place: NSF reports 74% of Americans do not get enough sleep each night.
Sleep Disorders - Uservices Sleep Disorders - Uservices - Objectives:
- Assess percentage of TE&Y at risk for excessive daytime sleepiness
- Demonstrate viability of sleep assessment as part of re-certification process
- Methods
- N= 437
- Epworth Sleepiness Scale
- Scores > 10 categorized at risk
Results - Results
- At risk employee is > 35% (95% CI 35.4-44.8%)
- Willingness to participate (confidentiality maintained)
- Confirmation Study
- Scores > 10 offered opportunity to wear a device to determine presence of OSA
- 20 tests ordered, 10 completed
- 9 confirmed positive for OSA
- Recommendations
- Additional research
- Continued voluntary screening
- Continued education and awareness
Actigraph - DU Actigraph - DU - Objectives
- Methods
- Sleep Diaries/Self Report
- Two Types of Actigraphs
- Epworth Sleepiness Scale & PSQI
- N (Questionaire) = 180 (60.4% response rate)
- N (Actigraph) = 36
Results - Results
- Lower mean sleepiness score than other sites (match approximate national average)
- Behavioral outcomes (actigraph):
- No statistical difference between those with feedback actigraph and those with non-performance actigraph
- Those with self-efficacy more likely to use data to change behavior
- Those without self-efficacy (external locus of control) unwilling to change behaviors
- Implications for changing behaviors and providing concrete change
Joint Projects and Funding UPRR/FRA Joint Projects and Funding UPRR/FRA - Coping Mechanisms – HIS
- Depression – DU
- Obesity – HIS
- Integrated Health Improvement Initiative - HIS
BAA – FRA Additional proposals currently under consideration.
Pilots assessed for system implementation Pilots assessed for system implementation Evidence-based development of programs and interventions to reduce or eliminate risks Implications for the industry Safety, health and productivity focus Additional safety research needed in all associated areas.
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