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

• Theory and research

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)

• Planned Nap Program
• Lodging
• Families
• Alternative to Discipline
• Sleep Disorder Screening
• Measurements
• Technology Review Process

• 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

• Completed

• 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

• Self and Peer Identification of Fatigue-Related Behaviors

• 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

• Overall Research Program

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

• UP willing to collaborate with industry initiatives

• Model and Boardgame Analysis

• CIT

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

• Create evidence-based interventions

• 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
• Determine fatigue levels
• Behavioral implications of feedback
• Data for biomathematical validation
• 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

• Informed discussions, communications and programs

• Implications for the industry

• Safety, health and productivity focus

• Additional safety research needed in all associated areas.