AGED CARE STAFF
Workplace Culture
Predicts Significant and Avoidable Costs in Staff Turnover, WorkCover
Claims, ACFI and Clinical Care
Fiona Stevens
Psychologist
WHAT IS CULTURE?
Only human?
June 7, 2005 The use of sponges as tools among some
dolphins could be the first documented case of a
material culture in a marine mammal species. The
behavior, called sponging, involves a dolphin affixing a
marine sponge over its snout to protect itself while it
pokes and prods for fish on the sea floor. Researchers
believe the use of this sponge tool is a fishing
technique that mother dolphins teach to their children.
The study is published in the Proceedings of the National
Academy of Sciences.
INTRODUCTIONS……
Robert Bowden
08 8357 4988 or 0432 070 623
rbowden@workxtra.com.au
www.workxtra.com.au
Fiona Stevens
08 8410 2342 or 0402 410 234
fs@centralpsychserv.com.au
www.centralpsychserv.com.au
Dr Peter Winwood
pwinwood@internode.on.net
De Stress Consulting
who is thinking of their
workplace, what are they up
to………
what’s your biggest worry?
you know your staff also worry about their work
Worry about signatures
Worry about relationships (bullying)
Cry before starting work
Can’t sleep
Fatigued and poor recovery (wake up and call the facility)
Worried about getting everything done
2 ways of looking at it
WHAT HAVE WE BEEN UP TO!
 Got started with support through EML Members Benefit Program
 We are now up to our 12th facility
 Based around concept of PSC = PsychoSocialSafetyClimate
 Extensive research, link between high PSC and organisational outcomes
including affective commitment, lower injury rates
PSYCHOSOCIAL SAFETY CLIMATE (PSC)
“ The philosophies, policies and practices through
which Management clearly demonstrates the
extent to which employees are valued as a business
asset, and their complete health and welfare is
protected as a priority”.
It is the cause of causes…
Factors that make up PSC
 Management Support & Priority
 Organisational Commitment & Participation
 Resources
 Cognitive, emotional, physical, facility
 Fatigue and Recovery
 Bullying and Anti-Social Behaviour
 Morale, Cynicism, Affective Commitment, Absenteeism
 Self Care and Home - muscle joint pain
PSC CAN BE MEASURED
The key outcomes of PSC are:
WHS Outcomes:
 Injuries and Incidents
 WorkCover Claims and Cost
(RTW times)
 Sick Leave
 Safe Work Practices
 Fatigue and Recovery
Workplace Engagement and
Productivity Outcomes:
 Workers Engagement
 Service Quality and Care
 Complaints
 Staff Turnover
 Cynicism
 Workplace Morale
 Workplace commitment
 Employee Productivity
 Innovation
 ACFI Funding
Safetyclimate
PSC = PsychoSocial
This is about keeping your staff, your residents safe
Low PSC
= more ambulence callouts
= more incidents including falls
= more WC injuries
= longer RTW times
How safe is that?
High PSC = a safer workplace
Safety Culture
 Safety
culture is inextricably linked with, but
distinguishable from, organisational culture
 Dependent on how the organisation deals with the often
conflicting goals of safety and profitability - and the trade
offs between the two
 The demonstrated level of commitment to safety
 If an employee is concerned about a safety issue, are
channels open to communicate this to management?
 If so, how will management respond?
Are messengers shot?
SURGEON SHOOTS DURING OPERATION
ANAESTHETIST DEAD-PATIENT FAINTS
Rio de Janeiro. Reuters. April 1996. A Brazilian surgeon shot a colleague,
who was responsible for the anaesthesia of the patient, during
abdominal surgery. While this was happening, the patient woke from
anaesthesia and, on seeing the bloodbath, fainted. The Resident who was
present attempted to save the life of the anaesthesist, then ended the
abdominal operation.The surgeon was long gone over the mountains…
There was disagreement regarding the surgery between the two doctors,
members of a private clinic at Macae, near Rio de Janeiro, where the
operation took place. During the dispute, the 60 year old surgeon,
Marcelino Pereira da Silva, took out a revolver and put three shots into
the head of Elimson Ribeiro Elais, age 40. Search is on for the surgeon.
WHAT HAVE WE FOUND?
 PSC can be measured and specific tailored interventions can be designed,
implemented and measured.
 Every workplace (and aged care facility) is different and has different
needs (even if it is part of a bigger group)
 By changing PSC you change:
 Injury rates
 Clinical care
 Absenteeism
 Agency use
AGED CARE STUDY 1
 Highest rate of musculo skeletal injuries in the WC system
 Measured the PSC in 6 facilities
 Compared outcomes including
 Number of injuries
 RTW time
 Cost of injuries
 Link between PSC and outcome variables
‘A MULTIDISCIPLINARY
APPROACH TO INJURY
MINIMISATION IN THE AGED
CARE HEALTH SECTOR’
A Pilot Project
Funded by Employers Mutual Ltd
THE SURVEY QUESTIONNAIRE
 Developed specifically for the ACAA study
 Has proven remarkably effective in providing insight into a wide range of
important aspects of injury in Aged Care
 Significant Observations
 High correspondence between direct observations at sites and measured PSC
level
 Consistent with the top down nature of PSC, the significant role of the actual site
manager (whether this is Owner Proprietor or another.
 Identifying ‘Hot Spots’ within the organisation i.e. RN group
 Ongoing value of the questionnaire
 Benchmarking – assessing the individual facility against industry standards
 Guiding targeted interventions
Study Facility Claims and Costs for Injuries Reported Since July 2008
Facility Name
High PSC
Facility
2008/2009
2009/2010
Low PSC
Facility
2008/2009
2009/2010
EAP
Yes
Yes
No
No
No of
No
Type of Claim Cost of
Employ Claim Physica
Claims
Psych Total
ees
s
l
53
52
120
120
4
2
18
9
3
2
18
9
1
0
0
0
7330
288
High
Claim
(s)
Cost
/Head
5087
288
$138
$5
160521
(159797)
Mean
Costs 2
yrs prior
2687
$3733
37774 17231 $314 242878
447983
Table 1: Observed Difference in WorkCover Claims in High and Low PSC facilities in the
Study (Exemplar)
PSC AND WORKCOVER CLAIMS COSTS
Figure 1: Relationship between PSC Levels and Claims Costs per Employee within Study Facilities
STUDY 2
Ongoing
Looking at the most efficient ways to change
organisations
 Debrief the stats with all staff = “stories behind the stats”
 Enables change via the exec group getting detailed feedback
 Targetted programs eg “Handling Work Handling You”
 EAP services especially physiotherapy alters culture immediately =
ok to ask for help
Repeat questionnaires – any changes?
HOW TO CHANGE PSC
‘... there is no more delicate matter to take in
hand, nor more dangerous to conduct, nor more
doubtful in its success, than to set up as a leader
in the introduction of changes. For he who
innovates will have for his enemies all those who
are well off under the existing order of things,
and only lukewarm supporters in those who
might be better off under the new.’ (Machiavelli,
1469–1527)
UPPLIFT APPROACH
PSC
Floor/Care/Service Staff
EN
RN
Clinical Nurses
Area/Facility Managers
CEO/Executive
Board
INVESTIGATING PSC ACROSS WORK
AREAS
VARIATION IN REPORTED RESOURCES BY
WORK AREA
FATIGUE & RECOVERY ACCORDING TO
WORK AREA
BULLYING REPORTS ACCORDING TO
WORK AREA
WORK MORALE, ETC. ACCORDING TO
WORK AREA
WORK ENGAGEMENT BY WORK AREA
Summary Points
• Look at your difficulties in your organisations as
opportunities to learn about your people to
create change.
• Your culture is measurable and effects all
outcomes of your business
Summary Points
• YOU are responsible to create and
influence PSC – it will change – why not
make sure it changes to your expectations
• Please look at Workplace injuries and
bullying differently……
• Learn more about real leadership
QUESTIONS ?