Organisational Stress –a management model

Dil Sen, Clinical Senior Lecturer in Occupational MedicineCentre for Occupational & Environmental Health, University of Manchester, UKEASOM Aug.2015

Lake Bled, Slovenia

““Hard work never killed Hard work never killed anybody…anybody…

but why take a chance?”but why take a chance?”Charlie McCarthy

(Edgar Bergen,1903-1978)

Agenda

DefinitionsSome myths & confusionsFacts & figuresCore featuresA management model

Hazard & risk mechanisms (ILO)

"Psychosocial hazards are those which relateto the interaction between job content, management systems, environmental controlon the one hand, and workers' competenciesand needs on the other."

“a natural reaction to excessive pressure” (HSE)not a disease…till it’s excessive/goes on for long time,can lead to physical & mental ill harm (evidence base)PRESSURE is the stimulus in the STRESS equation -

STRESS is a negative imbalance in the system (transactional model of Cox & Mackay or Selye’s model of psychological strain)

when perceived DEMAND(s) exceed ability to COPE (job demands – control model)

pose an important problem via the negative impact on work capacity & productivity

What is stress ?

"managers only get stressed" - not so"it's my own fault" - predisposition ?"it's good for you" - arousal "yes"...stress "no"same as job dissatisfaction, BUT people with high level of job satisfaction can also be greatly stressed

can be used to define cause…or effect (confusing?)

Some myths...

Facts & figurestotal number of cases of stress in UK in 2011/12 was 428 000 (40%) out of a

total of 1 073 000 for all work-related illnesses (LFS) [Slight decrease!]on average each case lead to 24 working days lost (10.4 million days lost in

total, 2011/12) [UK] industries reporting highest rates of total cases of work-related stress (three-

year average) were human health and social work, education and public administration and defence [UK]

occupations reporting highest rates of total cases of w-r stress (3-year average): health professionals (in particular nurses), teaching and educational professionals, and caring personal services (eg. in welfare and housing )

European Agency for S&H at Work - ~28% affected in EUE20billion/yearsecond biggest OH problem in EU after back pain….

11% of all disease claims (Nat.Council of Compensation Insurance)

stress is a process that happens over time and to people

individual perception & cognition very important (perception of control ?)

Imbalance 1 - demand v coping capacity (Karasek & Theorell)

Imbalance 2 - effort-reward paradigm (Siegrist)other influences: “flexible workforce” & “short term contract” culture

consequencesconsequences are physiological;behavioural;cognitive;emotional

Core features

PHYSIOLOGICAL

PHYSICAL HEALTH

PSYCHOLOGICAL HEALTH BEHAVIOURAL

TYPE A PERSONALITY

PSYCHOLOGICAL

Individualcharacteristics

Symptoms Disease

Sources of stress

Physical & Mental ill health

Career developme

nt

Intrinsic to job

Role in org

Relationships at work

Org structure/climate

Personal

PHYSICAL(CONTROL)

(SUPPORT)

(CHANGE management)

(DEMAND v CONTROL)

Some organisational "symptoms"

Physiological- not applicable

Behavioural-high absenteeism/sick leave-high staff turnover-poor industrial relations-increased acc/illness rates-poor quality/productivity-increased claims

Cognitive- not applicable

Emotional-low morale-loss employee contributions to planning/process improvements

Some 'Stressors'Workload

long workhours ( >45hrs) [Kecklund G. Scand J Work Env Health 2005;31(5):325-327

Milner A et al. Occup and Env Medicine 2015;72(8):573-586] OR not enough work monotonous work

Physical environment- hot/cold; noisy; bright/dark…..

Relationships- with boss, colleagues, subordinates- problems with delegation

"Work-life balance"- personal crises (money, health...)- work v family demands

Managing 'stress' at work

Step 1-"Do we have a problem?"(Recognition & Acceptance). Initiate risk assessment....

Step 2-”How bad ?” Analysis of work situation & identification of likely organisational risk factors

Step 3-”What do we need to do?” ACT on it..

Step 4-”Has it worked?” Monitor/audit what has been done and evaluate long term impact

Prevention

Organisational approaches

Preventive strategies -job redesign/worker management training/betterorg.communications

Timely reaction-earlyrecognition/management,group problem solving/reward orientated mgt style

Support strategy - treatment, rehabilitation & counselling

Hard

to

do

Easy t

o

do

Managing 'stress' - 5 steps

policy and proceduresorganisation of staffplanning and setting standardsmeasuring performanceaudit and review

R e v iew in g pe rfo rm a n ce

M e asu ring p e fo rm a n ce

P la nn ing a nd im p lem en ting

O rg an is ing

P o lic y

Auditing

The HSG 65 Modelhttp://www.hse.gov.uk/pubns/books/hsg65.htm

Information link

Control link

Policy

Development

Organisational development

Feedback loop to improve performance

Developing techniques of planning, measuring & reviewing

Is there a clear 'stress' policy & is it written down ?Does it specify who is responsible and the arrangements for identifying org.stressors, assessing risks and controlling them ?

Do employees (& managers) know....are they involved ?Is it up to date ?

Is there a policy ?

•Acknowledges that work-related stress is primarily an organisational, not individual, issue•Allocates roles and responsibilities (and explains the responsibilities of managers and staff)•Recognises that stress is a health and safety issue which can be integrated into existing arrangements

•Has an emphasis on prevention; lighter emphasis on provision of training/support services•Has in-built review mechanisms• Is applicable to all staff•Has been created in partnership with employees and is not ‘owned’ by the organisation

Characteristics of a good stress policy

Organisation of staff ? -competence, control, cooperation, communication

specific people for specific H&S tasks ( especially managers)

consultation with staff & representativesinform staff about risks & preventive measuresexpertise and training as appropriatespecialist support ( OHS, counselling)

setting of objectives to manage stressthe hazards/organisational stressors?what are the risks?are there standards (measurable, achievable, realistic ) for people and processes?

Planning ?

Active monitoring ( before things go wrong)- are standards being implemented ?- are they effective (check ill health data) ?

Reactive monitoring ( after things go wrong)- investigating incidents, complaints- why was 'performance' sub-standard?

Measuring performance

focus on the concerns of the majority of employeesdeveloped through work with partnersapplied & considered across “high-risk” sectors

health, education, finance, social care….covers the main stressors:

DemandControlSupportRelationshipsRolesChange

Management Standards [MS]

•remains popular across all employment sectors

•website receives over 25,000 visits per month

•many organisations have adapted MS tools for use with individuals for RA and as part of r.t.w procedures

•the most effective interventions have been those designed & implemented jointly (management, workers, TU)

www.hse.gov.uk/stress

Management Standards

Management Standards Process

The Management Standards

Who can be harmed & how?

Step 1: Identify the hazards

Step 2: Decide who might be harmed and how

Step 3: Evaluate the

risk and take action

Step 4: Record your findings

Step 5: Monitor and review

Gathering information

Linking to problems

Communicating the results

Action planning

Evaluation / Continuous Improvement

HSE Stress management Standards:Making the Management Standards work - pdfHSG218 – managing the causes of WRSManagement standards tools & downloadsCase studies

COEH teaching modules: Mental ill health & Stress at Work [Module 2F online]Common Mental Health problems and the Workplace [Module 3J]

Resources ?

by own staff, different department or outsidersto check effectiveness of 'Stress' policy

- degree of compliance with standards- areas where standards need review- stress case data, possible causes, trends....

Is there a review process ?

So who’s stressed then?

Any questions?

http://www.coeh.man.ac.uk/